Glenohumeral Arthritis (Shoulder Arthritis)

Posted: May 22 2020 #(C101472)

Glenohumeral osteoarthritis in a 74M - Prosthesis selection

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HPI

74M, RHD, retired surgeon c/o increasing right shoulder pain (8/10) and limited function Pain wakes the patient from sleep, SSV = 30% Exhausted conservative management to include NSAIDs, PT, activity modification, and fluoro-guided glenohumeral injection

PMH

h/o triple bypass, on plavix

active/passive ROM: FF 120/135 (R) vs 155/160 (L) ABD 140/145 (R) vs 155/160 (L) ER 5 (R) vs 30 (L) IR L3 (R) vs T10 (L) RTC strength: Jobes 5/5, ER 5/5, Subscap x 3 5/5 (R and L) Crepitus throughout ROM NVID w/o deficits

Poll

1 of 10

Based on the xrays provided, how would you manage this patient?

1 Nonoperative (continued conservative management)

2 Operative

3 Need more information to determine

4 Outside my area of expertise - best if I don't vote

Other

Submit

P: 114954

If you choose Operative Management, would you obtain additional imaging to guide surgical treatment?

1 No - current radiographs are sufficient

2 Yes - additional radiographic views

3 Yes - CT scan of the shoulder (CT)

4 Yes - MRI scan of the shoulder (MRI)

5 Yes - CT + additional radiographic views

6 Yes - MRI + additional radiographic views

7 Yes - MRI + CT

8 Yes - MRI + CT + additional radiographic views

9 Outside my area of expertise - best if I don't vote

Other

Submit

P: 114952

If you choose to order a CT scan to guide operative management, would you include contrast (CT arthrogram) and/or patient-specific 3-D planning software (3-D Software)?

1 I would not choose to order a CT scan

2 CT without contrast / without 3-D software

3 CT with contrast (CT arthrogram) / without 3-D software

4 CT without contrast / with 3-D software

5 CT with contrast (CT arthrogram) / with 3-D software

6 Outside my area of expertise - best if I dont vote

Other

Submit

P: 114997

If you choose Operative management, what technique would you use?

1 I would not choose Operative management

2 Arthroscopic debridement (comprehensive arthroscopic management)

3 Biologic resurfacing alone (Interpositional allografting)

4 Arthroplasty (includes prosthetic resurfacing, hemiarthroplasty, TSA, rTSA)

5 Arthrodesis

6 Outside my area of expertise - best if I don't vote

Other

Submit

P: 114955

If you choose Arthroplasty, how long would you wait to perform surgery after receiving a steroid injection?

1 I would not choose Arthroplasty

2 Immediately - I would not wait

3 at least 1 month

4 at least 2 months

5 at least 3 months

6 at least 4 months

7 > 4 months

8 Outside my area of expertise - best if I don't vote

Other

Submit

P: 114961

If you choose Arthroplasty, what procedure would you perform?

1 I would not choose Arthroplasty

2 Prosthetic humeral resurfacing alone

3 Prosthetic humeral resurfacing + Interpositional allograft

4 Hemiarthroplasty (stemmed) alone

5 Hemiarthroplasty (stemmed) + Interpositional allograft

6 Anatomic total shoulder arthroplasty (TSA)

7 Reverse total shoulder arthroplasty (rTSA)

8 Outside my area of expertise - best if I don't vote

Other

Submit

P: 114956

If you choose Anatomic total shoulder arthroplasty (TSA), how would you manage the subscapularis?

1 I would not choose TSA

2 Subscapularis tenotomy

3 Subscapularis peel

4 Lesser tuberosity osteotomy

5 Subscapularis-sparing

6 Outside my area of expertise - best if I don't vote

Other

Submit

P: 114958

If you choose Anatomic total shoulder arthroplasty (TSA), how would you fix the components?

1 I would not choose TSA

2 Press-fit humerus + press-fit glenoid

3 Press-fit humerus + cemented glenoid

4 Cemented humerus + cemented glenoid

5 Outside my area of expertise - best if I don't vote

Other

Submit

P: 115062

If you choose Anatomic total shoulder arthroplasty (TSA), what type of humeral component would you use?

1 I would not choose TSA

2 Stemless

3 Short Stem

4 Long Stem

5 Outside my area of expertise - best if I don't vote

Other

Submit

P: 114959

If you choose Anatomic total shoulder arthroplasty (TSA), what type of glenoid component would you use?

1 I would not choose TSA

2 Pegged - Poly

3 Pegged - Metal

4 Pegged - Hybrid Metal/Poly

5 Keeled - Poly

6 Keeled - Metal

7 Keeled - Hybrid Metal/Poly

8 Outside my area of expertise - best if I don't vote

Other

Submit

P: 114960

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Post-procedure P1

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