Monday, May 8, 2017

Failed total shoulder - conservative management

A middle aged patient had a total shoulder for glenohumeral osteoarthritis.

Postoperative films are shown here

After a decade of excellent comfort and function, the patient experienced increased pain, stiffness and clunking on movement. X-rays at that time are shown here

At the time of revision, the loose and worn glenoid component was removed, no bone grafting was performed. The head diameter of curvature was upsized to 56. Cultures were negative. Assisted elevation exercises were started immediately after surgery.

Immediate post operative x-rays are shown here revealing the massive glenoid defect with the head perched on the rim.

This is like a large basketball sitting on a small hoop.
A one year after revision, the shoulder is comfortable and with 130 degrees of active elevation.
X-rays show filling in of the defect.

Consultation for those who live a distance away from Seattle.

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