Thursday, February 23, 2017

Of women, ream and run, manipulation and swimming

We are often asked, 'how do women do with the ream and run'?

The answer is that it depends on the woman.

Here are the x-rays of an active woman in her 60s with degenerative arthritis and a Simple Shoulder Test of 5/12.

After a discussion of the options and in consideration of her active lifestyle, she elected to proceed with a ream and run procedure in order to avoid the potential risks and limitations of a prosthetic glenoid component.

At her six weeks check her shoulder was a bit stiff in spite of her great rehabilitative effort; she elected to have a manipulation under anesthesia and complete muscle relaxation - a full range of passive motion was achieved.

Four months after the ream and run, she returned with a much improved shoulder and these x-rays

Note the impaction grafted stem and the conservatively reamed glenoid, now with a radiographic joint space between it and the prosthetic humeral component.

Five months after her surgery she sent this video clip of her swimming at Coogee beach, the site of the famous "shark arm case (see this link)".

 and kindly gave us permission to show it here.

The following quote, variously attributed to Hippocrates and to Osler, comes to mind, "It is far more important to know what person the disease has than what disease the person has."