This retrospective cohort evaluated the ream-and-run procedure, a shoulder arthroplasty using a humeral prosthesis with nonprosthetic glenoid reaming, in active patients with primary glenohumeral osteoarthritis. It asked what factors drive humeral head medialization and whether medialization affects clinical outcome at 2 years.
When you counsel a young, active patient with glenohumeral arthritis who wants to exceed the activity limits of a total shoulder, the ream-and-run is the option that avoids a prosthetic glenoid and its loosening risk. This series shows it reliably improves SST from about 5 to 10 at 2 years, with the biggest gains in patients who start with low function and have a type-A2 (concentric) glenoid.
The key clinical insight: humeral head medialization, which surgeons worry about, did not correlate with worse outcomes at 2 years. Do not equate a few millimeters of medialization on radiographs with clinical failure this early. Even retroverted, biconcave type-B2 glenoids improved significantly, expanding who might benefit.
Two cautions for the consent discussion: the reoperation rate was about 13%, and Propionibacterium infection is a real threat in young men, driving most humeral exchanges. This remains a Level IV single-surgeon series, so generalize with care.
This retrospective cohort evaluated the ream-and-run procedure, a shoulder arthroplasty using a humeral prosthesis with nonprosthetic glenoid reaming, in active patients with primary glenohumeral osteoarthritis. It asked what factors drive humeral head medialization and whether medialization affects clinical outcome at 2 years.
When you counsel a young, active patient with glenohumeral arthritis who wants to exceed the activity limits of a total shoulder, the ream-and-run is the option that avoids a prosthetic glenoid and its loosening risk. This series shows it reliably improves SST from about 5 to 10 at 2 years, with the biggest gains in patients who start with low function and have a type-A2 (concentric) glenoid.
The key clinical insight: humeral head medialization, which surgeons worry about, did not correlate with worse outcomes at 2 years. Do not equate a few millimeters of medialization on radiographs with clinical failure this early. Even retroverted, biconcave type-B2 glenoids improved significantly, expanding who might benefit.
Two cautions for the consent discussion: the reoperation rate was about 13%, and Propionibacterium infection is a real threat in young men, driving most humeral exchanges. This remains a Level IV single-surgeon series, so generalize with care.