2021 AANA/ASES Specialty Session-Panel Cases

Video Transcription

Video Summary

The discussion centers on complex shoulder cases involving rotator cuff tears and arthritis, with expert panelists debating treatment options. An 85-year-old with progressive pain and moderate fatty infiltration might benefit from reverse shoulder arthroplasty for faster recovery, as other procedures require lengthy immobilization. Another 63-year-old with both arthritis and cuff tear had a subscapularis repair and tendon transfer, but eventually progressed to arthroplasty due to failure and arthritis progression. A 43-year-old laborer with irreparable infraspinatus tear but no arthritis underwent latissimus dorsi tendon transfer, favored for its mechanical advantage and functional restoration. Treatment decisions hinge on patient age, activity level, arthritis severity (e.g., Hamada classification), muscle quality, and patient goals (pain relief vs. functional recovery). Nonoperative methods often precede surgery; injections may help isolate pain sources. The experts emphasize individualized approaches, balancing surgical complexity, rehab time, and expected outcomes to optimize return to activity, including sports like tennis.

Asset Caption

Moderators: Julie Y. Bishop, M.D., Michael H. Amini, M.D.
Provocateur: Brian T. Feeley, M.D.
Panelists: Mark H. Getelman, M.D., John M. Tokish, M.D., Nikhil N. Verma, M.D., Bassem ElHassan, M.D., James D. Kelly II, M.D., Vani Sabesan, M.D.

Keywords

rotator cuff tears

reverse shoulder arthroplasty

tendon transfer

shoulder arthritis

shoulder surgery rehabilitation