An 80 yo active man was 8 years after an anatomic right total shoulder and had returned to full function (including swimming) in spite of some early evidence of cuff tear arthropathy of the left shoulder as seen on the x-rays below taken 10 years prior to his recent presentation. Because of his high level of function, there were no interim x-rays taken.
He presented 16 months ago with the sudden atraumatic onset of the inability to raise his left arm (that had been fully functional the day before).
Imaging revealed a fragmented acromial fracture and advanced cuff tear arthropathy.
His care was transferred to our partner Jonah Hebert-Davies who discussed staged management with the patient.
Three months later there was clinical a radiographic union of the acromial fracture.
Stage two was then performed: a reverse total shoulder arthroplasty.
Recently he wrote: “I just finished filling out the 8-year followup study for my right total shoulder. I have full use of my right shoulder without limitation. In addition, my left reverse total shoulder recovery is equally good now that I’m seven months post-op. I’m back to swimming with no symptoms of pain at all, doing freestyle, backstroke and breast stroke. With the long period of restricted activity after the original injury in December 2022, I have had a profound loss of upper extremity strength, mostly manifested by very slow swimming speeds. This certainly qualifies as first-world whining. Orthopedically both shoulders are a complete success, and I know that I will eventually regain at least some vestige of my pre injury shoulder strength.”
