2025 AANA/ASES Specialty Day All-Access Pass-AANA/ASES Session I: Instability

Video Transcription

Video Summary

The session opens a combined Specialty Day meeting between the Arthroscopy Association of North America (AANA) and the American Shoulder and Elbow Surgeons (ASES), featuring audience participation via smartphone voting. The main program begins with a debate on managing a 20-year-old contact athlete with 15% glenoid bone loss.<br /><br />J.T. Tokish advocates an arthroscopic bone block using suture-button/cerclage fixation, emphasizing that even “subcritical” bone loss (>~13.5%) should be addressed and arguing bone grafting can be safer and graft-agnostic while avoiding screw complications. Michael Amini defends the open Latarjet as reliable for young collision athletes but stresses its complication risks and key technical steps to improve safety, including proper subscap split, capsulotomy extension, and nerve-protection strategies. Patrick Denard promotes Bankart plus remplissage “almost every time,” citing biomechanical restraint of anterior translation, acceptable recurrence rates, low complication rates, and minimal external rotation loss across large reviews.<br /><br />Q&A covers fresh vs frozen distal tibia allograft, fixation method debates (screws vs buttons/cerclage), remplissage technique for varied Hill-Sachs morphology, and emerging procedures like the DAS.<br /><br />Case discussions include a 65-year-old active woman with recurrent instability treated successfully with a bone-block procedure, and a 22-year-old with pan-labral injury, subluxations, and bony defects managed arthroscopically with extensive labral repair, remplissage, and biceps tenodesis, with early good results.

Asset Caption

Moderators: Jeanne C. Patzkowski, M.D., FAANA, Brian R. Waterman, M.D., FAANA
Faculty: John M. Tokish, M.D., FAANA, Michael H. Amini, M.D., Patrick J. Denard, M.D., FAANA, Albert Lin, M.D.

Keywords

AANA ASES Specialty Day

shoulder instability

glenoid bone loss subcritical threshold

arthroscopic bone block distal tibia allograft

open Latarjet procedure

Bankart repair with remplissage

Hill-Sachs lesion management

suture-button cerclage fixation vs screws

pan-labral repair and biceps tenodesis