These authors conducted a retrospective study of patients having a ream and run procedure (RnR) between 2005 and 2014 and matched them to an anatomic total shoulder (TSA) cohort by age, body mass index, sex, and hand dominance.
Patients undergoing aTSA were counseled that they should expect overhead lifting restrictions of 10 pounds (4.5 kg), whereas those undergoing RnR did not have these restrictions.
They assessed preoperative and postoperative level of duty and occupation. Twenty-five RnR patients and 28 TSA patiets completed the questionnaire (82.8% compliance). Mean follow-up was 69.1 ± 24.8 months. 100% of the RnR patients returned to work, while 89.3% of TSA patients returned to work (P = .091). RnR patients had higher rates of return to work for heavy-duty workers only (7 of 7 vs. 2 of 4, P = .038). Mean duration of return to work was 2.5 ± 4.8 months for patients receiving RnR and 1.98 ± 2.6 months for those receiving TSA (P = .653).
The authors concluded that patients having the ream and run arthroplasty had a high return to heavy-duty work due to fewer surgeon-imposed restrictions.
===
Use the "Search" box to the right to find other topics of interest to you.
The authors concluded that patients having the ream and run arthroplasty had a high return to heavy-duty work due to fewer surgeon-imposed restrictions.
Comment: In a study just completed, we found that in our practice the outcomes of patients having the ream and run (RnR) and those having total shoulder arthroplasty (TSA) were essentially the same, but the patients having the two procedures were different.
We identified 544 patients who had either a total shoulder or a ream and run arthroplasty performed between 8/24/2010 and 8/9/2016.
Two year clinical outcomes were available on 263 (89%) of the 295 ream and run procedures and 281 (82%) of the 343 total shoulders enrolled during this study period.
Patients electing RnR were more likely to be male (92.0% vs. 47.0%), younger (mean±SD 58±9 years vs. 67±10 years), married (83.2% vs. 66.8%), from out of state (51.7% vs. 21.7%), commercially insured (59.1% vs. 25.2%), and had better SF36 scores (p<.001).
Shoulders having RnR in comparison to those having TSA were more likely to have type B2 glenoid pathoanatomy (46.0% vs. 27.8%) and greater glenoid retroversion (mean±SD 19±11 vs. 15±11 degrees).
The mean±SD final Simple Shoulder Test score for the RnR procedures was 10.0±2.6 vs. 9.5±2.7 for the TSAs. The percent of maximum possible improvement averaged 72±39 for the RnRs and 73±29 for the TSAs. Patients with work related shoulder problems had lower final SST scores (difference -2.3, 95% CI -3.5 to -1.1, p<.001) and lower %MPI (difference –25, 95% CI –39 to -12, p<.001). While age did not have an effect on RnR outcomes, younger patients tended to do less well after TSA.
Our investigation highlights the importance of patient selection in considering the surgical procedure for glenohumeral arthritis. Studies of shoulder arthroplasty outcome should characterize the patient and the shoulder using the important variables identified in our study.
===
Use the "Search" box to the right to find other topics of interest to you.
You may be interested in some of our most visited web pages arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
