In considering the options for a patient with a severe B2 glenoid, surgeons are concerned about performing an anatomic total shoulder because of the risks of prosthetic glenoid component failure.
Here are the preoperative x-rays of such a patient. The axillary "truth" view shows severe posterior humeral head decentering on a biconcave glenoid with over 30 degrees of retroversion.
After discussion of the risks and alternatives of an augmented glenoid, a posterior bone graft, and a reverse total shoulder, the patient elected the ream and run procedure (see this link). At surgery the articulation was stabilized with glenoid reaming combined with an anteriorly eccentric humeral head and a rotator interval plication. The procedure was performed without a preoperative CT and without a brachial plexus block. Assisted range of motion was started the evening of surgery. The patient was discharged on the day after surgery on a home exercise program (see this link).
At 2 years after this procedure, the patient returned for a ream and run on his opposite side. He had excellent comfort and function on the left with no symptoms of instability.
His x-rays at two years after surgery are shown below.
You can support cutting edge shoulder research that is leading to better care for patients with shoulder problems, click on this link.
Follow on twitter: https://twitter.com/shoulderarth
Follow on facebook: click on this link
Follow on facebook: https://www.facebook.com/frederick.matsen
Follow on LinkedIn: https://www.linkedin.com/in/rick-matsen-88b1a8133/
Here are some videos that are of shoulder interestShoulder arthritis - what you need to know (see this link).How to x-ray the shoulder (see this link).The ream and run procedure (see this link).The total shoulder arthroplasty (see this link).The cuff tear arthropathy arthroplasty (see this link).The reverse total shoulder arthroplasty (see this link).The smooth and move procedure for irreparable rotator cuff tears (see this link).Shoulder rehabilitation exercises (see this link).
Follow on twitter: https://twitter.com/shoulderarth
Follow on facebook: click on this link
Follow on facebook: https://www.facebook.com/frederick.matsen
Follow on LinkedIn: https://www.linkedin.com/in/rick-matsen-88b1a8133/
Here are some videos that are of shoulder interest
Shoulder arthritis - what you need to know (see this link).
How to x-ray the shoulder (see this link).
The ream and run procedure (see this link).
The total shoulder arthroplasty (see this link).
The cuff tear arthropathy arthroplasty (see this link).
The reverse total shoulder arthroplasty (see this link).
The smooth and move procedure for irreparable rotator cuff tears (see this link).
Shoulder rehabilitation exercises (see this link).
