Shoulder Pain in 62M

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PRESENTATION
5
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POLLS
6,880
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OUTCOMES
9
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VIDEOS
4
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EVIDENCE
93
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Comments
30
CASE DESCRIPTION
AGE 62 / Male
CC Right shoulder pain
HPI A 62-year-old male, right-hand dominant, presents with chronic right shoulder pain for many years. He has noted progressively decreased function and has failed a course of physical therapy, NSAIDs and corticosteroid injections. He is a laborer and wishes for pain relief and increased function.
PMH PMH/PSH: non-contributory
PE Focused physical examination of the right shoulder reveals no prior incisions. He has active forward flexion to 80, ER to 5, and IR to his sacrum. He has 5/5 deltoid and rotator cuff strength. He is neurovascularly intact.
Pre-procedure IMAGES:
https://upload.orthobullets.com/cases/102059/69ae144b-3dce-4617-abd8-68398144cf7b_ap_shoulder.jpg https://upload.orthobullets.com/cases/102059/a5528de1-81b2-42f1-825c-f7651caca206_ap_shoulder_2.jpg https://upload.orthobullets.com/cases/102059/7cd157e1-78c3-4d9f-8687-aaca4725e3aa_preop_ct.jpg https://upload.orthobullets.com/cases/102059/de59f576-8cac-43b2-aaf1-96aab0213846_ct_2.jpg https://upload.orthobullets.com/cases/102059/a9af08f2-e482-4a8e-a954-4703906f7d3b_ct_3.jpg
POLLS
OB Community
1) In addition to plain film radiographs, would you obtain any further imaging to guide your treatment?
Other
2) Would you use a classification system to guide management?
Other
3) If you choose Walch classification, how would you classify the glenoid?
Other
4) How would you manage this patient?
Other
5) If you choose Operative management, what technique would you use?
Other
6) If you choose Arthroplasty, what procedure would you perform?
Other
7) If you choose Anatomic Total Shoulder Arthroplasty (TSA), how would you take down the subscapularis?
Other
8) If you choose Anatomic Total Shoulder Arthroplasty (TSA), how would you manage the glenoid version?
Other
9) If you choose Anatomic Total Shoulder Arthroplasty (TSA), what type of glenoid component would you use?
Other
10) If you choose Anatomic Total Shoulder Arthroplasty (TSA) with an Onlay glenoid, what type of glenoid design would you use?
Other
11) If you choose Anatomic Total Shoulder Arthroplasty (TSA), what type of humeral stem/head would you use?
Other
12) If you choose Anatomic Total Shoulder Arthroplasty (TSA) with an inlay glenoid component, what post-operative weight limit would you advise the patient?
Other
CASE OUTCOMES
PROCEDURE 1: Right total shoulder arthroplasty with inlay glenoid
Intra-procedure P1
https://upload.orthobullets.com/cases/102059/7d4c24e9-1977-4466-aee5-1bf03a84de8f_intraop_1.jpg https://upload.orthobullets.com/cases/102059/b6e021c1-e12b-47c2-8432-93d290c047ad_intraop_2.jpg https://upload.orthobullets.com/cases/102059/eafd2b43-e56d-40c7-a4b1-532e6ee85e32_intraop_3.jpg https://upload.orthobullets.com/cases/102059/54d0be97-4a0e-4ecd-8982-43df464efce3_intraop_4.jpg https://upload.orthobullets.com/cases/102059/b7c28eb3-8137-4677-bbfb-09d42ac363fe_intraop_5.jpg
video
Post-procedure P1
https://upload.orthobullets.com/cases/102059/587fc997-ad97-4f3b-9843-33c9c3b02676_postop_1.jpg https://upload.orthobullets.com/cases/102059/ba21665d-53be-4da6-b140-2d36f5c0af80_postop_2.jpg
video
VIDEOS & PODCASTS (4)
EVIDENCE (93)
EXPERT COMMENTS