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World-class Expertise in Shoulder Replacement

Dr. Parsons interest in the shoulder started early during his orthopedic training when he spent an additional year in the laboratory studying shoulder biomechanics. During this time, he won the prestigious Charles Neer Award from the American Shoulder and Elbow Surgeons for excellence in clinical research. He went on to complete two shoulder fellowships where he trained under the mentorship of Frederick A. Matsen who pioneered the Ream and Run procedure. Upon starting practice, Dr. Parsons was the first surgeon in New Hampshire to perform a reverse shoulder replacement and over 2 decades has performed close to 1500 shoulder replacements.

His commitment to excellence in this procedure has fostered several consulting relationships with implant companies around prosthesis design and surgical navigation. He has authored or co-authored over 40 peer-reviewed scientific articles, 10 reviews articles and 12 book chapters on this topic. He is a member of the American Shoulder and Elbow Surgeons and a founding member of the New England Shoulder and Elbow Surgeons and he has lectured both nationally and internationally on shoulder replacement often serving as faculty at courses to mentor other surgeons learning of perfecting this procedure.

  • American Shoulder And Elbow Surgeons
  • New England Shoulder and Elbow Society

There are three types of shoulder replacement, each with its own indications, pros and cons. These include anatomic shoulder replacement, reverse shoulder replacement and the ream and run procedure. All of these procedures have a similar surgical approach and recovery but different indications. Dr. Parsons will discuss the various options with you based on your diagnosis, severity of arthritis and other considerations such as desired activity level or history of prior shoulder surgery.

Anatomic Shoulder Replacement

Anatomic Shoulder Replacement

This is a standard total shoulder replacement where the shoulder socket is resurfaced with plastic socket implant and the humeral head is resurfaced with a metal ball. This is generally indicated for people with bone-on-bone shoulder arthritis and an intact rotator cuff without severe degenerative joint destruction. By resurfacing both sides of the joint, anatomic shoulder replacement can result in substantial gains in comfort and function. There are many different implant designs on the market including standard length or shot stems or stemless implants. Each of these has a good track record with no substantial difference in speed of recovery, outcomes, durability or complications. Dr. Parsons will select the implant that is best suited to each patient’s anatomy, bone quality and other clinical features.

Reverse Shoulder Replacement

Reverse Shoulder Replacement

As the name implies, this procedure reverses the orientation between the ball and socket as shown in the picture. This has the effect of creating a more stable configuration and giving the deltoid muscle more leverage. The reverse shoulder replacement is classically indicated for patients with arthritis in combination with a rotator cuff tear, those with an irreparable cuff tear without arthritis, or those with failed prior rotator cuff tear that is not suitable for re-repair. It is also used in conventional osteoarthritis with an intact cuff in some older patients (>75 years), patients with severe bone erosion from advanced joint degeneration, failed prior shoulder replacements and certain severe shoulder fractures.

Pyrocarbon Ream and Run Procedure

Pyrocarbon Ream and Run

The Ream and Run is special type of partial shoulder replacement where the ball is resurfaced with an implant while the socket is shaped and smoothed to conform to the implant but no resurfaced. It is mainly indicated for younger patients and those who are very physically demanding both of whom may be at risk for eventual failure by loosening of the socket implant. Because the socket is not resurfaced, Ream and Run patients may engage in unrestricted strenuous activity once fully healed. This procedure tends to be an attractive option for people who do frequent and heavy weightlifting or strenuous labor or other activities. While the Ream and Run has the advantage of unrestricted activity, it has a longer recovery in terms of reaching maximal improvement (up to 2 years after surgery) and pain relief may not be as complete as with an anatomic shoulder replacement. For many patients, this is a fair trade-off to permit the strenuous activities they desire. Approximately 5-10% of patients may continue to have socket-sided pain and require a revision if severe enough.

Practice Information

Moby Parsons, M.D.

333 Borthwick Avenue
Suite 301
Portsmouth, NH 03801

Hours: Monday To Friday, 7:30am – 4:30pm

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