Friday, October 4, 2024

Bilateral B2 glenoids in a 70+ year old man. Anatomic total shoulder or RFE? 10 year followup

 A man in his early 70's presented with painful limitation of function of both shoulders. His axillary "truth" views revealed posteriorly decentered arthritic humeral heads on biconcave "B2" glenoids.

After discussion of the option of a reverse total shoulder, he elected to proceed with anatomic total shoulders.

The procedures were performed two years apart, the left 12 years ago and the right 10 years ago. His Simple Shoulder Tests before his left shoulder is shown below.

His Simple Shoulder Tests two years after his left, but just before his right are shown below, documenting the postoperative improvement on the left and the progression of symptoms on the right.

No preoperative CT scans or 3D planning were used. The procedures were performed under general anesthesia without a plexus block. The biceps tendons were preserved. Conservative glenoid reaming was performed - just sufficient to provide a single concavity without attempt to change glenoid version. Standard (non-augmented) all polyethylene glenoid components with a fluted central peg were used. Standard length smooth stems were fixed with impaction autografting.








Now at the age of 84, 10 and 12 years after his procedures, he reports the ability to perform 12 out of 12 functions of the Simple Shoulder Test with each shoulder.

Current AP (Grashey) views (but not axillary truth views) were available from his local hospital showing secure fixation of his humeral and glenoid components.


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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).