From arthritis to Half Ironman 8 months after ream and run arthroplasty

A 40 year old athlete presented with pain and stiffness of his shoulder and the desire to compete in the Half Ironman ( Swim: 1.2 miles, Bike: 56 miles, Run: 13.1).

His radiographs are shown below

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

At 6 weeks after surgery, he was hard at work at his rehabilitation.

At two months after surgery he had returned to golf and swimming.

At five months he was continuing to work on his shoulder flexibility, strength and swimming.

Further progress at 6 months.

At 8 months he completed his Half Ironman in under six and a half hours. 

His rehab continues. 

His dedication to his rehabilitation program enabled this remarkable recovery. We're grateful for his permission to show his recovery in this post. 

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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).

Ream and run for a 64 year old woman iron man athlete - 6 year followup

A 64 year old avid triathlete and 6 time iron man competitor presented with a painful stiff shoulder after a prior labral repair.  Her radiographs showed osteoarthritis with complete loss of joint space

and a biconcave glenoid

She was concerned a conventional total shoulder replacement would limit her ability to continue with her high demand activities. She had been treating her pain with steroid injections which do help significantly but were diminishing in efficacy, Advil and oxycodone a few times per month for sleep. She was actively performing home PT and range of motion exercises. She was still very active and planed to run the Boston Marathon. She could perform six of the 12 Simple Shoulder Test functions with her right shoulder.

She elected to proceed with a ream and run procedure.

Six years after surgery she returned to the office with a good functional result and the ability to perform all 12 Simple Shoulder Test functions. Her x-rays at that time are shown below, showing a canal-sparing impaction grafted stem, no evidence of stress shielding of her humeral bone, and a humeral head centered in a single glenoid concavity.

 She kindly send this video of her swimming form.

Comment: This case shows the outcome that can be achieved in a patient who is highly dedicated to the rehabilitation program after a ream and run procedure.

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