In 1991, Jim Rockstad was in a head-on car crash, and without airbags to protect him, he suffered whiplash and bulging discs in his neck. Soon after, he noticed he was losing the range of motion in his right arm. He couldn’t throw a baseball without pain shooting through his shoulder and arm.
“I still played racquetball – my passion – but it was harder to do as my range of motion was going away,” said Rockstad, who has played racquetball since 1974. He packed on the ice, swallowed Advil and kept exercising so he could continue racquetball. But his game was slowly going away.
In 2004, he saw a University of Washington TV special on shoulder replacement featuring surgeon Dr. Rick Matsen, then-chairman of UW Medicine Orthopaedics and Sports Medicine. Rockstad, who lives in Issaquah, Washington, near Seattle, immediately made an appointment at UW Medical Center.
Matsen evaluated Rockstad and told him when the pain became too great, he should come back for surgery. Rockstad knew it was simply a matter of time.
“In early July of 2005, I was painting a room and my shoulder would ‘clunk’ with each stroke of the brush. And I knew it was bone-to-bone,” Rockstad said.
Matsen performed the shoulder replacement surgery in late July 2005 when Rockstad was 62 years old.
“I requested a replacement that would keep me in the game and not wear out. I wanted to get more range of motion so that I could do the backhand swing again,” Rockstad said.
The surgery is called a humeral hemiarthroplasty with non-prosthetic glenoid arthroplasty, also known as a “ream and run.”
“This is a technique for helping active patients with shoulder arthritis continue to use their arms without the restrictions that we would impose on patients after a total shoulder replacement,” said Matsen’s new partner, Dr. Winston J. Warme, who recently retired from a career as an academic orthopaedic surgeon in the U.S. Army to join the UW Department of Orthopaedics and Sports Medicine.
The weak point of total shoulder replacements is that the plastic socket (glenoid) is prone to loosening, so recommended activity after surgery would preclude weight lifting, chopping wood or repetitive exercises that load the shoulder like push-ups or pull-ups, Warme said.
“Instead of putting in a piece of plastic that can become loose and a source of pain, we smooth out (ream) the surface to prevent catching and grinding of the joint after surgery,” he said. “We believe that some scar cartilage (fibrocartilage) forms.”
This procedure works for patients who have arthritis that restricts the normal function of their shoulder, but would like to continue in their active lifestyles, Warme said.
“We have had success in getting water skiers, weightlifters, racquetball players, loggers and others back to their activities,” he said.
Surgeons replace the humeral head, (ball), of the joint with a smooth metal prosthesis, and allow the body to heal up the socket which is made slightly larger than the ball part. The surgery takes about 90 minutes and most patients stay in the hospital for three days.
“It is critical for patients to get motion back after the surgery and to work hard to maintain it,” Warme said. “It is a more difficult recovery than with a total shoulder replacement as there is more discomfort for the first three to six months or so.”
But for Rockstad, the surgery and recovery were worth the discomfort. Three months after surgery, he began hitting a racquetball ball lightly for a short time twice a week, followed by an ice pack. Just a few months later in January 2006, Rockstad returned to playing racquetball and using light weights to strengthen his shoulder and arm.
He now plays three times a week, at least two hours each time. Rockstad played 16 games over three days in March 2007 at the National Masters Racquetball Association event in Portland. By summer 2008, Rockstad had won a bronze medal in the 65-plus singles division of the Washington State Senior Games.
“Most players who hear about my replacement can not believe it,” Rockstad said. “I hit the ball harder now that I ever did, and the range of motion is wonderful. I work out with weights every week so as to keep the strength up in my upper body to help with my game.”
Rockstad can’t imagine where he would be without his shoulder replacement, and he’s looking forward to playing another 10 to 20 years.
At age 66, “I see no reason why I can not play for many, many years more which is really exciting to me. Without a doubt, this replacement is the best thing I have ever done for my health as it allows me to continue to work out in the later years.”
Learn more about the
ream and run procedure.
Photo submitted.