Two Cases of Shoulder Pain
November 29, 2021
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.
Case Presentation (44 yo F)
Case Presentation (65 yo F)
Post-thermal Capsulorrhaphy Pain and Stiffness
September 28, 2021
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?
Arner 2021 (from case responses)
Nolte 2021 (from case responses)
Spiegl 2014 (from case responses)
Rheumatoid Arthritis in Young Patient
August 19, 2021
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?
Pseudoachondroplastic Dwarfism and Osteoarthritis
August 9, 2021
This is a 62 year-old female patient with pseudoachondroplastic dwarfism and osteoarthritis. What are their options?
Yoga Instructor with Osteoarthritis
June 4, 2021
This is a 56 year-old female patient with bilateral glenohumeral joint dysplasia with osteoarthritis. What are her options?
C glenoid Presentation (from case responses)
Large Enchondroma in Patient with Hemiplegic Cerebral Palsy
March 31, 2021
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?
Traumatic Rotator Cuff Tear 5 Weeks Following Anatomic TSA
March 23, 2021
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?
Role of Reverse Arthroplasty in the Weightbearing Shoulder
March 5, 2021
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?
Management of Charcot Shoulder with Reverse Prosthesis
October 5, 2020
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.
RSA with Concerning Radiographic Findings
September 18, 2020
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?
Revision Reverse in the Setting of External Rotation Lag and Axillary Nerve Dysfunction
September 14, 2020
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?
Management of Scapular Spine Fracture after Reverse Prosthesis
August 3, 2020
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?
Metal Back Glenoid
January 27, 2020
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?
Bilateral Gorhams Disease
January 21, 2020
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?
Cuff Tear Arthropathy Hamada VI with Type II OS Acromiale
January 8, 2020
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?
Severe Superior Scapular Tilt, Unstable Reverse
January 3, 2020
This case is a patient from Dr. Wayne Burkhead. Any advice or input is welcome.
Shoulder Arthroplasty without Acromion
November 11, 2019
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?
Persistent Pain and Stiffness Following TSA
November 8, 2019
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?
Ongoing Shoulder Pain Following Complex Surgical History
April 19, 2019
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?
Shoulder Pain and Decreased Range of Motion in the Setting of Complex Surgical History
February 5, 2019
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?
Anterior and Lateral Pain Following Extensive Surgical History
December 14, 2018
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?
Painful TSA in Setting of Significant Glenoid Bone Loss
November 15, 2018
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?
August 9, 2018
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?
Humeral Head Bone Loss
July 16, 2018
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?
Painful Resection Arthroplasty
June 7, 2018
Patient presents with painful resection arthroplasty after multiple failed surgeries. What are her options?
History of Prosthetic Joint Infections
December 7, 2017
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?
Patient with RSA and Forearm Amputation
May 8, 2018
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.
Syrinx, Charcot Joint, Instability
February 23, 2018
Middle-aged patient with persistent pain and instability in the setting of syrinx with concern for Charcot joint. What are his options?