Sunday, July 16, 2017

A 40 year old athlete with capsulorrhaphy arthropathy - ream and run

A decade ago we met a 40-year-old athlete who had significant problems with his right upper extremity since a dislocation that he sustained on a military obstacle course in basic training. His recurrent dislocations were treated with a Magnuson Stack procedure in 1985.

When he first presented to us, he had a painful stiff shoulder and these radiographs.

His 'truth' axillary view showed glenoid retroversion and posterior decentering of his humeral head on the glenoid face. No CT scan was needed to define his pathology.

His Simple Shoulder Test was 5 out of 12 and he could no longer participate in competitive cycling, his sport.

Because he wanted to return to weight training and competitive athletics, he elected to proceed with a ream and run procedure to avoid the risks and limitations associated with a polyethylene glenoid component. His humeral component was fixed in place with impaction autograft.

We saw him recently because he wanted a ream and run on his left shoulder. This gave us a decade followup on his right shoulder. His current right SST score is 12 out of 12. His right shoulder is asymptomatic. Here are his current films.

Note the centering of the humeral head prosthesis in the regenerated glenoid concavity.

Here are the films of his left shoulder, before and immediately after the recent ream and run.

This conservative surgical approach has preserved the maximal amount of glenoid and humeral bone stock.

The reader may also be interested in these posts:

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