Wednesday, September 10, 2014

Ream and Run for the bad arthritic triad and B2 glenoid revealed by the truth view - two years later

A patient about 60 years of age presented with severe left shoulder pain and the ability to perform only 5 of the functions of the simple shoulder test. In our office we obtained the standard x-ray views, shown below. Again we see on the axillary (truth) view that he has glenoid retroversion, a biconcave glenoid, and posterior subluxation of the humeral head on the glenoid (= the bad arthritic triad, BAT).

 He brough in a CT scan
 and an MRI
neither of which gave us more information that his standard views.

We saw him back in the office today, two years after surgery. He reported he had no shoulder pain, could perform 12 of the 12 Simple Shoulder Test functions and had a full range of motion. His standardized radiographs show regeneration of the space between the humeral head prosthesis and the bone of the glenoid, secure fixation of the impaction grafted stem, and centering of the humeral head on the glenoid with the use of the anteriorly eccentric humeral head prosthesis.


One could not ask for more.

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