Monday, October 17, 2016

What can be done for severe erosive arthritis?

A 70 year old healthy and fit patient presented to us with pain and lack of function of the left shoulder after treatment for breast cancer. There was no history of steroid use or infection. Neurologic exam and C-spine MRI were normal. The x-rays are shown below.


After a discussion of the options, the patient elected a hemiarthroplasty with maximal bone preservation.

Three months after surgery the shoulder is comfortable and has smooth motion to 140 degrees. Strength is coming along nicely with the supine press program.

X-rays at three months, shown below, show congruent, sclerotic joint surfaces and a humeral prosthesis centered in the glenoid concavity.

The patient is pleased with her progress as are we.

Comment: This represents a conservative approach to a complex problem.