AANA24 Shoulder All-Access Pass-CONCURRENT SCIENTIFIC SESSION 1A: Shoulder Rotator Cuff

Video Transcription

Video Summary

The knee joint preservation session featured expert discussions on meniscal and cartilage injuries, repair techniques, and biologic treatments. Dr. Henry Burke emphasized the importance of meniscus ramp lesion repairs alongside ACL reconstruction to improve knee stability, detailing all-inside suture techniques and rehabilitation. Dr. Mary Mulcahy compared inside-out versus all-inside repair for bucket handle meniscus tears, noting similar failure rates and outcomes, and highlighting the importance of anatomic reduction and biologic preparation. Dr. Lutul Farrow addressed horizontal cleavage tears, advocating for partial meniscectomy without resecting back to capsule and highlighting repair as a safe option in younger patients. Dr. David Flanagan championed repair of radial meniscus tears, citing biomechanical evidence of the detrimental impact of tears and meniscectomies on joint health and advocated for advanced suture techniques. Contrastingly, Simon Gertz argued for selective meniscectomy over repair in many cases, citing high failure rates and lack of long-term healing evidence. Dr. Brian Cole presented a nuanced approach to cartilage repair, emphasizing skillful decision-making based on patient factors and joint biomechanics. Bert Mandelbaum detailed the impact of bone marrow lesions on cartilage and advocated early intervention using core decompression and biologics like BMAC. Dr. Don Buford reviewed biologic injections (PRP, microfat, bone marrow concentrate), concluding they can reduce symptoms and slow arthritis but do not regenerate hyaline cartilage. Dr. Jaishan Dragoo advocated treating incidental chondral defects during ACL reconstruction to prevent progression, while Dr. Armando Vidal urged caution, arguing many acute lesions may heal without intervention and treatment can complicate outcomes. Lastly, Dr. Aaron Critch presented meniscal root repair with centralization techniques to address meniscus extrusion, showing improved biomechanics and patient outcomes. Overall, the session highlighted evolving strategies balancing repair, resection, and biologic augmentation to preserve knee joint function.

Asset Caption

Moderators: Michael H. Amini, M.D., Ashley Bassett, M.D.

Keywords

knee joint preservation

meniscal injuries

cartilage repair

ACL reconstruction

meniscus ramp lesion

all-inside suture technique

meniscectomy

biologic treatments

bone marrow lesions

meniscal root repair