Controversies in the Overhead Athlete's Shoulder (AANA22)-Case Presentations Shoulder

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Video Summary

The panel discussed a complex case of a 19-year-old baseball player with shoulder injuries including labral tears and internal impingement. They emphasized precise surgical techniques, favoring knotless anchors above the equator to avoid damaging cartilage and careful repair of the posterior labrum. The experts cautioned against overtightening sutures to prevent stiffness and loss of motion. They also addressed associated shoulder conditions like Bennett’s lesions and stressed conservative rotator cuff treatment, usually limited to debridement, to avoid advancing the capsule and causing stiffness. The discussion highlighted the importance of evaluating throwing mechanics, noting hip tightness and suboptimal arm positioning that contribute to injury risk. Experts advocated for a multidisciplinary approach involving biomechanists and therapists, stressing individual "nodes" in mechanics rather than enforcing a perfect formula. Overall, the session underscored tailored surgical and rehabilitation strategies, biomechanical analysis, and humility in managing throwing athletes to optimize outcomes and prolong careers.

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John D. Kelly IV, M.D.

Keywords

shoulder injuries

labral tears

internal impingement

knotless anchors

throwing mechanics