This retrospective cohort of 176 consecutive patients characterizes the prognosis for improvement in comfort and function after the ream-and-run arthroplasty for glenohumeral arthritis. The ream-and-run is a humeral hemiarthroplasty with concentric glenoid reaming and no polyethylene glenoid component. It asks which patient factors predict who improves and who needs reoperation.
When a young, active patient with glenohumeral osteoarthritis wants activity beyond what total shoulder arthroplasty allows, the ream-and-run offers a glenoid-side solution that avoids polyethylene wear and loosening. This paper is prognostic, not comparative. No prospective trial has yet compared the ream-and-run to total shoulder arthroplasty, so weight the evidence accordingly.
The practical decision rule: the ideal candidate is an older man with primary osteoarthritis, no prior surgery, and reasonable preoperative function (SST ≥5). Multiply-operated shoulders and women fared worse. Counsel patients that improvement continues for at least 18 months, so early stiffness should not trigger premature revision.
One actionable pitfall the authors flag: postoperative subscapularis reattachment tears led them to protect the repair and enforce 150 degrees of assisted flexion for six weeks.
This retrospective cohort of 176 consecutive patients characterizes the prognosis for improvement in comfort and function after the ream-and-run arthroplasty for glenohumeral arthritis. The ream-and-run is a humeral hemiarthroplasty with concentric glenoid reaming and no polyethylene glenoid component. It asks which patient factors predict who improves and who needs reoperation.
When a young, active patient with glenohumeral osteoarthritis wants activity beyond what total shoulder arthroplasty allows, the ream-and-run offers a glenoid-side solution that avoids polyethylene wear and loosening. This paper is prognostic, not comparative. No prospective trial has yet compared the ream-and-run to total shoulder arthroplasty, so weight the evidence accordingly.
The practical decision rule: the ideal candidate is an older man with primary osteoarthritis, no prior surgery, and reasonable preoperative function (SST ≥5). Multiply-operated shoulders and women fared worse. Counsel patients that improvement continues for at least 18 months, so early stiffness should not trigger premature revision.
One actionable pitfall the authors flag: postoperative subscapularis reattachment tears led them to protect the repair and enforce 150 degrees of assisted flexion for six weeks.