UPMC Video Rounds - Orthopaedic Surgical Treatments

Bryson Lesniak, MD, associate professor, Department of Orthopaedic Surgery:

The determination for arthroscopic versus open stability procedures of the shoulder, for shoulder dislocations, either single or multiple, really is multifaceted approach. And recent data has been showing that, especially with collision athletes, football players, hockey players, open procedures may afford them a better outcome. So, we look at position of the player, the sport they play, and the age of the player and determine what the best kind of procedure is for them. Then take into account, obviously, MRI findings, and clinical exam findings as well.

Too many joint injuries, or ulnar collateral ligament tears are happening earlier and earlier with youth baseball players. That used to happen to professional players, or even college players. But now it's happening in high school, and even youth athletes. Because of that, we're seeing more, and more injuries. We're seeing more, and more ways to try to minimize the impact of the surgery. And so, rather than doing a total reconstruction, people are doing primary repair of a ligament, especially in young athletes, and augmenting that repair with biologic reconstructions, or biologic injections. And suture and anchor reinforcements of that ligament.

We're looking at several research projects involving the throwing motion. We're looking at research projects involving rotator cuff injuries. And looking at patient's motion analysis, and whether or not any abnormal motions are clearly evident with their ability to put their arm over their head, or reach out for certain objects. And then, trying to correct those inefficiencies, correct those abnormalities, in hopes that that will resolve their problem.

Learn more about the UPMC Department of Orthopaedic Surgery.