Glenoid Cartilage Defect in 44M

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PRESENTATION
4
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POLLS
3,416
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OUTCOMES
5
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VIDEOS
3
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EVIDENCE
17
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Comments
13
CASE DESCRIPTION
AGE 44 / Male
CC Right shoulder pain
HPI A 44-year-old male laborer presents with several months of persistent right shoulder pain. The pain began when he "pulled" his arm at work. The pain is present at night and prevents him from getting a restful night of sleep. He has attempted oral NSAIDs with minimal relief. He is unable to work due to this pain. Denies numbness or tingling of the right arm.
PMH Obesity
PE A focused physical examination of the right upper extremity reveals no gross deformities. There is no appreciable effusion or swelling over the right shoulder. Active ROM is 0-180 without appreciable pain. There is guarding throughout the range of motion with flexion and abduction. Rotator cuff, deltoid, biceps, and triceps strength is 5/5. He is neurovascularly intact.
Pre-procedure IMAGES:
https://devupload.orthobullets.com/cases/101753/2bb43712-06ec-4e4e-816b-17f80b3e9d5c_screen_shot_2021-04-30_at_11.25.56_am.jpg https://devupload.orthobullets.com/cases/101753/2ae1e26f-f94d-46bc-b393-fb714c73a398_screen_shot_2021-04-30_at_11.25.49_am.jpg https://devupload.orthobullets.com/cases/101753/1c82f807-b952-456e-873d-84cc083f9b0a_screen_shot_2021-04-30_at_11.26.25_am.jpg https://devupload.orthobullets.com/cases/101753/99bdfd94-13b2-417a-afc1-d86a95d70392_screen_shot_2021-04-30_at_11.26.10_am.jpg
POLLS
OB Community
1) In addition to the plain radiographs, would you obtain additional imaging to guide management?
Other
2) Would you use a classification system to aid in treatment?
Other
3) How would you manage this patient?
Other
4) If you choose Operative management, how would you treat this patient?
Other
5) If you choose Biologic Resurfacing, what graft would you use?
Other
6) If you choose Biologic Resurfacing, how would you perform the procedure?
Other
7) If you choose Arthroscopic Biologic Resurfacing, how would you manage post-operative weight-bearing?
Other
8) If you choose Arthroscopic Biologic Resurfacing, when would you allow full active range of motion?
Other
CASE OUTCOMES
PROCEDURE 1: Biological resurfacing of right glenoid cartilage defect (cartiform procedure)
Intra-procedure P1
https://devupload.orthobullets.com/cases/101753/d40b3b98-4d7f-4f7c-8092-4a13f973feb0_screen_shot_2021-04-30_at_11.27.37_am.jpg https://devupload.orthobullets.com/cases/101753/3220f854-aec1-4495-973c-af5a1d64cf52_screen_shot_2021-04-30_at_11.27.20_am.jpg
video
Post-procedure P1
https://devupload.orthobullets.com/cases/101753/df44a850-8cc1-4e82-a96f-10eb51f3edd0_screen_shot_2021-04-30_at_11.31.54_am.jpg https://devupload.orthobullets.com/cases/101753/b21b01e9-6755-4274-aa02-4a922b73eee1_screen_shot_2021-04-30_at_11.31.48_am.jpg
VIDEOS & PODCASTS (3)
EVIDENCE (17)
EXPERT COMMENTS