Friday, April 22, 2016

Avoiding and managing stiffness after a ream and run procedure or other shoulder arthroplasty

Here is some information we share with individuals having a ream and run procedure regarding avoiding and managing stiffness.

You have elected to have a ream and run procedure for your shoulder arthritis. This procedure offers the opportunity to perform major activities with your shoulder without fear of failure of a plastic socket (glenoid). The key to success after this procedure is for the patient to carry out the key stretching exercises five times a day and holding the stretch for a full two minutes until the shoulder has healed. The most important exercises are A, B, and C as shown on this link.

In spite of their best efforts, some patients have difficulty maintaining the range of motion we achieve at surgery. For this reason, it is very important that (1) the stretching exercises you were shown in the hospital are done with good relaxation five times per day, (2) that you use anti-inflammatory medications, such as two Aleve per day (unless you cannot tolerate them), and (3) that you let your surgeon know via email if you are having difficulty in achieving and maintaining the necessary range of motion. If there is any question, please have a family member or friend email your surgeon a photo taken from the side like that below, which shows the desired range of motion at six weeks after the ream and run surgery.

If the shoulder gets stiff after this surgery, which sometimes happens, we can often get the shoulder back on track with a manipulation under anesthesia. This manipulation does not require a surgical incision or an over night stay in the hospital. In this procedure we administer a brief intravenous general anesthetic and a muscle relaxer (succinylcholine ) and then move the shoulder through a full range of motion. This usually breaks up any adhesions that may have formed.

If the shoulder remains stiff, sometimes an open surgical release is considered. This is an open surgical procedure at which time the tight tissues are cut to help restore the shoulder motion. An overnight stay is usually needed after this procedure.

Please let your surgeon know if you have any questions at anytime.


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).