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Congratulations to Dr. Evan Lederman for his recent publication!

Title: The Evolution of the Superior Capsular Reconstruction Technique

Alan M. Hirahara, MD, FRCSC; Evan S. Lederman, MD; Wyatt J. Andersen, ATC; and Kyle Yamashiro, PT, DPT, CSCS

Introduction

Irreparable, massive rotator cuff tears can result in unacceptable functional deficits in patients. When the supraspinatus tears and retracts medially, the superior capsule is also disrupted, and superior constraint is lost. With no superior restraint to the humerus, the humeral head migrates superiorly, causing a decrease in the acromial-humeral distance. [1-4]

Biomechanical analysis has shown that a defect in the superior capsule results in a minimum 200% greater glenohumeral superior translation and subacromial peak contact pressure compared with an intact capsule. [3] The malposition of the humeral head leads to functional abnormalities and pseudoparalysis.

Numerous proposed treatments for massive rotator cuff tears – including debridement and tenotomy, tendon transfers, and reverse total shoulder arthroplasty – have yielded mixed results and high complication rates. [5-12] In particular, reverse shoulder arthroplasty can result in humeral or glenoid fractures, persistent anterior or posterior instabilities, loosening of the glenoid or humeral cemented components, dislocations, and infection. [5-7]

The superior capsular reconstruction (SCR) was described by Hanada et al [13] in 1993 and by Mihata et al [1] in 2013 as an alternative procedure to increase function and decrease pain by restoring the restraint mechanisms in the shoulder. Using a graft to recreate the superior capsule, the humeral head is centered in the glenoid, allowing the larger muscles (ie, deltoid, latissimus dorsi, and pectoralis major) to function appropriately. Mihata et al [3,4] have found that the SCR reduces glenohumeral superior translation and subacromial contact force.

Full article link below.

ICJR.net  March 2018

Congratulations Dr. Evan Lederman!

Congratulations Dr. Evan Lederman (Arthroscopic Surgery, Sports Medicine, Shoulder & Knee Reconstruction Orthopedic Physician and Surgeon at TOCA)! Dr. Lederman has been invited as a speaker to the 2017 Current Concepts in Joint Replacement (CCJR). The 18th annual course is held in Las Vegas, Nevada annually in May. The CCJR meeting is one of the largest joint replacement in the US with over 1,000 attendees.

Dr. Lederman will be speaking on topics such as “Controversies in Shoulder Reconstruction”, “Preventing Infection in Shoulder Arthroplasty: Navigating the Minefields”, “What would YOU do? Challenges in Shoulder Surgery” and “Tips, Tidbits & Surgical Pearls: Critical Keys to Success in Shoulder Arthroplasty – Humeral Cemented Revision: Techniques for Safe Extraction”.

To learn more about Dr. Lederman or to schedule an appointment visit www.tocamd.com or call 602-277-6211!

COURSE DESCRIPTION

The course is open to orthopaedic surgeons, residents, nurses, and members of the orthopaedic and allied health industries.

• This meeting will focus on both primary and revision outcomes, surgical approaches, new materials and design as well as address problems of articulation choice, fixation, bone deficiency, instability, trauma, and infection for hip, knee, and shoulder replacement.

• Topics delve into a triad of design, patient factors and technical proficiency responsible for achieving clinical longevity in hip, knee, and shoulder reconstruction.

• Hemi and total shoulder arthroplasty topics focus on improved instrumentation, design modularity, evolving surgical techniques, and optimal patient outcomes.

• An assemblage of contemporary thought leaders will probe the boundaries of these problems and offer solutions for joint pathologies where arthroplasty is indicated.

• An assemblage of contemporary thought leaders will probe the boundaries of these problems and offer solutions for joint pathologies where arthroplasty is indicated.

• Plenary commentary, didactic clinical reports, technique videos, debate, case challenges, and live surgery define the formats of presentation, which provide an optimal learning opportunity for orthopaedic surgeons and other allied professionals involved in joint reconstruction.

LEARNING OBJECTIVES

As a result of attending this symposium, the participant will be able to:

• Appraise evolving surgical techniques and implant technologies through didactic and interactive live presentation as well as evaluate early and long-term clinical outcomes.

• Identify problems and concerns relevant to hip, knee, and shoulder arthroplasty including polyethylene wear, short and long term tissue response, inter-component failure, and peri-prosthetic fracture.

• Discuss optimal clinical application of current and evolving fixation techniques in primary and revision procedures including cement, hydroxyapatite, porous coating, press fit, impaction grafting, and evolving porous metal technologies

• Appreciate current solution options for hip, knee and shoulder arthroplasty failure where revision is an endpoint and understand the contributory roles of bone loss, soft tissue deficiency, and infection.

ACCREDITATION STATEMENT

The Current Concepts Institute is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

#Recovery #Results #Relief #JointReplacement #Orthopedics#Sportsmedicine