AANA25 Knee Access Pass-GENERAL SESSION: Debate Your Mentor (Main Stage)

Video Transcription

Video Summary

This session, moderated by Dr. John D. Kelley, featured lively debates between mentors and mentees on cutting-edge orthopedic treatments, focusing on cartilage repair, rotator cuff tears, shoulder instability, and graft options for ACL reconstruction.<br /><br />Dr. Brian Wooderman and Dr. Brian Cole debated treatments for a 24-year-old athlete with a medial femoral chondral lesion. They discussed osteochondral allograft (OCA) versus matrix-induced autologous chondrocyte implantation (MACI). Both agreed that OCA and MACI offer durable, hyaline-like cartilage repair, but OCA may have advantages in treating osteochondral defects due to its ability to replace bone and cartilage simultaneously, superior long-term survivorship, and quicker weight-bearing protocols. MACI, evolving with arthroscopic techniques, remains a viable option for surface lesions.<br /><br />In another debate, Dr. Buddy Savoy and Dr. Lee Murphy discussed management of massive rotator cuff tears in athletic patients. Savoy emphasized extensive releases, biological preservation, and minimal anchors for repair simplicity, achieving high healing rates. Murphy presented dynamic anterior cable augmentation using biceps tendon transposition, offering vascularized, mechanical benefits with minimal extra cost. Early studies suggest this method improves humeral kinematics and healing outcomes.<br /><br />Drs. John Tokish and Travis Decker debated bone graft options for shoulder instability in collision athletes, comparing distal tibia allograft (DTA) and latarjet procedures. Tokish favored DTA for structural bone restoration and graft availability, while Decker supported latarjet for its proven stability, return-to-sport data, and multiple stabilizing effects despite known complications. Both acknowledged the evolving evidence and the importance of surgeon expertise.<br /><br />Finally, Nick and Kevin Bonner debated ACL graft choices, contrasting quadriceps tendon versus bone-patellar tendon-bone (BTB) grafts. Nick advocated for quadriceps tendon citing lower harvest morbidity, size, and emerging literature, while Bonner favored BTB for established longevity, lower failure rates, especially in elite athletes, and rehab advantages supported by registry data.<br /><br />The session showcased the dynamic exchange of ideas, experience, and emerging evidence shaping orthopedic practice, underscoring the importance of tailored approaches balancing biological, mechanical, and patient-specific factors.

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Keywords

orthopedic treatments

cartilage repair

osteochondral allograft

MACI

rotator cuff tears

shoulder instability

ACL reconstruction

bone graft options

quadriceps tendon graft

bone-patellar tendon-bone graft