AANA25 Wrist & Elbow Access Pass-GENERAL SESSION: Arthroscopy Around the World (Main Stage)

Video Transcription

Video Summary

The "Arthroscopy Around the World" session, moderated by Dr. Mark Gettleman, highlighted advanced knee and shoulder arthroscopic techniques from global experts. <br /><br />Dr. Elisabetta Kohn discussed osteochondral knee defects, emphasizing the superiority of osteochondral scaffolds over membranes, particularly synthetic hydroxyapatite-collagen and coral-based scaffolds. The latter recently gained FDA approval in the U.S. and shows promising bone and cartilage regeneration, especially in young or early osteoarthritis patients. Her long-term studies report stable outcomes over 10 years.<br /><br />Dr. Fidelis Rangjin Prince addressed ACL injuries, outlining when repair rather than reconstruction is appropriate. Key criteria include tear type (proximal one-fourth of ligament), tissue quality (especially synovial sheath integrity), and patient age (best over 21). Their comparative study showed ACL repair can yield comparable failure rates and better quadriceps strength in select patients.<br /><br />Dr. Giuseppe Filardo reviewed orthobiologics for knee osteoarthritis, focusing on platelet-rich plasma (PRP). Despite clinical trials and meta-analyses showing PRP’s superiority over placebo, corticosteroids, and hyaluronic acid, the effects are modest and patient selection (younger, less degenerative cases) is essential. Cell-based therapies like BMAC and adipose derivatives show no clear advantages yet.<br /><br />Dr. Mario Rongo detailed the use of fracturoscopy (arthroscopy during open fixation) for complex tibial plateau fractures, demonstrating superior fracture reduction visualization, ability to detect meniscal and ligament injuries, and improved long-term alignment and function.<br /><br />In shoulder and elbow talks: Dr. Barnak promoted biceps tendon augmentation for massive rotator cuff tears, highlighting its biological and mechanical benefits with various techniques including tenotomy/tenodesis and rerouting. Dr. Lozano reviewed options for irreparable subscapularis tears, favoring latissimus dorsi transfers and discussing anterior capsular reconstructions and reverse arthroplasty for older patients. Dr. Andreas Voss explored AC joint injury management, emphasizing the importance of restoring strut function and AC capsule stability with patient-specific surgical decisions due to the heterogeneity of injuries and outcomes. Lastly, Dr. Argyun covered posterolateral rotatory instability of the elbow, underlining diagnostic complexity, soft tissue involvement, and predominantly arthroscopic tissue placation techniques over open reconstructions.<br /><br />The session concluded with interactive discussions clarifying rehabilitation protocols, patient selection criteria, and surgical decision-making nuances. Overall, the program illustrated cutting-edge arthroscopic advancements and individualized treatment paradigms across key joints.

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Keywords

arthroscopy

knee osteochondral defects

osteochondral scaffolds

ACL repair

platelet-rich plasma

fracturoscopy

biceps tendon augmentation

subscapularis tear treatment

AC joint injury management

elbow posterolateral rotatory instability