AANA25 Shoulder Access Pass-CONCURRENT SESSION 1B: Shoulder Papers

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Video Summary

The Concurrence Session 1B focused on shoulder instability and rotator cuff repair, featuring expert presentations on surgical techniques, outcomes, and innovations. Scott Feeley discussed graft resorption patterns after the Latarjet procedure, highlighting paradoxical findings that critical glenoid bone loss was associated with less superior graft resorption, challenging Wolff's Law, and noted that inferior screw resorption correlated with failure and need for revision. Ivan Wong followed, comparing anatomical versus supersized distal tibial allograft reconstructions, demonstrating that graft remodeling occurs regardless of initial graft size, with anatomical sizing reducing hardware complications.<br /><br />Feeley also examined the relationship between postoperative distance to dislocation (DTD) and recurrent instability after Latarjet, finding a high recurrent instability rate with DTD under 8.5mm linked to recurrence, suggesting that adjunct procedures like remplissage might be beneficial. Dr. Satanovich presented on shoulder instability in seizure patients, showing significantly higher failure rates for arthroscopic soft tissue repairs compared to bone augmentation, emphasizing the need for tailored approaches in this cohort.<br /><br />Dr. William Sukoning highlighted the benefits of arthroscopic bone block techniques for shoulder instability, citing improved visualization, safer graft placement, and preserved subscapularis integrity. In a related presentation, Julian Carpishon reported on a randomized trial comparing bridging reconstruction versus superior capsular reconstruction (SCR) for massive rotator cuff tears, finding both effective but bridging showed trends toward better functional outcomes and strength preservation.<br /><br />Additional talks covered the validation of the Rotator Cuff Healing Index (ROHI), long-term outcomes of subacromial spacer use for irreparable cuff tears showing sustained functional improvement despite radiographic deterioration, and a retrospective study showing perioperative IV dexamethasone reduced opioid use after rotator cuff repair. ANNA President Alan Curtis discussed using in situ biceps tenodesis combined with partial repair and subacromial balloon spacers to treat massive cuff tears, aiming to prevent subacromial scarring and improve repair protection. Overall, the session emphasized evolving surgical strategies, tailored patient management, and multidisciplinary approaches to optimize shoulder instability and rotator cuff repair outcomes.

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Keywords

shoulder instability

rotator cuff repair

Latarjet procedure

graft resorption

glenoid bone loss

distal tibial allograft

remplissage procedure

seizure patients

arthroscopic bone block

bridging reconstruction

superior capsular reconstruction

Rotator Cuff Healing Index