AANA25 Shoulder Access Pass-CONCURRENT SESSION 2H: AANA and Latin America

Video Transcription

Video Summary

The session covered multiple topics related to knee and shoulder orthopedics, focusing on surgical techniques and indications with a Latin American perspective. <br /><br />Dr. Jesús Ignacio Cardona discussed the consensus on lateral extraarticular tenodesis (LET) alongside ACL reconstruction. The procedure helps reduce rotational instability and graft failure, particularly in patients under 25 involved in pivoting sports, hyperlax patients, or those with significant rotatory instability. The technique involves graft fixation near the lateral epicondyle and careful avoidance of tunnel convergence with ACL tunnels. Not all patients require LET; indications depend on age, activity, and instability severity.<br /><br />Francisco Figueroa echoed expanding indications for LET in patients younger than 40, those returning to contact pivot sports, meniscal repair cases, and high BMI patients. Evidence shows decreased graft failure and meniscal suture failure rates with LET. Downsides include longer muscular recovery and uncertain long-term impact.<br /><br />Dr. Cesario Treva focused on revision ACL reconstruction, emphasizing thorough imaging (X-rays, CT, MRI) to assess tunnel position and plan single or two-stage revisions. Single-stage is preferred unless tunnels are widened or complex. Bone grafting and proper hardware removal are important in staged procedures. Revision has higher failure and lower return-to-play rates than primary ACL surgery.<br /><br />Diego highlighted complex meniscus tear repair, stressing meniscus preservation to avoid osteoarthritis. He advocated repair techniques augmented by biologics like PRP and intrameniscal injections to enhance healing, especially in challenging tears (root, radial, horizontal).<br /><br />Fernando Hernández-Pérez covered meniscus root and ramp lesions, recommending repair due to their biomechanical importance and high prevalence with ACL injuries.<br /><br />Cesar Guillermo Vietovich presented on trochlear dysplasia management for patellar instability, describing classifications and surgical options including MPFL reconstruction combined with trochleoplasty tailored by patient age and cartilage status.<br /><br />Pablo Conejo discussed indications for total knee arthroplasty beyond end-stage osteoarthritis, including post-traumatic cases and neuromuscular disorders, emphasizing patient factors and surgical planning.<br /><br />Alfonso Ricardo Barnechea described a low-cost arthroscopic AC joint reconstruction technique effective in acute cases using nylon sutures and standard portals.<br /><br />Cristian Lozano examined orthobiologics in rotator cuff repair, highlighting mixed evidence for PRP and cellular therapies in improving tendon healing, with promising but limited long-term data.<br /><br />The panel concluded with Q&A on surgical nuances, preferences for LET over ALL, and revision strategies, reflecting evolving practices to improve stability, healing, and patient outcomes in sports-related knee and shoulder injuries.

Asset Caption

Moderators: Diego Perez Salazar Marina, M.D., FAANA, Fernando Hernandez-Perez, M.D., FAANA
Jesus Ignacio Cardona-Medina, M.D. | Francisco Figueroa, M.D. | Cesareo T. Vasavilbaso, M.D. | Cesar Guillermo Zvietcovich Cornejo, M.D. | Pablo Cornejo, M.D. | Alfonso R. Barnechea, M.D. | Christian M. Lozano, M.D., M.B.A.

Keywords

knee orthopedics

shoulder orthopedics

lateral extraarticular tenodesis

ACL reconstruction

meniscus repair

trochlear dysplasia

patellar instability

total knee arthroplasty

arthroscopic AC joint reconstruction

orthobiologics

rotator cuff repair