Ream-and-Run Shoulder Arthroplasty

What is it?
The ream-and-run procedure is a type of shoulder replacement surgery designed to relieve pain while avoiding the use of a plastic socket (polyethylene glenoid). It is essentially a shoulder hemiarthroplasty: the ball of the upper arm bone is replaced with a metal implant, while the socket (glenoid) is not resurfaced with plastic. Instead, the surgeon carefully reshapes and smooths the socket with a process called concentric reaming, creating a stable surface that allows the new ball to move smoothly against the patient’s own bone.

Who is it best for?
This procedure is most often recommended for younger, active patients with shoulder arthritis who want to remain highly active after surgery. It has been popularized for people who participate in high-impact activities, heavy lifting, or vigorous sports, where a plastic socket might wear out or loosen more quickly. By avoiding polyethylene in the socket, the ream-and-run aims to reduce the risk of early loosening and make the replacement more durable for demanding lifestyles.

How is it different from standard shoulder replacement?
In a traditional anatomic shoulder arthroplasty, both the ball and the socket are resurfaced—the ball with metal and the socket with plastic. In the ream-and-run, only the ball is replaced; the socket is reshaped but left without an implant. This makes it especially suited for patients whose activity levels could put extra stress on a plastic socket.

What are the potential downsides?
Because the socket is left as bone instead of covered with plastic, recovery can be more demanding. The joint may feel stiff at first, and regaining motion requires a high level of commitment to stretching and rehabilitation. Patients who are unable to maintain the rigorous rehab program may have a higher risk of persistent stiffness. There is also a possibility of continued pain if the bone surface does not remodel as expected.

What is recovery like?
Recovery after a ream-and-run requires hard work and dedication. Patients typically use a sling for a short period, but aggressive stretching begins soon after surgery. The goal is to gradually restore full motion before focusing on strengthening. While most people are able to return to active lifestyles, it may take 6–12 months of consistent effort to achieve the best outcome. Those who commit to the process often report excellent pain relief and the ability to participate in activities that might not be recommended after a standard replacement.