Sunday, November 22, 2015

Ream and run - day one rehabilitation video

A patient in the mid 30's from the opposite coast presented to us with shoulder pain, stiffness, and limited function. He'd previously had a SLAP repair in 2009 and an open surgical debridement in 2010 without substantial change in his symptoms. He answered "no" to 7 of the 12 questions of the Simple Shoulder Test. He had essentially no motion at the glenohumeral joint. He brought in the x-ray he'd had 'back home' - it is shown below.

In clinic we repeated the AP view with a similar result

However as shown below, the axillary view (= the 'truth view') revealed severe posterior subluxation without any evidence of glenoid retroversion.

At surgery, the humeral head looked like this.

The resected head looked like this.

We performed a ream and run that included the use of an anteriorly eccentric head and a rotator interval plication. Here are his postoperative films.

His assisted range of motion the morning after surgery can be seen in this link.

Be sure to visit "Ream and Run - the state of the art"  regarding this radically conservative approach to shoulder arthritis at this link.

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