Hype, Promise, and Reality: Orthopedic Use of Biologics in 2019 (AANA19)-Biologic Preservation of the Shoulder-Dr. Brian J. Cole, M.D., M.B.A.

Video Transcription

Video Summary

The talk provides an overview of orthobiologic treatments for shoulder conditions, focusing on their use in-office or as surgical adjuncts. Emphasis is placed on treating articular cartilage defects, osteoarthritis, and rotator cuff issues. For symptomatic humeral head cartilage lesions, fresh osteochondral allografts are preferred. Techniques such as marrow stimulation with collagen membranes show promise for glenoid defects. In cases of widespread arthritis, conservative treatments like corticosteroids and PT are standard, while orthobiologics (e.g., bone marrow concentrate, adipose tissue) may offer symptom relief, though evidence remains inconclusive. For rotator cuff tears, biologics aim to improve tendon-bone healing and reduce scar formation; marrow stimulation (“crimson duvet”) and bone marrow concentrate demonstrate potential benefits. Scaffolds are used in revision repairs with poor tissue quality. Superior capsule reconstruction (SCR) offers a viable solution for irreparable tears with minimal arthritis, with about 75% success. The speaker concludes that combining growth factors, cells, and scaffolds holds future promise for shoulder repair advancements.

Asset Caption

Instructional Course Lecture: Hype, Promise, and Reality: Orthopedic Use of Biologics in 2019

Keywords

orthobiologic treatments

shoulder conditions

articular cartilage defects

rotator cuff tears

superior capsule reconstruction