AANA25 Knee Access Pass-CLOSING SESSION: The Aging Athlete

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Video Summary

The session focused on managing joint health in aging athletes, emphasizing biologic treatments, arthroscopic techniques, and surgical decision-making for knees, shoulders, hips, and ACL injuries. Dr. Jason Dragoo discussed biologic injections like platelet-rich plasma (PRP), hyaluronic acid (HA), and micronized fat tissue for osteoarthritis, highlighting that higher molecular weight HA and concentrated PRP show better efficacy. Combining PRP with HA offers prolonged benefits, and adipose-derived therapies may surpass these. Emerging treatments include cultured stromal (stem) cells, showing promise in disease modification.<br /><br />Dr. Don Buford reinforced the importance of precise, ultrasound-guided biologic injections in knees and shoulders to maximize treatment accuracy and efficacy, demonstrating advanced techniques and sharing favorable long-term outcomes, particularly with bone marrow concentrate.<br /><br />Dr. Alexander Golent explored when to opt for arthroscopic surgery versus joint replacement in degenerative knees, emphasizing patient age, activity level, severity, and joint condition. Arthroplasty suits older, less active patients with extensive arthritis, while joint preservation suits motivated patients with localized damage. Surgery should be individualized based on patient goals and joint pathology.<br /><br />Dr. JT Tokish presented a shoulder algorithm differentiating treatment for massive rotator cuff tears: reverse shoulder replacement for older or arthritic patients; conservative or surgical options for functional individuals; and superior capsular reconstruction or lower trap transfer based on muscle viability in younger, non-functional patients.<br /><br />Dr. Joseph Rusbarski addressed hip preservation, indicating joint space narrowing and cartilage damage predict poor arthroscopic outcomes. Careful patient selection is critical; arthroplasty can restore function even in athletic patients.<br /><br />In a debate, Kevin Plancher supported meniscal root debridement in older adults, while Kevin Bonner urged repair to improve knee survivorship and slow arthritis progression.<br /><br />Regarding ACL tears in older athletes, Dr. Kevin Farmer advocated non-operative management initially, reserving surgery for patients with instability or high activity demands. Dr. Jarrett Woodmass argued for reconstruction regardless of age, highlighting improved function and safety with appropriate techniques and fixation.<br /><br />Overall, treatment of aging athletes requires individualized decision-making balancing biologic therapies, precise interventions, and surgical options aligned with patient activity, joint condition, and expectations.

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Keywords

aging athletes

joint health management

biologic treatments

arthroscopic surgery

knee injuries

shoulder injuries

hip preservation

ACL injury management

platelet-rich plasma

hyaluronic acid therapy

surgical decision-making