I'm back after 9 years

[jss]

Like Designista, I used the BoneSmart resource before my hip resurfacing in January 2015. Now it's time for a shoulder.

Three years ago I had a debridement of my left shoulder. The surgeon told me that I'd rubbed a hole in the hyaline cartilage on the humeral head and didn't have a lot left on the glenoid fossa; and that I'd be back for a replacement in about two years (that was three years ago).

I don't know if I'm a candidate for a 'ream and run' procedure, but do want to pursue that route. Google as I may, I can't find anyone in the Dallas area that advertises that procedure. Would anyone know of someone in the Dallas area?

 

[benne68]

Welcome back, @jss

Sorry to hear that you are now in need of a TSR. While I can't help directly, I've alerted our other staff members to your post and hope someone will be able to share a recommendation.

 

[Jamie]

I don't have many resources for the ream and run. But it does appear this clinic has a number of locations in the Dallas area and at least some of the surgeons do the ream and run. They are associated with the Shoulder Center at Baylor University and I believe that would be an excellent place to start looking.

Shoulder - Shoulder Resurfacing - AOA Orthopedic Specialists

An alternative to total shoulder arthroplasty (replacement), shoulder resurfacing involves only repairing the surface of the humeral head. In a typical total shoulder replacement, the shoulder surgeon would have to replace both parts that make up the joint; the humeral head and the glenoid cavity.

www.arlingtonortho.com

With the damage you describe, you may not be a candidate for ream and run anyway. Shoulder replacements are usually much easier than either the knee or hip, so don't be hung up on that procedure. I love my new shoulder and it works very well for me!

 

[jss]

Thanks benne and Jamie for the replies.

The appeal of the ream and run is the lack of restrictions. Since Dec 2020 I've followed the surgeon's restrictions because I seriously didn't want another artificial joint (I already have 6). Rotating tires on our vehicles, hanging sheet rock on the ceiling and swimming up to three miles is as vigorous as I've been with it since surgery. Am I likely to retain that level of activity after a TSR?

And I do realize that I may not be a candidate for ream and run. I will holler at Arlington Orthopedic today!

BTW, I've seen it attributed to several people and don't know who said it originally, but they sure knew what they were talking about; "Getting old isn't for sissies."

 

[Layla]

As you're doing your research, you may want to check this resource out -
Top Seattle Surgeon - Interview and Blog The surgeon isn't in your area, but you may find the information beneficial as you research options? The member that posted it (dapplega) experienced ream and run. You can also type key words like "ream and run" into the Search at the top right of the page and any threads where its been discussed will pop up.
All the best to you!
@jss

 

[Layla]

Just noticed...with your history here and the mention of six artificial joints, wondering if you'll share names of procedures and the date. It doesn't need to be an exact date at this point, the year will suffice. Your signature may benefit others while reading and looking for people or threads to follow. Please consider doing this as time allows. Thanks!
@jss

 

[jss]

Thank you Layla; I have run across Dr Matsen while researching options. I would consider traveling to Seattle for the procedure. I travelled to Columbia, SC for my hip resurfacing and to Barcelona, Spain for the artificial cervical discs. Both have been outstanding outcomes (so far), so I'm not averse to such a trip.

 

[Layla]

Thank You for those dates! That took you some time. We appreciate it!
Consider tagging (dapplega) if you have any questions about Dr Matsen, I do believe he still checks in here on occasion and it appears he just stopped by the forum a few days ago. I am sure he'd be happy to answer any questions through his experience with ream and run.
@jss

 

[jss]

My first appointment with a prospective surgeon today... After discussing my condition, medical history, job, lifestyle, hopes for the future, etc... he agreed that a ream and run would be the preferred path forward. He suggested that it would last 15 years, as would an anatomical TSR (if I altered my lifestyle). He does a few ream and runs per month and has former patients bench pressing 300 lbs. You can tell from my picture that I'm not a weightlifter. The only thing that concerned me was his assertion that a TSR usually alleviates all pain and that the ream and run alleviates only about half of it.

Because of my insurance I have to endure six weeks of physical therapy before surgery. I consider that a good thing as that will give me time to continue to research, learn and compare options. Anyway, that's where we're at.

 

[CosmoCaliGirl]

Hearing your journey is inspiring thank you for sharing here. I’m glad you’re here.

 

[jss]

Random update. Six weeks of physical terrorism/therapy is in the books. Imaging shows a number of bone spurs, little cartilage and no supraspinatus tear. So I'm a go for ream and run on April 3rd.

Questioning the doctor about details of the surgery... Rather than detach any of the glenohumeral ligaments or the subscapularis from the humerus, he instead cuts the humerus under where the ligaments insert and folds them out of the way with the attached bone; then reattaches the bone to the humerus after the ream and run. The bone to bone union grows back much faster than the ligaments would have grown back into the bone, reducing the amount of soft tissue damage and length of recovery. He says this is an increasingly common technique.

Looking forward to getting this behind me and getting life back on track!

 

[mendogal]

I had just read about this procedure two days ago!

So I'm very much interested in following your post op recovery thread to learn as much as possible for other members' benefit.

 

[jss]

A question for you shoulder replacement veterans out there. I know that doctors are all over the place, but it seems like generally they have you in a sling for 6 weeks before you start therapy. How long are you in the sling? How long before you can pick up something as heavy as say a suitcase?

 

[djklaugh]

@jss I was in the sling (with a padded bolster) for 6 weeks with the right shoulder and 3 weeks with the left. Don't quite know why the change but those were the surgeons (different one for each shoulder) directions. With the first one (right) my surgeon initially said I'd have a permanent restriction to not pick up anything heavier than 25lbs. But when I saw him again about 3 years later he said that restriction was not necessary. With the left one the surgeon never did give me any restrictions about weight hefting. Between the shoulder surgeries and again after both I traveled across country, shlepped suitcase around airports and all over New England. And I do NOT have a "pack light" gene! Thank goodness for good wheels on luggage!

Sort of depends on how much you pack into that suitcase. I'd guess it would be about 6 months after surgery -- enough time to fully heal and to complete the necessary PT.

 

[jss]

@djklaugh, thanks. We were planning our summer vacation. I can pack everything I need in a plastic Walmart bag, but my wife, like you can't pack light and we always take THREE suitcases. I was wondering if I'd be able to manage that load by July; which sounds optimistic at best. We usually go to the Caribbean, but because I'll still be recovering, and because of another family issue, we're going to float around the Texas Hill Country this summer.

Had pre-op this week and it looks like I'm a go for the ream-and-run procedure this Wednesday. They've got me starting therapy just two days later. That seems early as the nerve block shouldn't have worn off yet. Is that 'normal'?

 

[dapplega]

Just catching up on this thread. For my Ream and Runs I was not required to wear a sling unless for comfort. For the first six weeks only 5x daily stretching and no lifting anything more than a coffee cup and no external rotation. This was to protect the subscapularis repair (although I noted your surgeon separates the bone instead of the ligament).

 

[EL84]

Random update. Six weeks of physical terrorism/therapy is in the books. Imaging shows a number of bone spurs, little cartilage and no supraspinatus tear. So I'm a go for ream and run on April 3rd.

Questioning the doctor about details of the surgery... Rather than detach any of the glenohumeral ligaments or the subscapularis from the humerus, he instead cuts the humerus under where the ligaments insert and folds them out of the way with the attached bone; then reattaches the bone to the humerus after the ream and run. The bone to bone union grows back much faster than the ligaments would have grown back into the bone, reducing the amount of soft tissue damage and length of recovery. He says this is an increasingly common technique.

Looking forward to getting this behind me and getting life back on track!

Can you please update your post surgery status.

Also who was the surgeon and where was the surgery?

Thanks

 

[jss]

@EL84, my surgeon was Michael Howard at Plano Orthopedics and Sports Medicine in Plano, TX, with the actual surgery at a nearby surgical center in Dallas. It was outpatient.

I'm getting a little better every day. The doctor x-ray's me every month and tells me that recovery is on schedule. PT does their voodoo to me once a week and tells me the same thing. After the first month I was out of the immobilizer, but still in the sling. I was promoted from being able to hold nothing heavier than a cell phone on the operative side, to nothing heavier than a coffee cup. The doctor told me to do my PT exercises at home only once a day. I can remove the sling at night, which really helps sleeping.

 

[Jamie]

It's great that you're documenting this procedure for all our shoulder BoneSmarties. This is a relatively new procedure and it sounds like your surgeon may have made some good tweaks to the process to help with healing and functionality. I hope you can continue to journal your recovery here, as that really helps others (and the staff of BoneSmart!). I'm adding your surgeon to my list, since it sounds like he's done a good job for you.