His x-rays show a radiolucent line around the humeral component. There was no evidence of glenoid component loosening,
In clinic we cultured his skin, which showed 1+ growth for each of two types of Cutibacterium and 1+ growth of coagulase negative Staph. These data, combined with his clinical and radiographic findings suggested a high risk for periprosthetic infection. We proceeded to a single stage revision of his total shoulder to a ream and run procedure with impaction allograft and Vancomycin beads. The patient was started on the Red antibiotic protocol (see this link).
Comment: It is a difficult decision to remove a well-fixed glenoid component. However, the positive glenoid explant supports its removal.
To see a YouTube of our technique for total shoulder arthroplasty, click on this link.
We have a new set of shoulder youtubes about the shoulder, check them out at this link.
Be sure to visit "Ream and Run - the state of the art" regarding this radically conservative approach to shoulder arthritis at this link and this link
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