Oct 05, 2020

Management of Charcot Shoulder with Reverse Prosthesis

Enclosed is an interesting case as follow-up to the advice some of you offered previously. Please take a look at the outcome and offer input. I wonder if the evidence-based approach or the eminence-based approach adequately inform…or perhaps the execution of the plan was poor. You can decide.

Sep 18, 2020

RSA with Concerning Radiographic Findings

This is a 66 year old female who underwent a RSA by Dr. Warner in 2017. In 2019, she returned for a follow-up and XRs demonstrated lateral bony resorption of the humerus adjacent to the stem but with the distal 2-3 cm of the stem still covered with bony incorporation. She has excellent motion however. Our office recommended observation, but a second opinion recommended a revision RSA. She returned to our office recently for further discussion. What are her options?

Sep 14, 2020

Revision Reverse in the Setting of External Rotation Lag and Axillary Nerve Dysfunction

This is a 69 year old male who underwent a RSA in 2018. He also underwent a vascular bypass on the same extremity due to a suspected blood clot on POD#1. He was doing better until he noticed intermittent pain ultimately from a failed RSA. Following a complex reconstruction by Dr. Warner in 2020, he has limited motion and weakness. What are his options? 

Aug 03, 2020

Management of Scapular Spine Fracture after Reverse Prosthesis

This is a 70 y/o female who is s/p RTSA in August 2019 who was diagnosed with an acromial stress fracture in December 2019. She has has continuous pain since her surgery. Here is a similar case. What are her options?

Feb 21, 2020

Follow-up: No Acromion

This is a follow up to a previous case describing a patient lacking an acromion from Dr. Ron Navarro. Please see the case presentation for input from international experts and more questions.

Jan 27, 2020

Metal Back Glenoid

This is a patient with a complex surgical history. Initially underwent a TSA for AVN 20 years ago and has had multiple surgeries since. She presents to clinic with severe pain and an SSV of 45%. What are her options?

Jan 21, 2020

Bilateral Gorhams Disease

This is a 74 year old male RHD, insulin dependent, diabetic patient with bilateral osteoarthritis. A MRI indicates a large intra-articular cyst, a subscapularis and supraspinatus tear, and flattening of the humeral head. What are his next steps?

Jan 08, 2020

Cuff Tear Arthropathy Hamada VI with Type II OS Acromiale

This patient is a 71 year old female with cuff tear arthropathy Hamada VI with a painful type II acromiale. The treatment plan is a reverse total shoulder arthroplasty with iliac bone graft. The question is, do we treat the painful mobile Os acromiale or not?

Jan 03, 2020

Severe Superior Scapular Tilt, Unstable Reverse

This case is a patient from Dr. Wayne Burkhead. Any advice or input is welcome. 

Nov 11, 2019

Shoulder Arthroplasty without Acromion?

Patient with history of scoliosis has had severe shoulder pain for several years that is worsening. She congenitally lacks an acromion. Can a reverse shoulder arthroplasty be done on an individual that lacks an acromion?

Nov 08, 2019

Persistent pain and stiffness following TSA

This patients presents to our clinic with a complex surgical history that reports persistent pain and stiffness following a total shoulder arthroplasty. What are her options?

Apr 19, 2019

Ongoing Shoulder Pain Following Complex Surgical History

Patient with a complex surgical history presents to clinic with ongoing chronic shoulder pain following total shoulder arthroplasty with posterior glenoid bone graft reconstruction. CT demonstrates graft nonunion, while diagnostic arthroscopy revealed a loose glenoid component. What are her options?

Feb 05, 2019

Shoulder Pain and Decreased Range of Motion in the Setting of Complex Surgical History

Patient underwent a RSA and reported significant improvement until she received surgical treatment for her esophageal dysfunction. During this procedure, she underwent a medial claviculectomy for exposure, resulting in pain, functional deficits, and Horner syndrome. If the goal is to restore function, what are her options? 

Dec 14, 2018

Anterior and Lateral Pain Following Extensive Surgical History

Patient presents with new anterior and lateral pain and a "change in contour" following an extensive medical history, including: open rotator cuff repair, reverse total shoulder arthroplasty, removal of hardware, and deltoidplasty. What are his options?

Nov 15, 2018

Painful TSA in Setting of Significant Glenoid Bone Loss

Patient presents with pain 13 years following a total shoulder arthroplasty. When a conversion to reverse shoulder arthroplasty was attempted, surgery was aborted due to significant glenoid bone loss. What are his options?

Aug 09, 2018

Glenohumeral Osteoarthritis

Patient presents with glenohumeral osteoarthritis following a history of shoulder dislocations. Although he reports no further problems with stability, he has gradually worsening ROM and a locking sensation when sleeping. Given that he desires to continue his military career, what are his options?

Jul 16, 2018

Humeral Head Bone Loss

Patient presents with gross humeral loosening and 1 out of 5 biopsies positive for P. acnes after a hemiarthroplasty. What is the pathologic process, and what are her options?

Jun 07, 2018

Painful Resection Arthroplasty

Patient presents with painful resection arthroplasty after multiple failed surgeries. What are her options?

Dec 07, 2017

History of Prosthetic Joint Infections

Patient presents with continued shoulder pain after a history of prosthetic joint infections. There is pain at external rotation suggesting a mechanical etiology. What are his options?

May 08, 2018

Patient with RSA and forearm amputation

Patient underwent RSA 8 years ago with great function, but has increased pain and deteriorating function over the last few years. She has a forearm amputation, with a prosthesis, so she uses her other arm for everything else. 

Feb 23, 2018

Syrinx, Charcot Joint, Instability

Middle-aged patient with persistent pain and instability in the setting of syrinx with concern for Charcot joint. What are his options?

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