Sunday, September 13, 2020

Rock climbing after the ream and run

Case 1

An active technical climber presented with a painful stiff left shoulder than was limiting his ability to pursue challenging international routes. Here is a photo of him climbing in Laos.

Below are his x-rays at presentation showing osteoarthritis and a biconcave glenoid with posterior decentering.

One year ago he had a left ream and run using an anteriorly eccentric humeral component. His postoperative films show good alignment of his humeral head with his reamed glenoid in both views.

Four months ago he returned for a ream and run on the right shoulder.

His postoperative films are shown here.

This week he sent this video of him "dry tooling" in his gym, stating that his shoulders are getting stronger everyday.

This man has obviously put forth a terrific rehabilitation effort and it is paying off. 

Case 2

A man in his late 50ies from a couple of states South of here presented able to perform only half of the functions of the Simple Shoulder Test and with these radiographs of his arthritic left shoulder.

Here's his standardized axillary view. No CT scan or 3-D reconstruction was necessary.

His goal was to return to rock climbing after shoulder arthroplasty without having to worry about wearing out a plastic glenoid component. He elected to have a ream and run procedure. Here are his immediate postoperative x-rays showing prosthesis fixation with impaction grafting and the use of an anteriorly eccentric humeral head component that helped center his head on the glenoid. He also had a rotator interval plication.

At three months after surgery he had returned to sport climbing as shown here.

Here's a more recent video

Finally here's a bit of rope climbing after a left ream and run.

To see our technique for the ream and run click on this link

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