AANA24 Shoulder All-Access Pass-GENERAL SCIENTIFIC SESSION: Rotator Cuff I (Main Stage)

Video Transcription

Video Summary

The General Scientific Session on Rotator Cuff repair featured debates and presentations by experts discussing advanced repair techniques, biologic augmentation, and innovations in treatment.<br /><br />Dr. Mark Gettleman advocated for the single-row repair technique, specifically the SCOE row method using triple-loaded anchors placed near the articular cartilage margin with multiple suture passes and tuberosity microfracture to optimize healing. He emphasized that this approach yields a high healing rate (92% by MRI) with lower failure rates and is cost-effective compared to double-row repairs which have higher retear rates and increased expense.<br /><br />In contrast, Dr. Sarah Edwards supported the double-row technique, highlighting its biomechanical superiority, full footprint coverage, and better functional outcomes especially for large tears. She acknowledged its higher cost and complications but stressed individualized repair strategies combining margin convergence and patches when needed.<br /><br />Dr. Sal discussed acromioplasty in rotator cuff repair, noting its frequent use despite studies showing little clinical benefit, justified mainly by improved surgical access, potential reduced reoperation, and favorable reimbursement.<br /><br />Dr. Larry provided insights on managing subscapularis and anterior superior tears, focusing on the importance of identifying and incorporating comet tissue for improved repair strength and visualization, advocating a combined intra- and extra-articular approach.<br /><br />Several speakers tackled biologic augmentation to improve healing. Dr. Mazzocca reviewed PRP, bone marrow, adipose, and bursal tissue as progenitor cell sources, emphasizing variability and promising early results with biologics, especially bursa-derived cells. Dr. J.T. Tokish presented the "biceps smash" autograft technique using the patient's own biceps tendon as a cost-effective augmentation that preserves viable tenocytes and shows promising incorporation and tendon thickening on MRI.<br /><br />Dr. Len Seely discussed acellular dermal grafts for augmentation in massive tears, providing second-look evidence of graft vascularization, good clinical outcomes, and low inflammatory reaction.<br /><br />Dr. Buddy Savoie reviewed bioinductive collagen implants that stimulate tendon-like tissue formation, showing a 3x reduction in retear risk and superior tendon quality in medium-large tears with low complications.<br /><br />Dr. Steve Prada described various biologic scaffold options, demonstrating a biocomposite scaffold combining PLLA and collagen that provides initial strength and biology with encouraging early clinical success and an overall 8% retear rate in challenging tears.<br /><br />Overall, the session underscored the ongoing evolution in rotator cuff repair emphasizing tailored mechanical techniques combined with biologic augmentation to enhance healing, reduce failures, and improve patient outcomes while considering cost-effectiveness and practical surgical strategies.

Asset Caption

Moderators: Sara L. Edwards, M.D., Augustus D. Mazzocca, M.D., FAANA

Keywords

Rotator cuff repair

Single-row repair technique

Double-row repair technique

Biologic augmentation

Acromioplasty

Subscapularis tears

PRP therapy

Biceps smash autograft

Acellular dermal grafts

Bioinductive collagen implants