Case #1
Case #1 • Right Shoulder Pain • 74 y/o F, RHD, long standing history of shoulder pain. • Healthy and active (tennis and golf) • PE: • FF 170 • ER 40 • IR Lumbar Spine • + Crepitus • 5/5 supra, ER, Negative belly press.
Case #2
Chief Complaint • Right Shoulder Pain and Weakness Histor y of Present Illness • 65y/o amibdextrous male • 18 Month history of right shoulder pain after a fall. • Underwent open rotator cuff repair 12 months ago. • Still with pain and weakness.
Past Surgical History • Cervical Spine Surgery • Right Open Rotator Cuff Repair Past Medical History • Non-contributory Social History • Non-Smoker, No Etoh, No IVDU Medications • None
Physical Exam
Imaging B A
Imaging A B C
Treatment?
Intra-op Images A B
Intra-op Images A B
Intra-op Images A B
Intra-op Images
Intra-op Images
Case #3
• 65F presents after shoulder dislocation • Recurrent instability following reduction • Patient comes with MRI • Displaced bony Bankart fracture • Treated with RTSA • 5 year follow up • VAS 0/10 • SANE score 90%
Case #4
Case • CC: R shoulder pain, limited function. • HPI: 69 y/o RHD man now 2 years s/p Right TSA. • Never achieved pain relief and functional improvement • PMH: Non-contributory • PE: • Inc c/d/I • +TTP anteriorly • AROM: 70/30/BP – large shrug • PROM: 150/45/BP
What Now?
Our Patient • CT Arthrogram • WBC, CRP, ESR • All Negative • Aspiration • WBC 150 • 1 of 2 Positive for P Acnes
Our Patient • Diagnostic Scope • Glenoid loose, removed • 5 out of 5 Positive for P Acnes
Our Patient • Aspiration Negative Following Course of IV Abx Very Satisfied
Our Patient • 2 Years later, presents with left shoulder pain “Doc, my TSA was terrible, and my RSA is great, why don’t we just do a RSA on this side”
Our Patient “My right shoulder is good, but I like my left shoulder better”
Case #5
Cases • 52m presents 12 months s/p L posterior proximal humerus fracture-dislocation • CT confirms residual posterior dislocation of humeral head and non-union • Treated with RTSA
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