Thank you, and you know, I didn't see those videos. This makes it even easier, because I haven't, she's better than I thought, bruh. These are my disclosures. I want to thank Mike O'Brien for his mastery, and I also want to give a shout out to J.T. Tokish for his servant leader's heart. That's why Anne is doing so well. So let's define the rules of engagement. Is this pseudoparasis, which is defined as less than four inflection, full range of motion, no escape. John Tokish is talking about eliminating pain. She's had injections, but that video shows that she can do it. She has probably loss of three out of five tendons. But for today's purposes, I want to use my mentor, Steve Burkhart's definition, active four inflection, less than 90, which he has. Full passive four inflection, we saw that. She actually can hold her arm at 90. She's better than Burkhart would define as pseudoparalysis. So I get my ire shuffled about this, because our obligation as surgeons is number one, restore anatomy, restore anatomy. And my other principle that I try to live by, try to live by, is first do no harm. First do no harm. So this is the fasciolata harvest, and this is Bessem's minimally invasive lower trap exposure. And the gloves are off, as we say in Philadelphia. And I had a great mentor, John Lachman, Lachman test. And he always say, he called me Jack. Repair's always better than reconstruction. That's usually, you're talking about the postulatal corner of the knee, that's almost always applicable to my practice. Now I'm not up here preaching fish oil. Again, one of my shoulder mentors, Steve Burkhart, published this 2015, he had 56 patients. And I had Pat Denards in the audience, other Burkhart fellows. And his four inflection improved from 47 to 159. AACS scores 37 to 88. And pseudoparalysis, defined by his definition, was reversed in 95% of patients. But you gotta fix it right. You gotta fix it right. I've learned through many people in this room, particularly Buddy Salvois, to do an inferior release. Whatever you do, folks, this is what I learned, the gray hairs, if you get the head down, that's 90% of the ballgame. I do an inferior release, I do a thorough cortical humeral release, and I haven't forgotten the art of margin convergence. You forget about this double row stuff, and tension type, put it where the good Lord made it. Margin convergence is the key to this procedure. You want a tension-free repair, I augment, I use the biceps we just heard from Guillermo. Alan Curtis has a wonderful series on using the balloon. Larry Field just published this article on using the biceps. I do all these things, except when I can't get the balloon paid for, Alan, for now, but anyway, it's another talk. But you gotta fix it right. Our own Buddy Salvois showed that not only does it work, but it heals. Now, I would argue this data, and Buddy Salvois is, like me, a Catholic in recovery, he cannot lie. 96% ultrasound healing on MRI. 96%, and the ASDS scores were 83. And in my humble hands, we just got this accepted at arthroscopy, and I'm not John Tokrish or Mark Edelman, this is JK here, we got 86, 85.5 ASDS scores, and in my series, there was no correlation with Goutelier's score or Hamadegri. As my brother at trial would say, any questions? She's 55, and according to Mike Kazan's work, she has about a 70% chance of re-tear by the meta-analysis literature. She's 55. Now, this is Ivan Wong's minimally invasive harvest, right, well guess what, that ain't gonna fly in Philly. The only time someone in Philly wants you to mess with their thighs, they do a thigh lift, okay? All right, it ain't gonna fly. And the dermal allograft is expensive, it's dead. Of course, I use Irish donors when I use this because they're soaked in alcohol, they never get an infection. They have an immunogenic response and unpredictable results, and Albert Lin showed us that they stretch, they stretch. And Ben Kibler was saying, well, lower traps, no big deal, Ben Kibler, he talks like this, John is a big, big, big syphilis, scab diseases, you can't abduct your arm, it's a low trap. Well, I have my lower trap transfer, look, guys, this is how I tipped a waiter last night. So, now, Joaquin showed us that these SCRs work, but when you compare them to, and the lower trap, but Steve Burkhart wins, he wins, 159. So what do you want for your loved one? Do you want Passine's trap harvest? Or do you want Mahada's fashionable auto-harvest? What do you want? Or do you want this? What do you want? Come on, man, get a life. Come on, man. Hey, JT, I wish I had a microphone to drop here. Appreciate it. Thank you. Please note that the views of Dr. John Kelly do not necessarily represent the views of Anna Isikoff of the American Academy of Orthopedic Surgeons.

surgical techniques

shoulder repairs

anatomy restoration

avoiding harm

orthopedic surgery