The Orthobullets Podcast Coinflips⎪Shoulder & Elbow⎪Progressive Shoulder Pain in 67F
Jul 26, 2025
Join Gerald Williams, a leading shoulder surgeon at Rothman Orthopedics; Jed Kuhn, editor-in-chief at the Journal of Shoulder and Elbow Surgery; and Eric Black, vice chair at Summit Health, as they unpack the complexities of treating progressive shoulder pain in a 67-year-old woman. They discuss diagnostic challenges, the importance of preoperative templating, and choosing the right implants. Their insights highlight the evolving practices in shoulder surgery and emphasize personalized approaches for optimal patient outcomes.
AI Snips
Chapters
Transcript
Episode notes
Recognizing B2 Glenoid Deformity
- The patient's shoulder x-rays show glenoid posterior subluxation and humeral head flattening, indicative of a B2 glenoid deformity.
- Such findings raise suspicion of traumatic and possibly osteoporotic pathology in an elderly female.
Imaging Strategy: CT then MRI
- Obtain a CT scan first for precise glenoid morphology and preoperative planning in complex deformities.
- Add an MRI if rotator cuff pathology is strongly suspected for comprehensive assessment.
Choosing Reverse Arthroplasty for Severe Deformity
- Consider reverse shoulder arthroplasty for severe glenoid deformities beyond anatomic implant tolerances.
- Maximize base plate fixation by balancing bone preservation and screw engagement, even if it means accepting some implant lateralization.