AANA24 Wrist & Elbow All-Access Pass-CONCURRENT SCIENTIFIC SESSION 4C: Wrist/Elbow Innovations

Video Transcription

Video Summary

This session focused on debates and advances in hand and wrist arthroscopy, with expert discussions on lateral epicondylitis, distal biceps repair, and wrist arthroscopy for fractures.<br /><br />Regarding lateral epicondylitis, Dr. Hassebrock advocated for arthroscopic treatment, highlighting its ability to address complex pathology like ECRB tendinosis, subtle instability, plica, and synovitis inside the joint. He cited multiple studies showing arthroscopy yields outcomes comparable or superior to open surgery despite a modest increase in operative time. Conversely, Dr. Fernandez defended open surgery, emphasizing that current evidence does not show clinically meaningful superiority of arthroscopy, noting similar complication and reoperation rates and pointing to cost and complexity as downsides.<br /><br />In distal biceps repair, Lathe advocated for onlay suture anchor fixation, citing biomechanical equivalence to inlay fixation and potential lower risk to the posterior interosseous nerve (PIN). Fernandez defended inlay fixation with endobutton and screws, emphasizing superior biomechanical strength, less gapping, and clinical outcomes, especially in regard to restoring anatomic footprint.<br /><br />Wrist arthroscopy discussions included its utility in intraarticular distal radius fractures to assess reduction and detect soft tissue injuries, though long-term outcome benefits remain unclear. Advances in needle arthroscopy were highlighted, allowing minimally invasive diagnosis and treatment in diverse wrist and hand pathologies.<br /><br />The panel also discussed practical considerations, including incision choices in distal biceps repair, postoperative rehab approaches, and the nuanced role of biologics like PRP in lateral epicondylitis. Overall, the session underscored the importance of tailoring surgical technique to individual pathology, surgeon skill, and available evidence, while embracing arthroscopy's growing role in complex upper extremity cases.

Asset Caption

Introduction by Moderators: Noah D. Weiss, M.D., Sanjeev Kakar, M.D.

Keywords

hand arthroscopy

wrist arthroscopy

lateral epicondylitis

distal biceps repair

ECRB tendinosis

onlay suture anchor fixation

inlay fixation with endobutton

needle arthroscopy

PRP in lateral epicondylitis