Short-term Clinical Outcomes of Hemiarthroplasty With Concentric Glenoid Reaming: The Ream and Run Procedure

Abstract

The purpose of this study was to evaluate the short-term clinical and radiographic outcomes of humeral hemiarthroplasty and concentric glenoid reaming (“ream and run” procedure) and to compare the outcomes with those of total shoulder arthroplasty (TSA) for glenohumeral arthritis. Patients with glenohumeral arthritis who underwent the ream and run procedure with a minimum follow-up of 2 years were retrospectively reviewed. The primary outcome was revision to TSA. Secondary outcome measures included functional outcome scores, range of motion, and radiographic assessment. The outcome measures were compared with those of age- and sex-matched control patients who underwent anatomic TSA during the study period. One patient in the ream and run group required revision to TSA 14 months after the surgery because of excessive shoulder pain. There were significant improvements in the postoperative outcome scores and range of motion and external rotation in the ream and run group. Postoperative radiographs showed concentric glenoids without posterior subluxation in all except 1 shoulder. The outcome measures in the ream and run group were similar to those in the TSA control group except for active forward elevation and external rotation. The ream and run procedure provides improved pain relief and shoulder function at short-term follow-up for patients with shoulder arthritis. [ Orthopedics . 2018; 41(6):e854–e860.]

Shoulder Hemiarthroplasty with Nonprosthetic Glenoid Arthroplasty

“…As a result, the outcome of the procedure may be strongly influenced by the status of the patient and the shoulder prior to surgery: patients with higher levels of function before surgery are more likely to be satisfied with their outcomes postoperatively 26 . Many patients having the RnR procedure have levels of postoperative function that are equal to or better than those for aTSA 16,23,26,27,30,34,38,48,50,51,[56][57][58][59][60][61][62][63][64] (Fig. 6, Table I).…”

Prosthetic shoulder arthroplasty in patients 40 years or younger: outcomes stratified by diagnosis and surgery

“…The ream-and-run procedure combines HA with concentric spherical glenoid reaming to correct glenoid articular surface incongruity in order to recenter the humeral head and create durable glenoid articulation without implant or graft [46][47][48][49][50][51][52][53]. The procedure provides an alternative to TSA using a conventional all-polyethylene glenoid implant.…”

“…Its development was motivated by concerns over early glenoid implant loosening, especially in younger, more active patients, and the unpredictable results following either glenoid implant removal or revision implantation [ 49 ]. Recent studies have demonstrated higher rates of return to sports and strenuous work following ream-and-run compared with TSA [ 48 , 52 ]. In our series, one patient with severe bilateral posterior glenoid erosion and dysplasia underwent staged bilateral ream-and-run procedures at 20 and 24 years of age to partially correct glenoid version and create a smooth articulation.…”

Anatomic Augmented Glenoid Implants for the Management of the B2 Glenoid

“…17 The "ream-and-run" procedure in which the glenoid is prepared to create a concentric surface also has had inconsistent results. 10,[18][19][20] Of particular concern with hemiarthroplasty is that revision to total shoulder arthroplasty may be necessary, and evidence shows that pain relief and improvements in function are not as robust as when total shoulder arthroplasty is performed as a primary procedure. [20][21][22] Asymmetric reaming is a technique in which the "high side" of the anterior glenoid is reamed to correct glenoid retroversion and recenter the humeral head prior to resurfacing the glenoid with an implant.…”

“… 17 The “ream-and-run” procedure in which the glenoid is prepared to create a concentric surface also has had inconsistent results. 10 , 18 – 20 Of particular concern with hemiarthroplasty is that revision to total shoulder arthroplasty may be necessary, and evidence shows that pain relief and improvements in function are not as robust as when total shoulder arthroplasty is performed as a primary procedure. 20 – 22 …”