Ream and run to salvage failed hemicap.

 A 35 year old physically active patient presented with a history of 6 prior surgical procedures culminating in a hemicap. Since that operation the shoulder was extremely stiff and painful. X-rays in the clinic showed a hemicap that had eroded into the glenoid bone.

The patient desired a revision to a ream and run performed under general anesthesia without a nerve block.  Surgical findings included a tightly contracted capsule and subscapularis, a medially eroded glenoid, several suture anchors on the face of the glenoid, no synovitis, a frozen section showing no neutrophils, and a well fixed humeral component.

The glenoid was reamed to a diameter of curvature of 54 mm, and a canal sparing stemmed implant was inserted with a 48 15 humeral head. Because of the history of multiple prior surgeries and the glenoid erosion, the patient was placed on the red protocol. The postoperative films are shown below.

Four hours after surgery the patient had this range of motion.

The patient was discharged home on the first post op day on mild analgesics.

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