This case-matched study compares the "ream and run" procedure (humeral hemiarthroplasty plus nonprosthetic glenoid reaming) against total shoulder arthroplasty for glenohumeral arthritis. It asks whether avoiding a prosthetic glenoid can still deliver TSA-equivalent self-assessed function in young, active patients.
The clinical trade-off here is time versus hardware risk. A young, active patient with glenohumeral arthritis who wants to avoid the well-documented risk of glenoid component loosening can choose the ream and run, but must accept that function lags TSA for roughly a year before catching up.
Counsel patients accordingly: at 12 months R&R shoulders scored significantly lower (SST 7.8 vs 9.6), yet by 18 to 36 months the two are statistically indistinguishable. Selection matters. Inflammatory arthritis is excluded, and severe posterior glenoid erosion may not be a candidate because reaming would sacrifice too much bone stock.
Weigh the evidence carefully. This is a single-surgeon, non-randomized case-matched series of 35 patients with only 2 to 3 year follow-up, which does not reach the 5-plus year window when glenoid components typically fail, so the theoretical durability advantage of R&R remains unproven.
This case-matched study compares the "ream and run" procedure (humeral hemiarthroplasty plus nonprosthetic glenoid reaming) against total shoulder arthroplasty for glenohumeral arthritis. It asks whether avoiding a prosthetic glenoid can still deliver TSA-equivalent self-assessed function in young, active patients.
The clinical trade-off here is time versus hardware risk. A young, active patient with glenohumeral arthritis who wants to avoid the well-documented risk of glenoid component loosening can choose the ream and run, but must accept that function lags TSA for roughly a year before catching up.
Counsel patients accordingly: at 12 months R&R shoulders scored significantly lower (SST 7.8 vs 9.6), yet by 18 to 36 months the two are statistically indistinguishable. Selection matters. Inflammatory arthritis is excluded, and severe posterior glenoid erosion may not be a candidate because reaming would sacrifice too much bone stock.
Weigh the evidence carefully. This is a single-surgeon, non-randomized case-matched series of 35 patients with only 2 to 3 year follow-up, which does not reach the 5-plus year window when glenoid components typically fail, so the theoretical durability advantage of R&R remains unproven.