Thursday, April 4, 2024

Where's the wear, where's the osteolysis? 17 year ream and run followup

 A 55 year old active man with limiting pain and stiffness of the left shoulder presented with these x-rays.



Wishing to avoid the risks and limitations associated with the plastic glenoid component used in conventional total shoulder arthroplasty, he elected to proceed with a ream and run procedure.


At followup 17 years after his procedure, he demonstrated excellent comfortable range of motion. 



X-rays showed stable fixation of the impaction autografted humeral component along with healing of the reamed glenoid without evidence of glenoid wear and no humeral osteolysis.




Comment: While glenoid erosion can occur after hemiarthroplasty with a chrome cobalt humeral head, in many cases, as in this one, the reamed glenoid heals to a stable surface. Additional clinical research is needed to determine the factors associated with glenoid wear.

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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).