Management of Glenoid Bone Loss in Shoulder Instability: Where We Are in 2023
Instr Course Lect. 2024;73:691-707.ABSTRACTThe management of glenoid bone loss in shoulder instability can be challenging. Although shoulder instability can often be managed with arthroscopic soft-tissue procedures alone, the extent of glenoid bone loss and bipolar bone defects may require bone augmentation procedures for restoration of stability. In this setting, patient evaluation, examination, treatment options, and surgical pearls are vital. Furthermore, a treatment algorithm is established to guide both indications and the technical application of procedures including Bankart repair with remplissage, Latarjet procedur...
Source: Instructional Course Lectures - December 13, 2023 Category: Orthopaedics Authors: Michael T Kody Jack Anavian Ronald A Navarro Evan S Lederman Phob Ganokroj Ryan J Whalen John M Apostolakos Capt Matthew T Provencher Source Type: research
Case-Based Understanding of the Role of the Scapula in Common Shoulder Pathologies
Instr Course Lect. 2024;73:709-724.ABSTRACTScapular dyskinesis is an extremely common component of shoulder pathology, especially in the overhead athlete; despite its prevalence, proper diagnosis and management of scapular disorders remains an enigma for many clinicians. An understanding of the contribution of the scapula to pathomechanics and clinical symptoms is necessary to optimize both surgical and nonsurgical treatment of shoulder disorders. Without correction of scapular dysfunction, even effective management of the pathoanatomy is unlikely to produce optimal results. It is important to examine the role of the scapu...
Source: Instructional Course Lectures - December 13, 2023 Category: Orthopaedics Authors: Austin V Stone Jeffrey Grantham Aaron Sciascia William B Kibler Source Type: research
Elbow Ulnar Collateral Ligament Tears in 2023: Evaluation and Management
Instr Course Lect. 2024;73:725-736.ABSTRACTThe ulnar collateral ligament, also called the medial collateral ligament of the elbow, is the primary stabilizer against valgus loads. This ligament can be traumatically torn, such as in an elbow dislocation, or can tear through attritional damage with overhead sports. Although baseball pitching is the most common contributor, these injuries also occur with volleyball, gymnastics, and javelin throwing. Patients most commonly report a history of medial elbow pain with associated loss of command, control, and throw velocity. The ulnar nerve lies directly superficial to the posterio...
Source: Instructional Course Lectures - December 13, 2023 Category: Orthopaedics Authors: Peter N Chalmers Eric Bowman Brandon J Erickson Matthew V Smith Christopher L Camp Michael T Freehill Source Type: research
Evaluation and Management of the Athlete's Hip
Instr Course Lect. 2024;73:737-748.ABSTRACTHip and groin pain is common in athletes, and there are many possible underlying pathologies. It is important to describe athletic hip pathology in the context of sport-specific physiologic loads and biomechanical demands. Three distinct types of athletes with this pathology are collision athletes, hypermobility athletes, and endurance athletes. Although there is considerable overlap between sports, athletes with hip pain should always be evaluated in the context of their sport. Understanding the effect of sport-specific biomechanical demands may help with both diagnosis and treat...
Source: Instructional Course Lectures - December 13, 2023 Category: Orthopaedics Authors: Caitlin A Orner Madison Sakheim Robert W Westermann Joshua D Harris Thomas H Wuerz Michael Banffy Source Type: research
Measure Twice, Cut Once: The Future of Digitally Planned Knee Osteotomies
Instr Course Lect. 2024;73:749-763.ABSTRACTIt is important to highlight the use of patient-specific cutting guides for knee joint osteotomies. Rationale, pitfalls, and planning of conventional osteotomy techniques are examined. The benefits of using patient-specific guides focusing on the potential for improved accuracy, efficiency, and safety are reviewed. The versatility of guides to manipulate the slope in both the coronal and sagittal planes, as well as its ability to accommodate concomitant procedures, is discussed. The time and cost differentials between standard cutting guides and three-dimensional-guided templating...
Source: Instructional Course Lectures - December 13, 2023 Category: Orthopaedics Authors: Michael Buldo-Licciardi Ariana Lott Ian Savage-Elliott Andreas H Gomoll Anil S Ranawat Michael J Alaia Laith M Jazrawi Source Type: research
How to Recognize, Correct, and Avoid Intraoperative Complications During Anterior Cruciate Ligament Reconstructions
Instr Course Lect. 2024;73:765-777.ABSTRACTTechnical complications are a leading cause of graft failure following anterior cruciate ligament reconstructions. Complications can occur during any phase of the procedure, from graft harvesting to tunnel preparation to graft fixation. Predicting potential causes of technical difficulty and developing strategies to avoid potential pitfalls can limit the number of intraoperative complications. If adverse events do occur intraoperatively, prompt recognition and treatment can lead to favorable outcomes. It is important to discuss strategies to understand potential complications and ...
Source: Instructional Course Lectures - December 13, 2023 Category: Orthopaedics Authors: Andrew Kim J Brett Goodloe Edgar Garcia-Lopez Jeffrey D Klott Kelly M Dopke Brian Feeley Mark D Miller Frederick M Azar Robert A Gallo Source Type: research
Meniscus Extrusion, Radial Tears, and Root Tears
Instr Course Lect. 2024;73:779-793.ABSTRACTManagement of meniscal radial and root tears and extrusion is complex and has changed significantly over recent years. It is important to provide a comprehensive overview of the management of radial and root tears and meniscal extrusion and be aware of the currently available evidence on repair techniques, rehabilitation, and outcomes following radial and root repairs.PMID:38090940 (Source: Instructional Course Lectures)
Source: Instructional Course Lectures - December 13, 2023 Category: Orthopaedics Authors: Garrett R Jackson Enzo S Mameri Lika Dzidzishvili Michael J Alaia Scott A Rodeo Jorge Chahla J Lee Pace Source Type: research
Treatment of Patellofemoral Instability and
Chondral Lesions
Instr Course Lect. 2024;73:795-811.ABSTRACTLateral patellar instability is one of the most common knee disorders among adolescents. Numerous anthropometric features, including trochlear dysplasia, patella alta, high tibial tubercle-to-trochlear groove distance, and coronal and rotational plane malalignment, are considered primary risk factors for patellar dislocation, and the understanding of their complex interplay is continuously evolving. Because of the multifactorial nature of patellar instability, there is a lack of consensus regarding many aspects of surgical intervention. Medial patellofemoral ligament reconstructio...
Source: Instructional Course Lectures - December 13, 2023 Category: Orthopaedics Authors: Sharif Garra Zachary I Li Thomas R Carter Abigail R Hamilton J Lee Pace Laith M Jazrawi Source Type: research
Axial Plane Deformity: How to Avoid It and How to Correct It
Instr Course Lect. 2024;73:815-830.ABSTRACTMalreductions in the axial plane (ie, length and rotation) are common when managing long bone fractures. Careful attention to detail during the initial treatment can prevent these malreductions. Various fluoroscopy-based techniques exist for the prevention of malrotation and limb-length discrepancy during surgery for fracture. If malreductions do occur, a systematic clinical and radiographic evaluation can provide the necessary information to correct rotational malreduction and limb-length discrepancy.PMID:38090942 (Source: Instructional Course Lectures)
Source: Instructional Course Lectures - December 13, 2023 Category: Orthopaedics Authors: Mary Kate Erdman Patrick Schottel Milton Little Geoffrey S Marecek Source Type: research
Reducing the Burden of Disease Associated With Periprosthetic Fractures: Prevention and the Need for Improved Perioperative Care
Instr Course Lect. 2024;73:831-841.ABSTRACTThe management of periprosthetic fractures remains challenging and controversial. There continues to be a significant burden of disease and substantial resource implications associated with fractures following total joint arthroplasty. Achieving consensus opinions regarding the prevention and treatment of this problem has important implications given the profound effect on patient outcomes. Multidisciplinary care in the preoperative and postoperative settings is critical, with a specific focus on bone health.PMID:38090943 (Source: Instructional Course Lectures)
Source: Instructional Course Lectures - December 13, 2023 Category: Orthopaedics Authors: Geoffrey W Schemitsch Adam Sassoon Aaron Nauth Emil H Schemitsch David Laniado Diana K Lee Andrew Schmidt Source Type: research
Fixation Strategies for Periprosthetic Fractures With Stable Implants
Instr Course Lect. 2024;73:843-860.ABSTRACTThe fixation of periprosthetic fractures remains challenging and controversial. It is important to achieve consensus opinions regarding the management of stable periprosthetic fractures with internal fixation. Key strategies to optimize surgical decision making and fixation and manage complications following these difficult injuries are addressed.PMID:38090944 (Source: Instructional Course Lectures)
Source: Instructional Course Lectures - December 13, 2023 Category: Orthopaedics Authors: Aaron Nauth Andrew Schmidt Geoffrey W Schemitsch Jhase Sniderman Jeremy Alan Hall Ryan D Stancil Adam Sassoon Emil H Schemitsch Source Type: research
The Role of Revision Total Joint Arthroplasty for Periprosthetic Fractures With Unstable Implants
Instr Course Lect. 2024;73:861-878.ABSTRACTThe management of periprosthetic fractures with unstable prosthetic implants is a challenging and commonly encountered problem. It is important to address the many current issues and controversies regarding the treatment of periprosthetic fractures with revision total joint arthroplasty. Key strategies to optimize surgical decision making around the use of arthroplasty and management of complications following these complex injuries will be addressed.PMID:38090945 (Source: Instructional Course Lectures)
Source: Instructional Course Lectures - December 13, 2023 Category: Orthopaedics Authors: Adam Sassoon Andrew Schmidt Aaron Nauth Geoffrey W Schemitsch Rafi Husain Jeremy Alan Hall Emil H Schemitsch Source Type: research
Tibial Plateau Fractures: Addressing Commonly Encountered Challenges in Reduction and Fixation
Instr Course Lect. 2024;73:879-900.ABSTRACTTibial plateau fractures encompass a broad array of injuries. The mechanism of injury ranges from low to high energy. Devastating complications and associated injuries can occur in both low-energy and high-energy mechanisms; therefore, a careful and detailed physical examination and review of imaging must be performed. Furthermore, a mechanistic approach to fracture classification and morphology enhances the surgeon's understanding of the injury and the ability to predict associated injuries and develop effective strategies for management.PMID:38090946 (Source: Instructional Course Lectures)
Source: Instructional Course Lectures - December 13, 2023 Category: Orthopaedics Authors: John Morellato Matthew Graves Allan Liew Matthew Hogue Christopher K Folau Source Type: research
Limb Rotation in Lower Extremity Fractures
Instr Course Lect. 2024;73:901-918.ABSTRACTFractures of the tibia and femur are common. Rotation of the limb can affect the outcome of the injury, both in the immediate term and the long term. Because plain radiographs are two dimensional, rotation is hard to assess radiographically. As a result, rotational malalignment is common. It is important to provide technical tips on the assessment of rotation preoperatively, intraoperatively, and postoperatively. The goal is to better assess rotation so that deformity can be minimized. This applies to fractures of the tibia and femur. Even after careful treatment, rotational defor...
Source: Instructional Course Lectures - December 13, 2023 Category: Orthopaedics Authors: Michael Blankstein Patrick Schottel Mark Brinker James Krieg Source Type: research
Current Trends in Orthopaedics and Trauma in
Germany
Instr Course Lect. 2024;73:919-928.ABSTRACTDuring the Guest Nation Symposium (cobranded with the Deutsche Gesellschaft für Orthopädie und Unfallchirurgie, Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie, and Deutsche Gesellschaft für Unfallchirurgie) at the 2023 American Academy of Orthopaedic Surgeons Congress in Las Vegas, the goal was to compile nationally important content from German orthopaedics and trauma surgery. This resulted in a mix of content on the latest developments in trauma care, knee arthroplasty, spinopelvic importance for hip arthroplasty, stemless shoulder endoprostheses, joint p...
Source: Instructional Course Lectures - December 13, 2023 Category: Orthopaedics Authors: Maximilian Rudert Steffen Ruchholtz Bertil Bouillon Andreas Halder Matthias Pumberger Markus Scheibel Christina Stukenborg-Colsman Matthias M ünzberg Benedikt Friemert Source Type: research
