Technique or Technology? Shoulder arthritis in a 68 year old active woman: 16 year followup

A 68 year old woman presented with a stiff painful shoulder and these radiographs.

After discussion of the alternatives, including a reverse total shoulder, she elected to proceed with an anatomic total shoulder.  No preoperative CT was obtained and no 3D planning was carried out. The procedure was performed under general anesthesia without a nerve block. The long head tendon of the biceps was preserved. A standard length, thin,  smooth stem was fixed with impaction autografting. A standard all-polyethylene glenoid component with an ingrowth central peg was inserted with careful seating and minimal cement.

Six months after her right shoulder arthroplasty she presented with painful arthritis of her left shoulder requesting a similar procedure

At 16 years after her arthroplasties, she returned with excellent comfort and function of both shoulders and the x-rays below showing no evidence of stress shielding of the humerus and excellent bony ingrowth into the central peg (arrows)

Of note, as is typical for our practice, the costs of CT scans, plexus blocks, special components and a reverse total shoulder were avoided without compromise of the clinical outcome.

You can support cutting edge shoulder research that is leading to better care for patients with shoulder problems, click on this link

Follow on twitter/X: https://x.com/RickMatsen
Follow on facebook: https://www.facebook.com/shoulder.arthritis
Follow on LinkedIn: https://www.linkedin.com/in/rick-matsen-88b1a8133/

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).