Instructional Courses

Location: Liberty Salon L

Course Description:

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 repair, 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, extrusion and root tears will be emphasized as well as indications for meniscus transplantation. Variations of surgical techniques, such as newer all-inside techniques, gold standard repair techniques, novel centralization techniques and transplantation techniques will be covered. In addition, emerging biologic augmentation will be discussed.

Faculty:

James Lee Pace, MD; James Carey, MD, MPH; Thomas R. Carter, MD; Jorge Chahla, MD, PhD; Brian J. Cole, MD, MBA; Wayne K. Gersoff, MD; Laith M. Jazrawi, MD; Aaron J. Krych, MD; Matthew T. Provencher, MD, MBA, MC USNR (Ret); Scott A. Rodeo, MD

Location: Congress

Course Description:

This ICL round table will be an interactive session, which is case based and dealing with 3 shoulder problems we all encounter with overhead sporting activities. These common pathologies however can have subtle differences making the diagnosis more difficult and treatment approach not so straightforward. A distinguished faculty member will be at each table leading group discussions about the case and then discussion with all tables will take place. Faculty members will rotate tables after each case.

Topics:

1. SLAP (superior labral anterior posterior) tear in a thrower
2. ALPSA (anterior labral periosteal sleeve avulsion) lesion in a football player
3. HAGL (humeral avulsion glenohumeral ligament) in a hockey player
   

Faculty

Michael T. Freehill, MD; James P. Bradley, MD; Jacob G. Calcei, MD; W. Ben Kibler, MD; Albert Lin, MD; George A. Paletta Jr., MD; Richard K.N. Ryu, MD; Felix H. Savoie III, MD; John M. Tokish, MD; Nikhil N. Verma, MD

Location: Treasury

Course Description:

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 has been updated to involve care of patients with COVID-19, tricks for telemedicine to succeed and maintaining income will be discussed. This course will build the foundation to allow the physician a comfort level within the business aspects of a successful practice.

Faculty:

Kevin D. Plancher, MD; Peter G. Mangone, MD; Louis F. McIntyre, MD; Allston J. Stubbs IV, MD, MBA

Location: Monument

Course Description:

Not ‘if’ but ‘when’ – complications are an inevitable part of life as a surgeon. Although sometimes simple in theory, dealing with complications represents a challenge for many of us, and our response to these difficult events and the patients affected by them speaks to our effectiveness as physicians. Young surgeons are often unprepared for the bouts of failure that lay ahead.

Yet complications are perhaps our best educator and can be an important catalyst for improvement. Faculty will present the worst complications of their careers as it relates to common shoulder, elbow and knee surgeries. We will discuss both the technical errors and subsequent changes made as well as the life lessons learned along the way. This is intended to be a practical, ‘in-the-trenches’ approach to minimize complications, manage bad outcomes and deliberately improve going forward.

Faculty:

Matthew A. Tao, MD; Christopher S. Ahmad, MD; Beth E. Shubin Stein, MD; Alison P. Toth, MD

Location: Independence Salon E

Course Description:

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.

Described Techniques Include:

ACL repair, All epiphyseal ACL reconstruction, Partial transphyseal (tibia) and over the top (femur) ACL reconstruction, Kocher/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.

In addition, the paramount importance of return to sport timing and risk of re-injury will be discussed regarding pediatric ACL reconstruction

Faculty:

Davide E. Bonasia, MD; Annunziato Amendola, MD; Frank A. Cordasco, MD, MS; Jonathan C. Riboh, MD; Roberto Rossi, MD; Stefano Zaffagnini, MD

Location: Independence Salon C

Course Description:

This ICL features an expert panel that will present an evidence-based approach to current controversies in the management of multi-ligamentous knee injuries (MLKI), including preoperative planning, surgical technique and rehabilitation, to minimize complications and optimize patient outcomes. Common causes for failure and special considerations in the revision setting will be highlighted. Latest updates on ongoing multicenter clinical trials will be provided. A significant proportion of this ICL will be dedicated to an interactive case-based discussion to emphasize key points and ample time will be allocated to answer audience questions.

Faculty:

Aravind Athiviraham, MD; Michael J. Alaia, MD; Alan M. Getgood, MD, FRCS; Volker Musahl, MD; Brian R. Waterman, MD

Location: Archives

Course Description:

Methods to optimize outcomes following ACL reconstruction including graft choice, augmentation with ALL or LET, and internal augmentation with suture tape will be discussed.

• BTB or Hamstring Autograft are the Gold Standards for ACL Reconstruction
• Quadriceps Autograft is Reliable and Reproducible
• Quad Autograft Technique
• Augmentation for ACL Reconstruction
• Case-based discussion

Faculty:

Mary K. Mulcahey, MD; Cassandra A. Lee, MD; Clayton W. Nuelle, MD; Harris S. Slone, MD

Location: Liberty Salon N

Course Description:

This ICL will discuss the approach to the failed hip arthroscopy, particularly failed (1) FAI surgery - evaluation and treatment (2) capsular defects - arthroscopic repair and arthroscopic reconstruction, (3) management approach to lack of reparable labral tissue including segmental and circumferential labral reconstruction. and (4) when throw away the scope and do a periacetabular osteotomy.

Faculty:

Marc R. Safran, MD; Shane J. Nho, MD; Marc J. Philippon, MD; Andrea M. Spiker, MD

Location: Liberty Salon L

Course Description:

Hip pain in the athlete has seen an explosion of growth and interest in the last 20 years. More and more athletes are being diagnosed with hip injury resulting in pain and decreased performance. Advances in diagnostic technology and less invasive surgical techniques (hip arthroscopy) has aided the understanding of pathologies (including new and more recently recognized) and treatment. However, due to the nature of this rapid growth of knowledge, many team physicians are not aware of some of these newer diagnoses, the diagnostic tools and evolving examination techniques to identify these varied pathologies and / or treatments. This ICL will utilize the round table format for more individualized education in a small group format, which is ideal for this area, as different surgeons have differing degrees of baseline knowledge about hip problems in athlete (as well as their diagnosis and management, and return to play expectations), due to its relative recent growth, and sporadic adoption in orthopaedic surgery training programs. These tables will be staffed by experienced team physicians who are hip arthroscopists.

We will discuss early and midseason presentations of common sources of hip pain in athletes, including femoroacetabular impingement (FAI) with and without core muscle injury, hip microinstability, dysplasia (borderline and not borderline), hip subluxation and hip dislocation. Evaluation of these varied pathologies, including examination and imaging techniques, plus non-operative and operative management will be disussed. If time allows, we will also discuss common periarticular sources of hip pain, including adductor strains and tears, iliopsoas strains and hamstring avulsions.

Faculty:

Marc R. Safran, MD; Steven K. Aoki, MD; Brain D. Busconi, MD; JW Thomas Byrd, MD; John J. Christoforetti, MD; Joshua D. Harris, MD; T. Sean Lynch, MD; Shane J. Nho, MD, MS; James T Rosneck, MD; Andrea M. Spiker, MD

Location: Congress

Course Description:

This case-based course will review examining and diagnosing symptomatic patellofemoral cartilage pathology, technical tips and expected outcomes for cartilage restoration, indications and tips for adjunct procedures and consideration for patellofemoral arthroplasty. Each case will be presented and treatment options discussed to elucidate the key history and physical exam findings, treatment strategies, and rehabilitation principles for returning patients to activity and sport. Both operative and nonoperative strategies will be reviewed. This course seeks to have a case-based comprehensive approach to management of cartilage pathology in the patellofemoral joint.

Cases:

1. Evaluation and Non-Surgical Treatment for Patellofemoral Chondral Lesions
2. Cell-Based Cartilage Restoration in the Patellofemoral Joint
3. Osteochondral Allograft of the Patellofemoral Joint
4. Tibial Tubercle Osteotomy and Adjunctive Procedures
5. Patellofemoral Arthroplasty

Faculty:

Austin V Stone, MD; Jeffrey A. Guy, MD; Deryk G. Jones, MD; Drew A. Lansdown, MD; Christian M. Lattermann, MD; Cassandra A Lee, MD; Sabrina M. Strickland, MD; Adam B. Yanke, MD, PhD

Location: Treasury

Course Description:

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 and associated procedure (ACL, cartilage surgeries, meniscus transplant, etc.). Surgical technique for osteotomies will be presented in a case-based format.

Faculty:

Anil S. Ranawat, MD; Alan M. Getgood, MD, FRCS; Anil S. Ranawat, MD; Seth L. Sherman, MD; Armando F. Vidal, MD

Location: Monument

Course Description:

There have been significant advancements in the understanding, evaluation, and treatment of Osteochondritis Dissecans in the past decade, much of it being led by members of the ROCK group. Leaders within the ROCK group will present on these advances, including directly from the researchers leading these efforts. Our aims are to inform the attendees about changes and updates within our knowledge on OCD, and hopefully assist them in their management of this historically challenging pathology. The outline is:

• Rock group radiographic and clinical studies, plus new information on genetic studies
• New knowledge in OCD pathophysiology
• Advances in MRI capabilities in OCD
• Changes in OCD treatment pathway
• Case Discussion:
  • Non-operative OCD that fully healed radiographically
  • Drilling of OCD without fixation
  • Open curettage and fixation with proximal tibial bone grafting

Faculty:

Marc Tompkins, MD; Jutta M. Ellermann, MD; Theodore J. Ganley, MD; Crystal A. Perkins, MD; Kevin G. Shea, MD

Location: Independence Salon E

Course Description:

What can we do and not do to keep the athlete in the game in 2023? An ever-changing controversial landscape we all practice in. These are the facts! The purpose and goals of this ICL are to highlight and review those things one sees/confidently manages on game day to keep the athlete in the game with MSK injury. We will discuss the common and uncommon things one must manage at time zero to allow the athlete to safely return to play. This will include upper and lower extremity injuries we manage immediately after the injury. We will discuss decision making on who to MRI and maybe who we do not. Review those injuries that we may safely return to athlete to play knowing surgery may surely happen at the "end of the season”. This will be a case based ICL showing exactly how we manage these "controversial" topics and either allow the athlete to participate or they are out. These topics remain controversial and ever changing in our profession and impossible to find in a textbook or on the web. We will also highlight how the role and confidence and trust of the team physician by the injured athlete is an integral part of the shared decision making between athlete and team physician. After completion of this ICL the gameday coverage by YOU will enable one to manage safely and confidently these "in game injuries" and allow the athlete to return to participation as soon as possible.

Faculty:

Darren L. Johnson, MD; Annuziato Amendola, MD; Geoffrey S. Baer, MD, PhD; Peter A. Indelicato, MD

Location: Independence Salon C

Course Description:

The management of massive rotator cuff tears continues to evolve. We have new options to consider (subacromial spacer, augmentation, biology) with repair and constant debate on when to perform arthroplasty, partial repair, biceps tenodesis, tendon transfer and superior capsular reconstruction. We have a assembled a strong team of shoulder experts to present cases, discuss latest trends, and highlight the new options available. This ICL will be a case-based format with a focus on how to combine new products and options with traditional techniques.

Faulty:

Matthew Bollier, MD; Grant L. Jones, MD; Augustus D. Mazzocca, MD, MS; Felix H. Savoie III, MD; Nikhil N. Verma, MD

Location: Archives

Course Description:

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.

Faculty:

Brandon J Erickson, MD; Eric N. Bowman, MD; Peter N. Chalmers, MD; Gregory L. Cvetanovich, MD; Anthony A. Romeo, MD; Mark S. Schickendantz, MD

Location: Liberty Salon N

Course Description:

This course will review key components of meniscal repair and emphasize the importance of meniscus preservation. Indications for meniscus repair versus partial meniscectomy will be discussed. Techniques for repair of complex meniscal tears, including all-inside, inside-out, and outside-in repair, will be examined in a case-based discussion along with unique advantages, disadvantages, and indications for each. Finally, complications of meniscus preservation procedures and prevention with meniscal centralization and meniscus allograft transplantation will also be discussed.

Faculty:

Volker Musahl, MD; David C. Flanigan, MD; Aaron J. Krych, MD; Andrew Sheean, MD

Location: Liberty Salon L

Course Description:

This ICL will involve engaging roundtable discussion about the management of simple and complex shoulder pathology. Cases will include:

• Shoulder Instability
  • Pan-labral repair
  • Revision bone block procedure for failed Latarjet
  • Table discussion and summary of learning points
• Biceps
  • Biceps tenodesis for SLAP tear in overhead athlete
  • Subscapularis repair and associated biceps instability
  • Table discussion and summary of learning points
• Rotator Cuff
  • Primary massive rotator cuff repair
  • Revision rotator cuff repair with muscular atrophy & tendon deficiency
  • Table discussion and summary of learning points
• AC Joint Injuries
  • Acute type III AC separation with horizontal instability
  • Type V AC separation
  • Table discussion and summary of learning points

Faculty:

Mary K. Mulcahey, MD; Julie Bishop, MD; Jonathan F. Dickens, MD; Sara L. Edwards, MD; Xinning Li, MD; Matthew Provencher, MD, MBA, MC USNR (Ret); Nikhil N. Verma, MD; Brian R. Waterman, MD

Location: Congress

Course Description:

Ever encounter unexpected challenges while operating? We all have. This ICL will present cases that the panel has encountered that provided unexpected challenges or intraoperative complications, and how the panelists managed such cases. A case will be presented by each of 5 panelists. Panelists not presenting will be supervising discussion at the round tables. After presenting the case, the complication/challenge will be introduced. Prior to explaining how it was troubleshot, the round tables will discuss the case and how the challenge could have/have not been avoided and how to circumnavigate it in their own practice. The group will then follow back up with the presenting panelist as far as what was discussed at the round tables and what was performed. Additionally, the panelist will discuss what they employ to prevent said challenge/complication from occurring again. Cases will be based around commonly encountered sports medicine knee surgeries - ACL, meniscus, cartilage restoration, MCL/PCL/LCL, and multiligament injuries. You’ll walk away with knowledge on how to anticipate or avoid the unexpected in knee surgery.

Faculty:

Justin J. Ernat, MD; Aaron J. Krych, MD; Travis G. Maak, MD; Armando F. Vidal, MD

Location: Treasury

Course Description:

This ICL will cover the most recent updates regarding the uses of orthobiologics in the management of orthopaedic patients. Covered will be regulatory aspects of orthobiologics, basic science and clinical evidence in the treatment of osteoarthritis and soft tissue restoration, and strategies for billing in the use of orthobiologics. The presentations are as follows:

• Biologics for the treatment of osteoarthritis
• Orthobiologics in Soft tissue Restoration
• Regulatory Perspectives in Orthobiologics
• Billing in the Use of Orthobiologics

Faculty:

Stephen C. Weber, MD; Jason L. Dragoo, MD; Louis F. McIntyre, MD; Scott A. Rodeo, MD

Location: Monument

Course Description:

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 and associated procedure (ACL, cartilage surgeries, meniscus transplant, etc).

Surgical technique for osteotomies will be presented in a case-based format.

Faculty:

Volker Musahl, MD; David Dejour, MD; Alan M. Getgood, MD, FRCS; Anil Ranwat, MD; Stefano Zaffagnini, MD

Location: Monument

Course Description:

Shoulder arthritis in the young patient has become a more common problem, and the treatment options for these patients are numerous. A clear understanding of the available treatment options, and which patients are appropriate for each option is imperative to proper management of this problem. The goal of the IC is to cover the entire spectrum of arthritis in the young patient. The IC will begin with diagnosis, including pearls for the physical exam and what imaging tests are most appropriate and afford the most information for clinical decision making. Next, arthroscopic treatment options including microfracture, MACI, osteochondral allografts and others will be discussed. This will be followed by a discussion on soft tissue glenoid resurfacing and the ream and run procedure. Surgical pearls for each procedure will be provided. Anatomic total shoulder arthroplasty will then be discussed in detail including when to indicate young patients for this procedure and how to make sure the shoulder is truly “anatomic.” Lastly, complications, more specifically how to diagnose and manage these complications, following the above procedures will be discussed. The IC will conclude with 2-3 case presentations in which the audience is asked to participate and interact with the faculty.

Faculty:

Brandon J. Erickson, MD; Matthew T. Provencher, MD, MBA, MC USNR (Ret); Anthony A. Romeo, MD; Samuel A. Taylor, MD

Location: Independence Salon C

Course Description:

Most orthopaedic 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 to help 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 evolving and 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 clinical cases 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.

Faculty:

Gautam P. Yagnik, MD; Andrew B. Dossett, MD; Craig S. Mauro, MD; Steven S. Shin, MD

Location: Archives

Course Description:

The management of patellofemoral instability remains a complex and challenging algorithm for treating surgeons. A variety of anatomical factors, including osseous morphology and soft tissue injury and laxity influence decision-making to minimize the risk for recurrence and failure. Chondral status associated intra-articular injuries, and patient-specific goals and expectations further complicate decision-making. Rehabilitation and return to play continue to evolve as well with improved techniques to protect repairs and assess functional progress. This ICL will feature key opinion leaders in patellofemoral instability and will feature case vignettes ranging from simple to highly complex injury patterns for discussion. Physical examination, critical evaluation of imaging, and considerations for intraoperative decision-making will be reviewed. Technical pearls for MPFL reconstruction, trochleoplasty, tibial tubercle osteotomy, and femoral derotational osteotomy will be provided, and the rehabilitation approach and timelines for return to sport discussed. Complications and their management will also be reviewed by faculty.

Faculty:

Asheesh Bedi, MD; David R. Diduch, MD; Jason L. Koh, MD; Beth E. Shubin Stein, MD; Sabrina M. Strickland, MD

Location: Liberty Salon N

Course Description:

The treatment of bone loss in anterior shoulder instability presents many challenges and is evolving rapidly.

The traditional open bone block procedure has been challenged by recent developments of arthroscopic means of addressing bone loss on both the glenoid and humerus. This ICL will investigate in detail contemporary arthroscopic means of addressing attritional bone loss on both the humerus and glenoid.

Faculty:

John D. Kelly IV, MD; Travis J. Dekker, MD; John M. Tokish, MD; Ivan H. Wong, MD