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Ream and run and total shoulder: patient and shoulder characteristics in five hundred forty-four concurrent cases

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Abstract

Purpose

Total shoulder (TSA) is commonly used to treat arthritic shoulders with intact rotator cuffs; however, some patients choose a ream and run (RnR) to avoid the potential risks and limitations of a prosthetic glenoid component. Little is known about how patients selecting each of these two procedures compare and contrast.

Methods

We analyzed the patient characteristics, shoulder characteristics, and two year clinical outcomes of 544 patients having RnR or TSA at the same institution during the same six year period.

Results

Patients selecting the RnR were more likely to be male (92.0% vs. 47.0%), younger (58 ± 9 vs. 67 ± 10 years), married (83.2% vs. 66.8%), from outside of our state (51.7% vs. 21.7%), commercially insured (59.1% vs. 25.2%), and to have type B2 glenoids (46.0% vs. 27.8%) as well as greater glenoid retroversion (19 ± 11 vs. 15 ± 11 degrees) (p < .001). The average two year SST score for the RnRs was 10.0 ± 2.6 vs. 9.5 ± 2.7 for the TSAs. The percent of maximum possible improvement (%MPI) for the RnRs averaged 72 ± 39% vs. 73 ± 29% for the TSAs. Patients with work-related shoulder problems had lower two year SSTs and lower %MPIs. Younger patients having TSAs did less well than older patients. Female patients having RnRs did less well than those having TSAs (p < 0.001).

Conclusions

This investigation highlights important characteristics of patients selecting the RnR and the TSA for glenohumeral arthritis. Excellent outcomes can be achieved for appropriately selected patients having either procedure.

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Acknowledgments

We thank Susan DeBartolo, University of Washington Department of Orthopaedics and Sports Medicine, for her editorial work on this manuscript. We thank Winston J. Warme, M.D., University of Washington Department of Orthopaedics and Sports Medicine, for allowing us to include his patients in this analysis.

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Authors and Affiliations

  1. Department of Orthopedics and Sports Medicine, University of Washington, 1959 NE Pacific Street, Box 356500, Seattle, WA, 98195-6500, USA

    Frederick A. Matsen III, Anastasia Whitson, Winston J. Warme & Jason E. Hsu

  2. Department of Rehabilitation, University of Washington, 1959 NE Pacific St, Box 354745, Seattle, WA, 98195, USA

    Sarah E. Jackins

  3. The Mountain-Whisper-Light Statistical Consulting, 1827 23rd Avenue East, Seattle, WA, 98112, USA

    Moni B. Neradilek

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  1. Frederick A. Matsen III
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  2. Anastasia Whitson
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  5. Winston J. Warme
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  6. Jason E. Hsu
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Corresponding author

Correspondence to Frederick A. Matsen III.

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Ethical review committee statement

This study was approved by the Institutional Review Board (IRB) of the University of Washington (IRB Study #38897).

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Matsen, F.A., Whitson, A., Jackins, S.E. et al. Ream and run and total shoulder: patient and shoulder characteristics in five hundred forty-four concurrent cases. International Orthopaedics (SICOT) 43, 2105–2115 (2019). https://doi.org/10.1007/s00264-019-04352-8

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