Managing a B2 glenoid for an active man in his 40s.

 An active patient in his 40's presented with painful stiffness in his right shoulder and these x-rays showing severe glenohumeral arthritis and complete posterior decentering of the humeral head on the glenoid.

To avoid the risks and limitations of an anatomic total shoulder or a reverse total shoulder he elected to have a ream and run procedure. This was performed using an impaction grafted standard length humeral prosthesis with an anteriorly eccentric humeral head (see this link).

After surgery he was able to return to surfing, an activity he had not been able to enjoy for years prior to his procedure. His x-rays at four years are shown below.

Comment: Managing this severe glenohumeral pathology in a young patient is challenging. The eccentric humeral head component can be a big help. Stiffness after can be a problem and in this case required several shoulder manipulations under anesthesia in order to achieve the excellent result. The photo below shows his range of motion when he returned for a procedure on the opposite shoulder.

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Here are some videos that are of shoulder interest

Shoulder arthritis - what you need to know (see this link)

The smooth and move for irreparable cuff tears (see this link)

The total shoulder arthroplasty (see this link).

The ream and run technique is shown in this link.

The cuff tear arthropathy arthroplasty (see this link).

The reverse total shoulder arthroplasty (see this link).

Shoulder rehabilitation exercises (see this link).

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Note that author has no financial relationships with any orthopaedic companies.