Complex Shoulder Instability (AANA25)-Case-Based, Advanced Decision-Making in Complex Shoulder Instability: Anterior, Posterior, Bone Loss and Revisions

Video Transcription

Video Summary

In a seminar focused on shoulder instability, various experienced professionals discussed case management strategies for complex shoulder revisions. The session was interactive, featuring multiple case presentations that allowed the audience to contribute insights and experiences. The participants explored anterior-posterior bone loss and revision surgery cases, emphasizing the lack of consensus on standardized next steps due to the controversies and complexities involved.<br /><br />Dr. Tokish presented a case on a failed Latter Jay procedure, highlighting the need for comprehensive preoperative planning and introducing alternative surgical options, such as humeral head osteochondral allografts and distal tibia allografts. He underscored the significance of humeral bone loss management and the importance of using advanced technology like 3D printing for graft preparation.<br /><br />The session also discussed managing specific cases, such as a patient with a posterior instability pattern potentially linked to abnormal acromion morphology and hypoplastic glenoid. The panel debated the potential benefits of bone blocks, osteotomy, and the role of pacemaker-like devices in rehabilitation.<br /><br />Another case involved a first-time shoulder dislocation in a young quarterback. The discussions focused on whether to perform surgery immediately or adopt a conservative approach, factoring in the implications for athletic performance and the likelihood of recurrent dislocation. Moreover, the risks and benefits of various surgical techniques, including the Bankart repair and remplissage, were analyzed.<br /><br />Overall, the seminar provided valuable insights into the complexities and nuances of managing challenging shoulder revision cases, emphasizing the importance of clinical judgment, innovative technology, and collaborative discussion in achieving optimal patient outcomes.

Asset Caption

Richard K.N. Ryu, M.D. | Michael J. O'Brien, M.D., FAANA | Stephen A. Parada, M.D. | Jeanne C. Patzkowski, M.D., FAANA | John M. Tokish, M.D., FAANA

Keywords

shoulder instability

case management

complex revisions

anterior-posterior bone loss

revision surgery

Latter Jay procedure

humeral bone loss

3D printing

acromion morphology

shoulder dislocation

Bankart repair

remplissage