Monday, May 27, 2024

Ream and run: excellent outcome for a sports-active young man with severe anchor arthropathy

 A 40 year old active young man presented with pain and stiffness of his right shoulder twenty years after an arthroscopic labral repair and chondroplasty.  On examination his active and passive forward flexion were 100 degrees, external rotation to 0 degrees, internal rotation in abduction to 10 degrees. 

His preoperative AP and axillary "truth" views showed severe anchor arthropathy with a prominent suture anchor and decentering of the humeral head on the glenoid.





Wishing to avoid the risks and limitations associated with the polyethylene glenoid component used in conventional total shoulder arthroplasty, he elected to proceed with a ream and run procedure (https://www.reamandrun.com/). No preoperative CT, 3D planning or brachial plexus block were used.

At surgery the prominent suture anchor was identified


and removed with a trephine prior to reaming of the glenoid.






His two year postoperative x-rays are shown here.




He was extremely diligent in his rehabilitation, achieving 150 degrees of forward flexion the day after surgery.

At two months after surgery he had excellent active range of motion.

He sent frequent videos documenting his recovery.

Five months: 



One year:


One and a half years:


And two years:


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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).