Ream & Run Last Tuesday

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Topic Title: Ream & Run Last Tuesday
Created On: 07/30/2012 06:44 PM

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 02/13/2014 07:10 PM

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woodym2

Posts: 5

I want to thank all of you for your posts. I am a 43 year old male who had ongoing shoulder pain for a long time. Mine was caused by a lot of shoulder related injuries playing hockey. I had both shoulders scoped last spring, but it only provided relief for about 4 months. I decided to see Dr. Gerry Williams from the Rothman Institute here in the Phila. area. He too performs the ream and run procedure on the right candidates. Since I wish to resume all of my normal activities and my rotator cuff is in great shape, I was a good candidate for the procedure. I am 3 weeks post op, and I am doing extremely well! I saw Dr. Williams for my post op last Thursday, and he said I am ahead of schedule for my recovery. I am so glad I pushed through the pain doing my stretches the first two weeks because I can now (with the help of my other arm) get all the way back to 180°. I have been very faithful doing my stretches 5-6 times/day. After all, I have a golf club to swing this summer, so I have a lot of motivation to keep up with my PT!

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 10/15/2013 04:38 PM

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misty3

Posts: 132

I would guess that the tear is not so small if you have superior migration of the humeral head. When i had my replacement, the surgeon thought my rotator cuff was in good enough condition to keep the humeral head centered on the socket. However, the tendons on top, supraspinatus and infraspinatus, failed, as well as the subscapularis, which keeps the humeral head from shifting forward. So, it went up and out, and this problem will cause the plastic socket implant to loosen. Once the cuff is gone, basically all heck breaks loose and the hardware will fail. When they do the reverse, it does not matter that the cuff is gone. The only muscle working for me now is the deltoid.
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 10/15/2013 03:54 PM

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Southernstar

Posts: 5

Not really sure what a revision consists of. I have had rotator cuff surgery, shoulder replacemnt already. Now rotator cuff has a small tear again. I guess since the shoulder replacement did not give the desired results is why a reverse was recommended?
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 10/11/2013 07:19 AM

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misty3

Posts: 132

I saw a conference presentation on the reverse by a surgeon from mayo, i believe. He said that when he considers a patient for a reverse, the first question he asks himself is, how difficult will this be to revise? Now that is a scary thought! I already have told that my next revision will have at least a 50% complication risk. Yes, definitely wait till after christmas, that is approaching quickly! And primary replacements generally do quite well. Mine was a revision, so very complicated.
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 10/10/2013 06:34 PM

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Southernstar

Posts: 5

Well, I think I am going to Seattle to see a doctor. Not going anywhere until after Christmas. Everyone comes to my house and I wouldn't have it any other way. There were several doctors that were recommended to by the physical therapy department. one of the therapists worked in Seattle and had treated patients that had reverse by one of the doctors. He said he thought he did really good work, had did quite a few reverse and had good results with most of the patients. I am not expecting miracles. This arm has not been of much use for the last four years, so anything would be an improvement.Hope you continue to improve.
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 10/05/2013 05:29 PM

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misty3

Posts: 132

That protrubing lump in the front may be anterior escape, or dislocation. Mine was obvious as well, the head the arm bone had shifted forward and up, and i could not lift my arm at all. Yes, I have heard that too, Don't fall!! OK, doc, i promise not to fall for the rest of my life. They just don't want to face fixing us becuase it is just about impossible to have a good result.definitely go to the very best surgeon you can find and afford For a reverse, one who has done many of them. I did travel for mine, spent 10 days in another city. And i learned all that lingo. Better to know what you are facing because in this case, being so serious, ignorance is not so blissful.
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 10/05/2013 04:30 PM

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Southernstar

Posts: 5

I don't know a lot of the medical terms and could find out more if I really researched, I supposed. I guess I think ignorance is bliss. I am not overly concerned with exactly what is wrong with the shoulder. Just that it is not right. You can tell from looking at it with the protruding lump in the front that something is not right. He was spouting a lot of medical terms, but I am never asked for any papers or xrays because it is evident that something is wrong. I do know I will go somewhere else for the reverse if I decide to have it. Thanks for letting me know how you hare doing. My only restrictions is "please don't do anything that would cause a fall". LOL
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 09/29/2013 03:45 PM

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misty3

Posts: 132

I am OK. I still have pain, but it is managable, most of the time as long as I don't do much. ROM is better than it was, 90 forward flexion, 90 abduction. I cannot quite reach the back of my head. The anterior deltoid and pec are atrophied, for good. The greater tuberosity fracture is healing and has not shifted. That all said, I am on high restrictions, and have been strongly advised to take NO risks. The doc does not even want me to ride a bike. He was seriously considering a fusion before the reverse, and said if he needs to revise it now, it will be big trouble.i wish you positive thoughts on your decision.
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 09/29/2013 10:01 AM

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Southernstar

Posts: 5

Misty, How are you doing with the reverse replacement? Are you still in pain and how about the ROM. I am considering having the reverse since the other did not work? I live on the West Coast and am not sure who I going to check out. I have to do a considerable amount of research on doctors within a reasonable radius. I was not happy with the surgeon that did my rotator cuff surgery and the replacement, but he was highly respected in that field.
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 09/25/2013 06:19 AM

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misty3

Posts: 132

Well, yes and no. I went on to have a total shoulder replacement, which failed within a couple months, and now have a reverse replacement. But, I also had a bad rotator cuff.
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 09/24/2013 06:42 PM

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NOKARND51

Posts: 10

That sounds serious Misty. I am sorry to hear the profession screwed you up.How are you now?Did another surgeon improve the situation?
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 09/22/2013 07:51 PM

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misty3

Posts: 132

Nok, i had a resurfacing done with a hemicap and it was a disaster. I am a fellow shoulder sufferer, and know fullrom well, :-). It sounds like a good idea, but I would never recommend it. In fact, the cap is sitting in my kitchen junk drawer.
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 09/22/2013 01:24 PM

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NOKARND51

Posts: 10

I see the private message icon, but it has no send button, wsup with that?
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 09/22/2013 01:12 PM

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NOKARND51

Posts: 10

Thanks ROM,It's good to know a no-nonsense guy has had such excellent results with the procedure.Right now I'm not sure if my other hip or the shoulders should be the priority. The depression you mentioned gets me sometimes. Going to keep plugging along and time will certainly tell which problem needs to be fixed first. Also, Obamacare may soon exert some bearing on the situation I guess. NOK
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 09/18/2013 10:58 PM

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FullROM50

Posts: 81

I know where you're coming from. I met an individual who also had the hip resurfacing and is doing amazingly well. As far as the shoulder goes, the stem seems to be the proven way. The humerus is not where failures occur. The vast majority of failures in a conventional TSR involve loosening of the socket. There is plenty of information on that topic on Dr. Matsen's web site. I have heard about issues with the stem in the femor, but that doesn't apply here. In fact, the way the stem is press-fitted into the humerus, without the use of bone cement, while using pieces of the damaged head in the process further increases structural integrity and longevity of the joint. So I wouldn't worry about it. I'm an engineer, not a doctor, but I'd say there are also concerns about the greater degree of ROM compared to the hip. I have used my operated arm in full competitive randori (sparing), where I had to break hard falls on a 1.5" ethafoam mat over concrete. I do so at least twice a week. Hope this makes sense to you. FullROM50
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 09/18/2013 10:12 PM

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NOKARND51

Posts: 10

Hi ROM,The only thing concerning me about Matsen's R&R is the TSR type stem.I wonder, why not use a resurfacing type ball and reduce stresses on the humerus?Would Matsen consider that? Maybe he even does some with the shorter resurf type balls.Can you ask him?Just my thought since my hip BHR resurfacing has been such a success so far (10 years).Kind Regards,NOKARND (knockaround)
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 09/01/2013 07:40 PM

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FullROM50

Posts: 81

Hi NOKARND51,Thanks for the kind words. I was very frustrated at the time. I had been practicing judo since my teenage years, and have always considered it to be one of the best activities to stay in shape and healthy well into my senior years. The understanding of the art progresses throughout a persons life and at 52, I feel like I may be about half way there. So, as my arthritis in my shoulder got so bad that with each class it became more of a chore, I became very depressed, but swore that I was able to "crack the code", I would make the information available to others in the same situation. I'm very glad you find my postings useful. If you want to talk with me, feel free to email me and send me a number, I'll call you. Btw, there is a video of me 2.5 years after ream and run on the AAOS - a nation in motion website. I'm showing some judo throws. I also practice jiu jitsu some. Good luck!!
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 08/30/2013 11:02 PM

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NOKARND51

Posts: 10

Thanks FullROM,Very interesting. The dialog reminds me of the hip resurfacing procedure which has thus far been an enormous success for me ( March 2004 and lots of wrestling and jiu jitsu since). There were detractors, mostly doctors. Average folks did'nt know what to think, But many of my aqaintenances would not leave the area to see another surgeon or check out a new procedure.If I can find a shoulder procedure that works as well as this hip thing did, I will move forward.I'm still able to function in my endeavors, how long... I don't know. Your concern and willingness to help people find what you've found is appreciated. Most shoulder Docs are sending patients in another direction, and some of their experiences thus far are not what an athlete is looking for.Please keep writing and staying on this radar. A lot of guys just get busy doing their own thing and forget about the others who are facing the same mystery they once did. Reminds me of trying to get some help from classmates in college, or when yer new on a football team..."I learned it the hard way, you can too".More info from you will continue to be requested and appreciated!Hope all is well.
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 08/22/2013 06:00 PM

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FullROM50

Posts: 81

First, I want to agree with you that you need to select a very experienced shoulder surgeon. Dr. Matsen is likely the most experienced and he developed the ream and run procedure, a ground-breaking treatment for individuals with severe OA, who are otherwise quite healthy and desire high activity levels. For me, just being pain-free wouldn't have been good enough. This is why i decided to go this route. There are several success stories like mine out there. Yet, there are very few surgeons that understand this procedure. My surgeon Dr. Moskal in Sellersburg, IN was once a student of Dr. Matsen's and has also mastered ream and run. Dr. Moskal's patients have had very comparable success. Besides these two phenomenal surgeons, I know of no one else that I would trust performing this procedure. FullROM50
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 08/21/2013 10:32 AM

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rusty123

Posts: 3

Hello, I have been advised that I definitely need shoulder surgery. Two orthopaedic surgeons have given differing opinions as to what would work best for me: TSR and the Copeland procedure. Both surgeons appear to be general orthopaedists. I would appreciate any advice, especially from you since I also live in the southeast. I am extremely interested in your feedback about Dr. Masten and your trip to Washington. Preferably, I am looking for someone who is very experienced and only does shoulder surgery. Your help would be very appreciated.
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