Shoulder Hemiarthroplasty with Nonprosthetic Glenoid Arthroplasty: The Ream-And-Run Procedure

Abstract

Glenoid component wear and loosening are the principal failure modes of anatomic total shoulder arthroplasty (aTSA).The ream-And-run (RnR) procedure is an alternative glenohumeral arthroplasty for patients who wish to avoid the risks and limitations of a prosthetic glenoid component.During the RnR procedure, the arthritic glenoid is conservatively reamed to a single concavity, while the prosthetic humeral component and soft tissues are balanced to provide both mobility and stability of the joint.The success of the RnR procedure depends on careful patient selection, preoperative education and engagement, optimal surgical technique, targeted rehabilitation, and close postoperative communication between the surgeon and the patient.While the RnR procedure allows high levels of shoulder function in most patients, the recovery can be longer and more arduous than with aTSA.Patients who have undergone an RnR procedure occasionally require a second closed or open procedure to address refractory shoulder stiffness, infection, or persistent glenoid-sided pain. These second procedures are more common after the RnR than with aTSA.