Arthroplasty
Two Cases of Shoulder Pain
November 29, 2021
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Below are two cases, a 44 year-old female and a 65 year-old female. Each case has its own challenges. Please take a look at these cases and share your thought as to treatment.
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Case Presentation (44 yo F)
Case Presentation (65 yo F)
Post-thermal Capsulorrhaphy Pain and Stiffness
September 28, 2021
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This case comes from Dr. Bassem Elhassan. This is a 39 year-old male with post-thermal capsulorrhaphy pain and stiffness. He has progressed to arthritis. Has received two arthroscopic capsular releases with ongoing stiffness. What are his treatment options?
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Case Responses
Arner 2021 (from case responses)
Nolte 2021 (from case responses)
Spiegl 2014 (from case responses)
Rheumatoid Arthritis in Young Patient
August 19, 2021
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This case comes from Dr. Jacob Kirsch. This is a 20 year-old female diagnosed with RA 3 years ago. She has had severe left shoulder pain for 1 year. What are her options?
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Case Responses
Pseudoachondroplastic Dwarfism and Osteoarthritis
August 9, 2021
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This is a 62 year-old female patient with pseudoachondroplastic dwarfism and osteoarthritis. What are their options?
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Case Responses
Yoga Instructor with Osteoarthritis
June 4, 2021
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This is a 56 year-old female patient with bilateral glenohumeral joint dysplasia with osteoarthritis. What are her options?
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Case Responses
C glenoid Presentation (from case responses)
Large Enchondroma in Patient with Hemiplegic Cerebral Palsy
March 31, 2021
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This is a 52 year-old female with right-sided hemiplegic cerebral palsy and a large enchondroma. Her story is below. What are her options?
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Case Responses
Traumatic Rotator Cuff Tear 5 Weeks Following Anatomic TSA
March 23, 2021
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This is an active 61 year-old male who works as a roofer. He underwent a left TSA 3 months ago and returned to the office 5 weeks post-op following an injury where he fell on outstretched arms. What are his options?
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Case Responses
Role of Reverse Arthroplasty in the Weightbearing Shoulder
March 5, 2021
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This is a 62 y/o retired physical therapist who has been paraplegic since her 20's. She has had right shoulder pain for the past4 years and her strength has decreased over time. She has pain at night and with activity. What are her options?
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Case Responses
Management of Charcot Shoulder with Reverse Prosthesis
October 5, 2020
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This is a follow-up of a 40 year old male with persistent left shoulder pain and instability in the setting of syrinx with concern for Charcot joint. Please take a look at the outcome and offer input.
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Case Responses
RSA with Concerning Radiographic Findings
September 18, 2020
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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?
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Case Responses
Revision Reverse in the Setting of External Rotation Lag and Axillary Nerve Dysfunction
September 14, 2020
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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?
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Case Responses
Management of Scapular Spine Fracture after Reverse Prosthesis
August 3, 2020
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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. What are her options?
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Case Responses
Metal Back Glenoid
January 27, 2020
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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?
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Case Responses
Bilateral Gorhams Disease
January 21, 2020
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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?
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Case Responses
Cuff Tear Arthropathy Hamada VI with Type II OS Acromiale
January 8, 2020
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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?
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Case Responses
Severe Superior Scapular Tilt, Unstable Reverse
January 3, 2020
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This case is a patient from Dr. Wayne Burkhead. Any advice or input is welcome.
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Case Responses
Shoulder Arthroplasty without Acromion
November 11, 2019
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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?
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Case Responses
Persistent Pain and Stiffness Following TSA
November 8, 2019
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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?
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Case Responses
Ongoing Shoulder Pain Following Complex Surgical History
April 19, 2019
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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?
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Case Responses
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Shoulder Pain and Decreased Range of Motion in the Setting of Complex Surgical History
February 5, 2019
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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?
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Case Responses
Anterior and Lateral Pain Following Extensive Surgical History
December 14, 2018
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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?
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Case Responses
Painful TSA in Setting of Significant Glenoid Bone Loss
November 15, 2018
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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?
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Case Responses
Glenohumeral Osteoarthritis
August 9, 2018
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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?
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Case Responses
Humeral Head Bone Loss
July 16, 2018
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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?
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Case Responses
Painful Resection Arthroplasty
June 7, 2018
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Patient presents with painful resection arthroplasty after multiple failed surgeries. What are her options?
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Case Responses
History of Prosthetic Joint Infections
December 7, 2017
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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?
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Case Responses
Patient with RSA and Forearm Amputation
May 8, 2018
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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.
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Case Responses
Syrinx, Charcot Joint, Instability
February 23, 2018
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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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Case Responses