A 40 year old active athlete presented with pain, stiffness and clunking of the right shoulder after a prior labral repair. His radiographs are shown below showing a prominent suture anchor, inferior subluxation of the humeral head on the glenoid, and loss of the articular cartilage.

Preoperative cultures of the unprepared skin over the shoulder grew 2+ cutibacterium (see this link and this link).

Because he wished to avoid the risks and limitations of a prosthetic glenoid component, he elected to have a ream and run procedure. His surgery was performed without preoperative CT planning and without a brachial plexus block.

His intraoperative photos show a deformed humeral head with a large area of bone loss in the area contacting the prominent anchor

and a prominent suture anchor

A trephine was used to remove the suture anchor

His post operative films are shown here

His assisted range of motion on the evening of surgery is shown below.

Because of his strongly positive skin cultures, Betadine lavage, topical vancomycin, and post operative oral doxycycline were used.

Five days after surgery, he reported: Today is day 5 and I’m doing great. The intense nauseating pain used to have before surgery is gone! (I feel like that was the anchor causing that pain).

I can also stand in military posture with my hand at my side. Pre surgery I could not have my elbow fully extended with my hand on my hip. My hand would be about 4 inches away from my side.

I can also lay flat on my back without severe pain.

I’m taking all my prescriptions and have only had to use 1 oxy a day since Friday.

My rehab is going well and pain reducing significantly each day.

The picture below was from this morning at 6am today