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

摘要

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.