2023 Specialty Day Access Pass-Case Discussions

Video Transcription

Video Summary

The discussion centers on two challenging rotator cuff cases. The first is a 49-year-old female animal control officer with a massive, chronic rotator cuff tear complicated by work injury and delayed treatment. The panel debates imaging, repair strategies, grafting options, and the use of biologic augmentation versus superior capsular reconstruction (SCR). Despite limited tissue, they favor repair with human dermal allograft and adjunctive biceps tendon use, leading to successful return to work. The second case involves a 74-year-old male with a traumatic tear refusing initial surgery due to COVID fears. At later presentation, he shows a large irreparable tear with good residual muscle. Experts discuss repair attempts, augmentation, tuberoplasty, reverse shoulder arthroplasty, and subacromial balloon spacing. They favor balloon placement post-repair to relieve pain and preserve function, highlighting its minimal invasiveness and better outcomes compared to revision surgeries. Overall, treatment decisions hinge on patient age, tissue quality, and functional demands, aiming to balance joint preservation with symptom relief.

Asset Caption

Moderator: Mark H. Getelman, M.D., FAANA
Panel: Louis F. McIntyre, M.D., FAANA, Patrick J. Denard, M.D., FAANA, Joseph A. Abboud, M.D., Michael H. Amini, M.D.

Keywords

rotator cuff tear

biologic augmentation

superior capsular reconstruction

human dermal allograft

reverse shoulder arthroplasty

subacromial balloon spacing