Ream and run for the weight bearing shoulder

Thirteen years ago an active man in his 60s presented with right shoulder pain and stiffness. He had been unable to use his legs without braces and crutches since contracting polio at the age of 7.

His x-rays below show glenohumeral arthritis with posterior decentering on a biconcave glenoid.

He elected to have a ream and run procedure to avoid the risks and limitations of a prosthetic glenoid component.

Eight years ago he presented with left shoulder pain and stiffness and these x-rays showing osteoarthritis with somewhat less biconcavity and somewhat less posterior decentering. 

 

 

Again he elected a ream and run procedure.

We had the opportunity to see him back recently 13 years after his right ream and run and 8 years after his left ream and run. In spite of his dependency on crutches for ambulation he had excellent function of both shoulders and these x-rays showing stable impaction grafted standard humeral stems and mature, remodeled glenoid surfaces.

 

The weight bearing shoulder is a challenge, especially if the function of the legs has been compromised since childhood. Needless to say this patient was both physically active and highly motivated. 

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Here are some videos that are of shoulder interest

Shoulder arthritis - what you need to know (see this link)

Shoulder arthritis - x-ray appearance (see this link)

The smooth and move for irreparable cuff tears (see this link)

The total shoulder arthroplasty (see this link).

The ream and run technique is shown in this link.

The cuff tear arthropathy arthroplasty (see this link).

The reverse total shoulder arthroplasty (see this link).