Technique vs technology: managing a B2 glenoid in an active 67 year old woman. 9 year followup

It is said that "technology is something we buy and technique is something we learn".

In that light, let's consider an active woman in her mid sixties from Alaska presented with activity limiting shoulder pain and stiffness as reflected by her Simple Shoulder Test

Her radiographs at the time of presentation are shown below. Her axillary "truth" view shows posterior decentering of the arthritic humeral head on a posteriorly eroded glenoid with a degenerative cyst.

After discussion of non-operative management, anatomic total shoulder, reverse total shoulder and the ream and run procedure, she elected the latter.

No preoperative CT scan, MRI, or 3D planning was carried out. The procedure was performed under general anesthesia without a nerve block; no patient specific instrumentation was used; the biceps tendon was preserved; the glenoid labrum was preserved; the glenoid was conservatively reamed - just enough to create a single concavity; no glenoid component was used; the smooth (non-ingrowth) standard length humeral component was fixed with impaction autografting; and an anteriorly eccentric humeral head component was used to provide posterior stability.

Followup radiographs showed that her humeral component was stable without evidence of stress shielding and that her anteriorly eccentric humeral head was centered in the glenoid on the axillary "truth" view.

At nine years after her ream and run at the age of 76 she reported the ability to perform all 12 of the Simple Shoulder Test Functions and added that she recently spent 30 days canoeing many miles down then Chandalar and Yukon Rivers in Alaska, going 35 miles the last day. While the photos below are not from her trip, they show a bit about these two rivers.

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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).