IC101 - Team Physician Update: It's Not a Knee or Shoulder Injury, Am I Doing it Right? Gautam Yagnik MD; C Andrew B. Dossett MD; Craig S. Mauro MD; Steven S. Shin MD; Norman E. Waldrop, III MD
Most orthopedic team physicians can expertly manage common knee and shoulder injuries, like MCL sprains, ACL tears and shoulder instability. However, many sports surgeons are less comfortable with the sideline and definitive management of foot & ankle, hip, hand and spine injuries. In many settings, the appropriate subspecialty care is either not available or unfamiliar with treating high-level athletes and it is therefore the team physician's responsibility to definitively manage or at least guide the care of these athletes. The goal of this course is to provide the team physician with a concise update on current concepts and trends regarding the management of foot & ankle, hip, hand and spine injuries in high-level athletes. This course will explore many controversial topics including acute surgical stabilization of high ankle sprains, the relationship between hip pathology and core muscle injuries, definitive management of scapholunate ligament injuries and role of cervical fusion vs. disc replacement in the competitive athletes. The presenters will use a combination of evidence-based medicine and case examples to provide attendees with an algorithmic approach to managing these controversial injuries. Audience participation will be a critical element of the session and ample time will be left for case presentations, questions and discussion.
• Describe the evaluation and management of high ankle sprains, Lisfranc & turf toe injuries, as well as 5th metatarsal fractures including pertinent exam findings, imaging modalities and evolving indications for surgical stabilization.
• Discuss the use of intra-articular hip injections in the work up and management of groin pain. Clarify indications and timing of hip arthroscopy and provide return to play guidelines.
• Review the relationship between hip pathology and core muscles injuries. Which one should I fix? When should I fix both?
• Review the current trends in sideline and definitive management of hand & wrist injuries: metacarpal & phalanx fractures, scapholunate ligament injuries, scaphoid fractures and thumb UCL injuries. When is it safe to return to play?
• Understand the evolving treatment options for spine injuries in athletes. Discuss return to play guidelines for stress fractures and disc herniations in the lumbar spine. When can a player return after an ACDF? Is there a role for disc replacement?
IC102 Round Table - No Bone? No Problem. How to Successfully Manage Glenohumeral Instability with Bone Loss
Gregory L. Cvetanovich MD; Julie Bishop MD; Peter N. Chalmers MD; Brandon J. Erickson MD; C. Benjamin Ma MD; Brian R. Wolf MD, MS; Ivan H. Wong MD
In 2015, JBJS published a Topics in Training article titled 'Impact of Fellowship Training in Clinical Practice of Orthopaedic Sports Medicine'. They surveyed sports medicine trained fellows who had been in practice an average of 9 years, asking in particular, their comfort level with a variety of surgical procedures. Responders displayed a high comfort level with all shoulder procedures, except bone loss instability. In this case, only 31.5% of responders felt 'very comfortable' treating this entity. Therefore, the goal of this Round Table Instructional Course is to provide an interactive case-based discussion of complex cases in glenohumeral instability with bone loss. A series of illustrative cases will be presented including history, exam findings, and imaging addressing glenoid, humeral, and bipolar bone loss. These cases will be discussed in small groups with course faculty at the round tables and subsequently as a larger group. Brief discussion of evidence-based literature for the chosen treatment and technical tips and tricks will then be provided for the chosen treatment.
• Understand methods for identifying and quantifying bone loss in the setting of recurrent instability
• Have a better understanding of when it is necessary to address humeral sided bone loss (the Hill-Sachs lesions) and the learn about the most prevalent methods to surgically address the Hill –Sachs lesions
• Grasp the indications for addressing glenoid sided bone loss and the most common techniques to address this bone loss
• Gain a better understanding of the clinical scenarios in which one will encounter posterior glenoid bone loss and learn the best methods to address this pathology
• Learn tips and tricks to assist in executing all the surgical methods discussed
IC103 - When Your ACL Reconstruction Alone is NOT Enough: Challenging Instability Patterns Christopher M. Larson MD; Asheesh Bedi MD; Robert F. LaPrade MD, PhD; Corey A. Wulf MD
The ICL will discuss some 'Hot Topics' and 'Controversies' when ACL reconstruction alone might not be enough. Topics include ACLR in the hypermobile athlete and role for ALLR / LET, management and outcomes for associated meniscal root and radial tears in athletes, decision making with associated medial sided knee injuries, and when to consider staged procedures and tibial slope reducing osteotomies in a revision ACL setting.
• Understand the challenges of hypermobility and ACL injury and role for ALL reconstruction / LET
• Develop a strategy and understand the significance of meniscal root and complete radial tear/ repairs and rehabilitation modifications in the setting of ACL reconstruction
• Develop an approach to identify sMCL and POL knee injuries in the setting of an ACL tear and when they require surgical management
• Understand the role for staging revision ACL reconstruction and significance of increased posterior tibial slope as well as role for slope reducing osteotomies.
IC104 - Innovative Techniques for ACL Revision Surgery Roberto Rossi, MD; Robert A. Arciero MD; Davide E. Bonasia MD; Christopher D. Harner MD; Brian R. Wolf MD, MS
Revision ACL reconstruction has shown inferior outcomes compared with primary ACL reconstruction, and this can be due to different factors, including: bone defects, concomitant misdiagnosed peripheral instability, malalignment, chondral and meniscal lesions/degeneration. In some cases, mostly when primary ACL tunnels are malpositioned and there is no significant bone loss, ACL revision can be a relatively straightforward procedure. However, in most patients with failed ACL reconstruction, many factors should be considered during the planning and pre-operative work-up. During the first part of the IC, participants will be provided with the tools to understand the reasons for ACL failure and correctly plan the ACL revision surgery. In ACL revision surgery there are no standardized procedures and the surgery should be tailored for each specific case. When approaching this type of surgery, the surgeon should be familiar with unconventional ACL revision techniques in order to deal with different scenarios. In the second, case-based part of the IC, various uncommon surgical procedures will be described. These techniques can sometimes be valuable tools to avoid problems like proximal graft fixation, interference with previous tunnels, marked rotatory instability, malalignment, cartilage damage, and meniscal deficiency.
The IC will focus on the following topics:
• Pre-operative planning and decision making
• Two stage ACL revision
• One stage ACL revision with lateral plasty and anatomic/non-anatomic ACL reconstruction: Marcacci, Saragaglia, Yamaguchi techniques
• One stage revision with over the top femoral position
• Combined ACL revision and medial meniscus transplant
• Combined ACL revision and HTO
• Learn how to perform correct planning and pre-operative work-up in ACL revision surgery.
• Learn various unconventional techniques to avoid intraoperative troubles in ACL revision surgery
• Learn indications and technical aspects of procedures combined to ACL revision: meniscal transplant and high tibial osteotomy.
IC105 Round Table - Patellofemoral Instability from Simple to Complex: How to Get It Right and Avoid Complications
David R. Diduch MD; Jacqueline Brady MD; Andrew J. Cosgarea MD; David DeJour MD; James L. Pace MD; Beth E. Shubin Stein MD; Sabrina M. Strickland MD; Adam B. Yanke MD, PhD
This is highly interactive, case-based learning in small groups, with a moderator introducing cases for discussion at each table with individual faculty. Key concepts covered include optimizing MPFL reconstruction techniques, and how to recognize and when to address the various anatomic risk factors that contribute to patella instability. These include malalignment with elevated TT-TG, valgus alignment, patella alta, rotational deformities, and trochlear dysplasia. When is an MPFL reconstruction not enough, and which anatomic risk factors should be addressed? What adjustments are made for open physes? The international faculty represent very experienced PF surgeons with a lot to share in this area that can be controversial and not always clear cut.
• Attendees will understand techniques to optimize MPFL reconstruction and how to troubleshoot to avoid complications.
• To recognize, measure and make decisions about various anatomic risk factors for PF instability. What should be the threshold to change the anatomy?
• To understand techniques to address the risk factors as part of correcting PF instability and avoiding recurrent instability or complications.
• To provide a highly interactive small group learning format that enables engaged learning by the participants with individual faculty.
IC106 - The Sports Medicine Surgeon's Handbook for Shoulder Arthroplasty. Raffy Mirzayan MD; Joseph A. Abboud MD; Stephen F. Brockmeier MD; Nikhil N. Verma MD
Most practicing orthopaedic sports medicine surgeons perform shoulder arthroplasty but have received little training. This demand will continue to rise, as more patients in their practice are requiring shoulder arthroplasty. The purpose of this course is to allow practicing surgeons who are familiar with open and arthroscopic shoulder surgery to gradually transition to performing shoulder arthroplasty. The topics covered will include a step by step preparation for shoulder arthroplasty. This will be a cased based instructional course, which includes pre-op planning/templating, surgical exposure and soft tissue releases, glenoid exposure and preparation, choosing the right implant, fixation methods, post-operative care including pain management and physical therapy protocols.
• Participants should be able to appropriately indicate operative and non-operative care, and pre-op plan and template for shoulder arthroplasty. Discussion and cases of humeral and glenoid deformity, and the nuances will be included.
• At the completion of this session, participants should be able to perform a surgical approach to the glenohumeral joint, capsular releases, retractor choices and proper retractor placement to obtain adequate glenoid exposure and preparation.
• Participants should be able to choose the right implant (anatomic versus reverse) for each patient and understand the differences and implications for each implant design. Nuances of glenoid design, ingrowth, inset and augmentation will be included.
• At the completion of this session, participants should be able to decide between fixation methods (cemented vs cementless), stem length (short vs long), offset (lateral versus medial), neck angle (135 vs 155).
• At the completion of this session, participants should be able to know the appropriate post-operative management including pain management, opiate minimization and therapy protocols.
IC107 - HTO: What are You Waiting For? Volker Musahl MD; Alan M. Getgood MD, FRCS (Tr&Orth); Anil S. Ranawat MD, MD; Ronald van Heerwaarden MD, PhD
This course will review knee malalignment with special focus on coronal plane and sagittal plane alignment. Indications for proximal tibia osteotomies and distal femur osteotomies will be discussed. The advantages and disadvantages of closing wedge and opening wedge osteotomies will be examined in a case-based discussion with special attention to the tibial slope. Surgical technique for osteotomies will be presented in a case-based format.
• Upon completion of this course the participant will have a better understanding of treating knee arthritis as it relates to coronal plane malalignment.
• The participant will understand the issues related to tibial slope, specifically pertaining to the treatment of chronic ligament deficient knees and the triple varus knee.
• Upon completion of this course the participant will have a better understanding of the surgical technique for high tibial osteotomy and distal femur osteotomy.
IC108 - Incorporating Biologics into Your Office Based Practice: Fat, Bone marrow, PRP, Amnion, and Getting Reimbursed Laith M. Jazrawi MD; Scott A. Rodeo MD; C. Thomas Vangsness MD; Rachel M. Frank MD
The therapeutic use of biologics in orthopaedics is one of the most important and frequently misunderstood aspects of clinical practice. There are a myriad of agents with an equally diverse array of indications. As the landscape of orthobiologics is constantly changing, so too does the associated compensation. The aim of our course is to help orthopaedic surgeons navigate these daunting obstacles and optimize their clinical practice -- in terms of both clinical care and revenue.
• Gain deeper understanding of the common indications for various biologics in orthopedics.
• Learn how, when, and why to bill for the many biologic agents currently used in orthopedics.
• Understand the trajectory of biologics in orthopedics and the implications for future clinical practice and reimbursement.
IC201- A Case Based Approach for Meniscus Repair: Reconsidering Indications, Techniques, and Biologic Augmentation
Aaron J. Krych MD; David N. Caborn MD; James L. Carey MD, MPH; Jorge Chahla MD, PhD; Thomas M. DeBerardino MD; Lawrence S. Miller MD; James L. Pace MD; Scott A. Rodeo MD
The meniscus is vital to normal knee function and the health of the articular cartilage. While meniscus tears are very common, we proportionately devote little time and resources into improving our surgical indications and technique for meniscus preservation and restoration. Recently there have been advances in recognition of tear pattern and surgical treatment of meniscus pathology. As a surgeon, it is important to understand how and when patients can benefit from these procedures. This course will provide a case-based approach to guidelines on how to recognize and treat a variety of meniscus pathology in the isolated and concomitant setting. Recognition of specific tear patterns, including full-thickness radial tears, complex tears, and root tears will be emphasized. Variations of surgical techniques, such as transtibial pull-out for root tears, novel all-inside techniques, gold standard repair techniques, and transplantation will be covered. In addition, emerging biologic augmentation will be discussed.
• At the completion of this session, participants should be able to understand how to recognize tear patterns from pre op MRI and arthroscopy and utilize this information for planning and execution of meniscus preservation techniques.
• At the completion of this session, participants should be able to understand indications for meniscus repair in the active patient, pearls and pitfalls of a variety of repair techniques, as well as anticipated outcomes.
• At the completion of this session, participants should be able to recognize complex tears patterns, such as meniscus root tears and radial tears, and understand treatment options, including a variety of repair techniques.
• At the completion of this session, participants should be able to understand indications for meniscus transplant, current controversies, and expected outcomes and concomitant combined procedures, such as osteotomy and ligament reconstruction.
IC202 - Hip Arthroscopy - My Worst Day in the Operating Room: What Happened and How it Changed My Practice Travis Maak MD; Richard C. Mather, III MD; Shane J. Nho MD, MS; Marc J. Philippon MD; Michael J. Salata MD
Hip arthroscopy is a rapidly growing and evolving field in orthopaedic sports medicine. The ability to incorporate this field into the general sports practice is highly attractive and desirable, as this allows the orthopaedic sports surgeon to treat a unique young, athletic pathologic spectrum. Given this, hip arthroscopy has expanded to allow treatment of more complex pathologies and has been used with increasing frequency throughout the US and internationally. As hip arthroscopy surgical volumes increase, it is of paramount importance to know and identify the intraoperative pitfalls and complications that occur - even in a high-volume hip arthroscopy surgical practice. It is of equal, if not higher importance to understand how to avoid and manage these complications when they occur. This course will specifically focus on actual unplanned intraoperative worst day in the OR scenarios that have occurred in the high-volume hip arthroscopy practices of the course faculty. Specifically, the discussion will include a detailed description of the worst day in the operating room for each of the presenters, how the issue was identified and addressed, and how this experience changed future practice for the faculty. This will be a case-based learning environment in which the case will be presented followed by the ensuing 'Worst Day in the OR' and the subsequent aftermath and related practice changing decisions.
• At the completion of this session, participants should be able to identify the factors that contributed to the creation of the hip arthroscopy problem and explain why these factors were not recognized.
• At the completion of this session, participants should be able to develop a pre-operative plan to avoid or mitigate the risk of creating or encountering the presented surgical complications.
• At the completion of this session, participants should be able to adequately address and correct these surgical complications if or when they are encountered.
• At the completion of this session, participants should be able to summarize the most effective techniques that were employed to change practice to avoid these surgical issues in their own clinical practices.
IC203 - Surgical Techniques for ACL Reconstruction in Patients with Open Physes
Davide E. Bonasia MD; Annunziato Amendola MD; Frank A. Cordasco MD; Jonathan C. Riboh MD; Roberto Rossi MD; Stefano Zaffagnini MD
Pediatric ACL reconstruction is still a challenge for the orthopaedic surgeon. Many different surgical techniques have been developed with to goal of reducing physeal damage and re-rupture rates. In this case-based IC, a panel of European and US authors describe their indications for ACL reconstruction in the pediatric population and present a re-live surgery of their favorite surgical technique.
The focus will be on the following topics:
• ACL repair
• All epiphyseal ACL reconstruction
• Partial transphyseal (tibia) and over the top (femur) ACL reconstruction
• Kocker/Micheli technique
• All-epiphyseal over the top Marcacci/Zaffagnini technique
• Hybrid technique: All epiphyseal (tibia) and over the top (femur) ACL reconstruction
• Adult type reconstruction
• Return to sport and risk of re-injury
• Learn the indications for ACL repair and reconstruction in the pediatric population
• Learn different techniques to preserve growth plates or minimize physis damage
• Learn the importance of return to sports and risk of re-injury in such a delicate population.
IC204 Round Table - Revision ACL Reconstruction: Getting it Right the Second Time!
Mark D. Miller MD; Kevin F. Bonner MD; Daniel E. Cooper MD; Darren L. Johnson MD; Robert R. LaPrade MD, PhD; Robert G. Marx MD, MSc, FRCSC
Using a round-table format, several Revision ACL Reconstruction cases will be presented. The course will address techniques for both one- and two-stage revisions. Difficult problems such as excessive tibial slope, tunnel osteolysis, removal of hardware, combined meniscal and cartilage lesions, and a variety of other topics will be discussed. Experienced faculty will facilitate discussion at each table and explore various options for these difficult challenges. Faculty will rotate tables and rotate case presentations to allow the attendees to get maximum benefit from the ICL. The moderator has extensive experience in leading round-table Instructional Course Lectures and will invite only seasoned faculty who have excelled in ICLs using this format.
• Understand techniques to improve primary ACL reconstruction in order to avoid ACL graft failure.
• Discuss various options to address tunnel osteolysis in Revision ACL reconstruction.
• Identify when additional combined procedures such as osteotomy and meniscal and chondral procedures are needed in conjunction with ACL revision.
• Outline different treatment options for tunnel placement in revision ACL reconstruction.
• Describe when a two-stage ACL revision is required.
IC205 - Let's Learn How to Treat Shoulder Instability from our Most 'Elite Athletes' - Special Ops Military 'Athletes'
George J. Davies DPT, SCS, ATC CSCS; Jonathan F. Dickens MD; Matthew T. Provencher MD, MD, USNR; John M. Tokish MD
Shoulder instability is a major concern in athletics at all ages and levels of performance. So, what can we learn from extensive experiences of Military Orthopaedic Surgeons treating elite warriors? Dr. Dickens will present information on the epidemiology of shoulder instability and 'pearls' from his experiences. Dr. Provencher will present options and scientific rationale for selection of surgical procedures and 'tricks' from his experiences. Dr. Tokish will present the criteria for return to activity and outcome studies following shoulder instabilities and share his unique perspective and experiences. After their formal presentations, each presenter will share a unique case study and what we can all learn from these elite warriors.
• Recognize the significant number and impact shoulder instability has on Special Ops Military 'Athletes'.
• Compare and contrast different surgical procedures that can be used to treat shoulder instabilities and the rationale and evidence supporting the decisions.
• Design appropriate tests that can be used as evidence-based criteria for return to activity.
• Formulate the best clinical decision making to treat unique shoulder instabilities based on the case studies from these elite warriors.
IC206 Round Table - Ulnar Collateral Ligament Injuries: 2020 Treatment Strategies
Brandon J. Erickson MD; Christopher S. Ahmad MD; Peter N. Chalmers MD; Michael G. Ciccotti MD; Gregory L. Cvetanovich MD; Joshua S. Dines MD; Jeffrey R. Dugas MD; Salvatore J. Frangiamore MD; Anthony A. Romeo MD; Mark S. Schickendantz MD
Ulnar collateral ligament (UCL) injuries of the elbow are on the rise in overhead athletes of all levels of play. Many of these injuries can be managed non-operatively with rest and a return to throwing program with or without the addition of a biologic to aid in ligament healing. However, a subset necessitates surgical intervention. Surgical techniques have continued to evolve over the past several years and now include a primary UCL repair with internal brace, modified docking technique with added graft strands, and others. Furthermore, as more primary UCL repairs and reconstructions are performed, the number of revision UCL reconstructions has risen proportionally. The purpose of this roundtable is to review the most up to date strategies for treatment of UCL injuries including the use of biologics, UCL repair, primary UCL reconstruction, and revision UCL reconstruction. The panel will review several complete cases and will work through each case from diagnosis to management to return to play. The participants will be taken through each case and asked how they would proceed at varying steps in management. The faculty will provide pearls based on their experience in dealing with these difficult cases.
• Understand how to diagnose ulnar collateral ligament injuries with history, physical exam, and imaging
• Understand what imaging modalities are most useful, and how the experts are utilizing new imaging modalities (stress ultrasound) in their practice to aid in diagnosis, prognosis, etc.
• Learn tips and tricks for successful UCL reconstruction and UCL repair, what the evidence regarding surgical technique and graft choice, and understand the return to play process
• Understand the challenges surrounding revision ulnar collateral ligament reconstruction including tunnel placement, revision graft choice, management of the ulnar nerve, and rehabilitation/return to sport.
IC207 - The Business of Medicine: Hospital-Based, Academic, Private Practice - Learning How to Succeed
Kevin D. Plancher MD MPH; Brian J. Cole MD, MBA; Louis McIntyre MD; Allston J. Stubbs, IV MD
This course will give physicians a comprehensive understanding of all aspects of medicine from health insurance and coding to marketing and enhancing your visibility to compete in the current healthcare marketplace with a sports medicine practice. This course will build the foundation to allow the physician a comfort level within the business aspects of a successful practice. Introductory lectures that build on the previous year's topics will allow for multi-year rotation.
• Explain when and why marketing can positively affect a medical or hospital practice while analyzing the competitive marketplace to formulate a value proposition and apply it to a market segmentation targeting the right consumer
• Discuss the role of branding and customer loyalty to review the importance of an integrated marketing platform and allow for interpretation of key metrics.
• Understand the essentials of billing and coding to improve reimbursement and create an efficient, successful financial model through the utilization of physician extenders.
• Define the concept of consumerism and realize the role of social media and decision making by patients.
• Understand the intricate finances of a practice or department of orthopaedics & the role of ambulatory surgical centers, outpatient surgery, in and out of network and how to use your physician assistant and nurse practitioner to compete effectively.
IC208 - State of the Art Options for Complex Rotator Cuff Pathology: Grafts, Patches and Scaffolds-Do They Work? A Case-Based approach.
Mark H. Getelman MD; F. Alan Barber MD; Richard KN Ryu MD; John M. Tokish MD
This case-based approach will offer an interactive format that will focus on the application and use of available grafts and surgical options for the treatment of complex rotator cuff pathology ranging from partial to massive irreparable rotator cuff tears. The course will cover the use of dermal matrix allograft vs fascia lata autografts for Superior Capsular Reconstruction (SCR), augmentation techniques using dermal matrix allograft for poor quality tissue and revision repairs and the use of biologic in-growth scaffolds for partial thickness and intrasubstance tears. Management of the failed SCR will also be presented. In addition to reviewing the latest peer reviewed literature addressing the use of the different graft materials, a robust discussion will focus on the correct indications and video-intense advanced surgical techniques. Audience participation will be a critical element of the session and will be enhanced by the illustrative cases presented and the active role of the moderator and faculty panel to encourage audience participation.
• Identify and outline strategies for Massive Irreparable Rotator cuff using Superior Capsular Reconstruction and detailing the use of Dermal Matrix Allograft versus use of Fascia Lata Autograft for reconstruction. Failed SCR will also be addressed.
• Identify strategies for repairable rotator cuff with poor tissue quality and is at risk for failure. Instruct the audience on the indications and detail the surgical technique using dermal matrix allograft to augment the standard rotator cuff repair.
• Identify and outline management options for partial thickness rotator cuff pathology and the indications and surgical technique for biologic in-growth scaffolds.
IC301 Round Table - Multiple Ligament Injuries of the Knee: What Would You Do? Mark D. Miller MD; Darren L. Johnson MD; Robert F. LaPrade MD, PhD; Bruce A. Levy MD; Robert G. Marx MD, MSc, FRCSC; Gehron Treme MD
Using a round-table format, several Multiple Ligament Injury Knee cases will be presented. The course will address techniques for KD I-V injuries. Difficult problems such as associated fractures and neurovascular injuries, associated cartilage and meniscal injuries, surgical timing, and a variety of other topics will be discussed. Experienced faculty will facilitate discussion at each table and explore various options for these difficult challenges. Faculty will rotate tables and rotate case presentations to allow the attendees to get maximum benefit from the ICL. The moderator has extensive experience in leading round-table Instructional Course Lectures and will invite only seasoned faculty who have excelled in ICLs using this format.
• Describe the KD classification scheme for Knee MLI and be able to identify the correct classification for each case presented
• Discuss treatment options for each knee injury presented.
• Identify associated injuries in MLI cases and discuss treatment options.
• Outline options for surgical timing of MLI knee treatment
• Discuss rehabilitation of MLI knee injuries.
IC302 - Hip Arthroscopy in Athletes - A Sports Specific Approach Marc R. Safran MD; JW Thomas Byrd MD; Christopher M. Larson MD; T. Sean Lynch MD
UThis ICL reviews different hip pathologies, based on specific types of sports, where those pathologies are more common. These topics will be discussed by experts in the field of sports medicine and hip arthroscopy, and thus have experience treating athletes with these problems, and leading the way in research to best evaluate and manage athletes with these problems. Specifically, the mechanism of injury, pathophysiology, evaluation and management of these maladies of the hip will be discussed. This is meant to be an up-to-date primer of the evaluation and management (with rationale) of the athlete with hip pain.
The outline is as follows:
2) Laxity Sports
4) Endurance Sports (triathlons, ultra-marathons)
5) Unilateral Arm Dominant Sports (baseball, tennis, golf)
• At the end of the ICL, the attendee will have learned about the evaluation of athlete's hip pain
• At the end of the ICL, the attendee will have learned about the management options for hip pain in the athlete.
• At the end of the ICL, the attendee will have learned about the outcomes of hip arthroscopy in the athlete
IC303 - Meniscus Management Algorithm - When to Debride, Repair or Transplant: A Case Based Approach Scott A. Rodeo MD; Jorge Chahla MD, PhD; Scott C. Faucett MD; Andrew T. Pennock, MD
The aim of this course is to provide a comprehensive overview of the treatment algorithm for various types of meniscus pathology. We will discuss the important factors that should be considered in the decision for debridement versus repair, and then focus on specific tear patterns and indications and techniques for repair, including emerging concepts for repair of meniscal ramp lesions, meniscus root tears, radial tears, and horizontal cleavage tears. Important concepts and principles for post-operative rehabilitation will be discussed. We will also cover current indications and techniques for meniscus replacement, using allograft tissue as well as synthetic materials that are currently available (or undergoing FDA evaluation. Finally, we will discuss current techniques and data for 'biologic augmentation' approaches to improve meniscus healing.
• To understand the indications for meniscus repair, the different available techniques and when to perform a debridement. We will also discuss combining meniscus management with concomitant cartilage repair and ligament reconstruction.
• To discuss indications and techniques for repair of root, radial, and ramp lesions. Cases will be presented to illustrate treatment approaches for each case.
• To provide the latest information on the status of meniscus allograft and synthetic scaffold materials available for meniscus replacement. Indications and rehabilitation will be discussed, and illustrative cases presented.
• To critically review current techniques for biologic augmentation of meniscus repair. We will also discuss rehabilitation and return to sports after each procedure as part of the case presentations.
IC304 - Round Table - 4 Common Shoulder Problems in Overhead Sports: An Interactive, Round Table, Case-Based, Problem Solving Session
Michael T. Freehill MD; Asheesh Bedi MD; Michael G. Ciccotti MD; Stephen E. Lemos MD, PhD; George A. Paletta MD; Richard KN Ryu MD; Felix H. Savoie, III MD; Nikhil N. Verma MD
This ICL round table will be an interactive session, which is case based and dealing with 4 very common problems seen with overhead sporting activities. Monitors will be placed at 10 tables and individual cases presented. A faculty member will be at each table leading group discussions and then discussion with all tables will take place. Faculty members will rotate tables after each case. An audience response system will be used at each table to facilitate discussion.
• A 19-year-old collegiate diver with Grade III AC joint separation.
• A 17-year-old female volleyball player with chronic shoulder pain.
• A 23-year-old professional baseball pitcher with posterior shoulder pain and internal rotation deficit.
• A 21-year-old collegiate baseball pitcher with a Type II SLAP tear.
• The participant will learn the scope of treatment options for AC joint separations and the literature and personal experiences which support the different treatment options.
• The participant will learn the scope of both non-operative and surgical treatments of the challenging, athletic, multidirectional instability patient.
• The participant will learn the scope of treating the baseball athlete with internal rotation deficit from non-operative treatments to surgical options and techniques.
• The participant will learn the scope of treating SLAP lesions from non-operative treatments to surgical options and techniques in the baseball athlete.
IC305 - Extraarticular Reconstruction in ACL Deficient Knee: Back to the Future? Edoardo Monaco MD; Andrea Ferretti MD; Freddie H. Fu MD; Alan M. Getgood MD, FRCS (Tr&Orth) Bertrand Sonnery-Cottet MD
Understanding biomechanics and surgical techniques of extraarticular reconstructions will provide surgeons with tools for a more comprehensive treatment of rotatory instability in ACL deficient knee.
• Do ERs have a role in today ACL reconstruction?
• When and why I recommend Extraarticular reconstructions
• Anatomic ALL reconstruction: surgical technique and clinical outcomes
• Non anatomic LET: surgical technique and clinical outcomes
• Panel Discussion
• Understanding biomechanics of rotatory instability in ACL deficient knee
• How to select cases for using extraarticular reconstructions along with ACL reconstructions.
• How to perform an extraarticular reconstruction
IC306 - Joint Preservation Techniques for the Knee in 2020: The Utility of Biologics, Osteotomies, and Cartilage Restoration Procedures Rachel M. Frank MD; Andreas H. Gomoll MD; Eric J. Strauss MD; Armando F. Vidal MD
The goal of this instructional course lecture is to provide a comprehensive overview of joint preservation techniques for the knee, including biologic and reconstructive approaches, with an emphasis on evidence-based treatment guidelines for young, high-demand patients. This will be a case-based ICL with an emphasis on clinical and surgical decision-making, with case examples of in-season athletes, contact-athletes, endurance-athletes, and patients with previous failed joint preservation surgery. Experts within the joint preservation field will provide pearls and pitfalls for the management of these challenging patients, with real-life (as opposed to theoretical) case examples
• To understand the role of osteotomy as an adjust to cartilage/meniscal restoration.
• To discuss technical pearls for performing combined cartilage restoration, meniscus transplantation, ligament reconstruction, and/or realigning osteotomies.
• To discuss indications for biologic augmentation to joint preservation techniques in the setting of cartilage and/or meniscal restoration.
• To discuss management of the young, high level athlete requiring cartilage/meniscal restoration.
• To go through controversial clinical cases and determine best-practice treatment options.
IC307 - Arthroscopic Approaches to Failed Rotator Cuff Repair Ivan H. Wong MD; Brian J. Cole MD, MBA; Matthew T. Provencher MD MC USNR; Anthony A. Romeo MD
This instructional course lecture presents a case-based approach to the failed Rotator cuff repair, helping surgeons understand reasons for failure and options for treatment will be the main focus of this ICL. Surgical techniques including maximal repair, Graft augmentation, bridging reconstructions, superior capsular reconstructions, and tendon transfers will be presented and discussed.
• By the end of the ICL, participants will be better able to describe most relevant evidence for revision of rotator cuff repair
• By the end of the ICL, participants will be better able to describe technical pearls and outcomes for maximal cuff revision repair
• By the end of the ICL, participants will be better able to describe technical pearls and outcomes for graft augmentation
• By the end of the ICL, participants will be better able to describe technical pearls and outcomes for graft interposition
• By the end of the ICL, participants will be better able to describe technical pearls and outcomes for superior capsular reconstruction
IC308- Principles of Management of Common Pediatric Sports Injuries Shital Parikh MD; Eric W. Edmonds MD; Henry B. Ellis MD; Theodore J. Ganley MD; Daniel W. Green MD; William L. Hennrikus, Jr. MD; Benton E. Heyworth MD; Mininder S. Kocher MD, MPH; Kevin G. Shea MD; Eric J. Wall MD
Optimal management of pediatric sports injuries requires the understanding of unique characteristics of the immature musculoskeletal system like the growth of ligaments, role of physis and the periosteum. Though several adult sports surgeons treat children, one has to recognize that children are not small adults and adult-like procedures may not yield optimal outcomes. The principles of management of these sports injuries in children include anticipating future growth, anticipating future injuries, minimizing physeal injury, aggressive treatment of some injuries and recognizing the 'at risk' injuries. The ICL would offer round table discussion on common pediatric sports injuries, led by an expert faculty facilitator, providing an interactive learning experience. The cases for discussion would include pediatric ACL tear, discoid menisucs tear and juvenile OCD amongst others.
• Understand the principles of management of pediatric sports injuries including estimation of skeletal maturity, physeal contribution to growth, and physis-related complications
• Recognize the important clinical and radiographic features to anticipate and diagnose pediatric sports injuries
• Formulate a treatment algorithm that is unique to each patient, based on symptoms, imaging studies, growth remaining and available treatment options.
• Learn 'physeal respecting' surgical techniques that are specialized to children and adolescents, focusing on pearls and pitfalls of each technique.
• Understand potential complications and long-term consequences of pediatric sports injuries, their management and prevention