AANA25 Wrist & Elbow Access Pass-CONCURRENT SESSION 4C: Throwing Shoulder and Elbow

Video Transcription

Video Summary

The lecture series, led by experts including John D. A. Kelly IV, Ben Kibler, Dr. Funakoshi, Kevin Wilk, and Jeff Grantham, focused on complex shoulder and elbow injuries in overhead throwing athletes, emphasizing surgical innovations and risk management.<br /><br />Ben Kibler introduced the concept of the "Sicily lesion," a more comprehensive understanding of labral injuries beyond the traditional SLAP tear. He highlighted that posterior labral tears, especially those extending inferiorly beyond the 10-30 o'clock position, are more biomechanically significant than isolated superior labral (SLAP) tears. Internal impingement and altered shoulder mechanics cause these injuries. Kibler stressed restoring the native anatomy with a “Goldilocks” approach—neither over-constraining nor under-repairing the labrum, preserving biceps function, and repairing the “rip stop” area to stabilize the shoulder.<br /><br />Dr. Funakoshi presented a novel anterior glenohumeral capsular ligament reconstruction using hamstring grafts for overhead athletes with anterior instability, notable for maintaining balance between stability and laxity and enabling aggressive rehabilitation. Outcomes showed high return-to-play rates in throwing athletes.<br /><br />Kevin Wilk addressed risk factors for elbow and shoulder injuries in throwers, such as high pitching velocity, specialization, mechanics, and use of weighted balls and long toss. He advocated for comprehensive rehab focusing on the kinetic chain, range of motion, and avoidance of overuse.<br /><br />Jeff Grantham reviewed the role of internal brace repair versus reconstruction for ulnar collateral ligament (UCL) injuries, highlighting faster return to play and lower revision rates with internal brace in suitable partial or avulsion tears.<br /><br />The faculty emphasized individualized diagnosis beyond imaging, respecting normal anatomical variations, carefully managing repairs to avoid over-tightening or unnecessary debridement, and the importance of integrated rehabilitation to optimize outcomes in throwing athletes.

Asset Caption

Moderator: John D. Kelly IV, M.D., FAANA
William B. Kibler, M.D. | Tadanao Funakoshi, M.D., Ph.D. | Kevin E. Wilk, P.T., D.P.T. | Jeffrey R. Dugas, M.D. | William J. Grantham, M.D.

Keywords

shoulder injuries

elbow injuries

overhead throwing athletes

Sicily lesion

labral tears

anterior glenohumeral capsular ligament reconstruction

hamstring grafts

risk factors for throwing injuries

internal brace repair

ulnar collateral ligament (UCL) injuries