Thursday, November 16, 2017

Ream and run for arthritis in a 41 year old with a B2 glenoid - remodeling at one year

A 41 year old man from New York presented to us with severe pain and loss of function of the left shoulder years after a prior surgical procedure for anterior instability. He could perform only 5 of the 12 functions of the Simple Shoulder Test. His preoperative films show capsulorrhaphy arthropathy with severe decentering on the the axillary 'truth' view.

Because of his active lifestyle, he elected a ream and run procedure. At that time an anteriorly eccentric humeral head and a rotator interval plication were added to re-center his humeral prosthesis on the glenoid. No cement, polyethylene or CT scans were used.

At one year after surgery, his humeral head was well centered on the remodeled glenoid. His impaction grafted thin smooth stem is well fixed.


His SST score had improved to 8/12.

Comment: This highly motivated man has regained excellent passive motion and is continuing to work on his strength. It is a work in progress.


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