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Current Technique for the Ream-and-Run Arthroplasty for Glenohumeral Osteoarthritis
Frederick A. Matsen III, MD; Steven B. Lippitt, MD

Overview

Introduction The ream and run is a technically demanding shoulder arthroplasty for the management of glenohumeral arthritis that avoids the risk of failure of the glenoid component that is associated with total shoulder arthroplasty.

Step 1: Surgical Approach After administration of prophylactic antibiotics and a thorough skin preparation, expose the glenohumeral joint through a long deltopectoral incision, incising the subscapularis tendon from its osseous insertion and the capsule from the anterior-inferior aspect of the humeral neck while carefully protecting all muscle groups and neurovascular structures.

Step 2: Humeral Preparation Gently expose the proximal part of the humerus, resect the humeral head at 45° to the orthopaedic axis while protecting the rotator cuff, and excise all humeral osteophytes.

Step 5: Humeral Prosthesis Fixation Fix the humeral component using impaction autografting.

Step 6: Soft-Tissue Balancing After the definitive humeral prosthesis is in place, ensure the desired balance of mobility and stability. If there is excessive posterior translation, consider a rotator interval plication.

Step 7: Rehabilitation Achieve and maintain at least 150° of flexion and good external rotation strength.

Results In our study, comfort and function increased progressively after the ream-and-run procedure, reaching a steady state by approximately twenty months.

What to Watch For Indications

Contraindications

Pitfalls & Challenges

Introduction

The ream and run is a technically demanding shoulder arthroplasty for the management of glenohumeral arthritis that avoids the risk of failure of the glenoid component that is associated with total shoulder arthroplasty.

Glenohumeral arthritis is a condition in which the normal articular …


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