AANA24 Foot & Ankle All-Access Pass-GENERAL SCIENTIFIC SESSION: Rotator Cuff 2 and AANA Legacy Session (Main Stage):

Video Transcription

Video Summary

The General Scientific Session on Rotator Cuff repairs featured a dynamic, fast-paced debate among leading orthopedic surgeons discussing treatment options for a 52-year-old patient with a massive rotator cuff tear. The panel explored various interventions, including rotator cuff repair augmented with dermal allograft superior capsule reconstruction (SCR), lower trapezius tendon transfer, subacromial balloon spacers, and reverse total shoulder arthroplasty (RSA).<br /><br />Rob Hartzler advocated for rotator cuff repair augmented with dermal allograft SCR, emphasizing its efficacy especially in younger patients with repairable tears and its advantage in preserving native anatomy with promising midterm outcomes despite some structural deterioration. Eric Wagner supported the lower trapezius tendon transfer, highlighting its biomechanical rationale and functional restoration, especially in irreparable tears with muscle deficiency.<br /><br />Joe Abood presented the subacromial balloon spacer as a minimally invasive rehab facilitator with pain relief and functional improvements, suitable for select patients. Conversely, Evan Letterman argued for reverse total shoulder arthroplasty as a reliable, durable solution, particularly for older patients or those with irreparable tears, while acknowledging risks and the potential complexity of revision surgeries.<br /><br />The session underscored that no single treatment suits all patients; decision-making should be individualized considering patient age, tear reparability, functional goals, and risk tolerance. Key adjuncts like biologic augmentation (e.g., biceps anterior cable reconstruction) and tuberoplasty were also discussed for their roles in pain and functional improvement.<br /><br />Subsequent talks focused on inclusivity in orthopedics through programs like FutureScope, which mentor underrepresented medical students, and the importance of legacy, mentorship, and collaboration in the field. The presidential address by Dr. J.T. Tokish drew parallels between military discipline, leadership, and orthopedic practice, emphasizing teamwork, continuous learning, mentorship, and wellbeing.<br /><br />Overall, the session highlighted the evolving, nuanced approach to massive rotator cuff tears, the critical role of tailored patient care, and the broader importance of fostering diversity, mentorship, and resilience within the orthopedic community.

Asset Caption

Introduction by Moderators: Paul A. Sethi, M.D., Albert Lin, M.D.

Keywords

rotator cuff repair

dermal allograft

superior capsule reconstruction

lower trapezius tendon transfer

subacromial balloon spacer

reverse total shoulder arthroplasty

massive rotator cuff tear

orthopedic surgery debate

biologic augmentation

biceps anterior cable reconstruction

tuberoplasty

patient-specific treatment

FutureScope mentorship

orthopedic diversity

teamwork and leadership