Welcome

by Össur - Mark Tymchenko

Introduction – Contemporary outcomes of addressing tibial slope and tibiofemoral alignment; prescreening patients with bracing and protecting surgical ligament and meniscus repair procedures postoperatively; a new standard of practice for brace use to both prescreen patients and also to treat postoperatively to optimize outcomes.

by Dr. Gilbert Moatshe

Choosing candidates for coronal plane alignment around the knee, setting expectations, and utilizing Unloader bracing as proof of principle to prescreen patients.

• Genu varus + medial compartment OA with a case - by Dr. Daniel Whelan
• Genu valgus + lateral compartment OA with a case - by Dr. Nick Kennedy

Coronal plane malalignment risk factors in treating patients with cartilage replacement surgery and meniscal transplants, and Unloader bracing to validate dx and as post-op best practice.

• Genu varus + medial compartment cartilage resurfacing (or medial meniscus transplant) with a case - by Dr. Jorge Chahla
• Genu valgus + lateral compartment  cartilage resurfacing (or lateral meniscus transplant) with a case - by Dr. Adam Anz

Coronal plane alignment with osteochondritis dissecans of MFC or LFC  in open physes -Unloader bracing to assist with healing with a case, where are we and what is state of the art?

by Dr. David Wasserstein

Q&A / Break

Overview: Unloader bracing to support recovery after soft-tissue interventions: Medial Meniscus repairs with underlying varus alignment

by Dr. Patrick Kane

Unloader bracing for meniscal repairs:

• Utilization of medial unloader braces to protect medial meniscus root repairs in patients with underlying varus alignment with a case; review literature with higher BMI and varus being higher risk factors for root repair failure. - by Dr. Scott Faucett
• Lateral unloader brace use to protect LM root/radial repairs with underlying valgus alignment with a case. - by Dr. Iain Murray

Unloader bracing for ligament reconstructions:

• Utilization of lateral unloader braces to protect acute MCL repairs and reconstructions with a case (severe case with valgus alignment)
• Utilization of medial unloader braces to protect acute FCL and complete PLC reconstructions with a case (severe acute case with significant varus malalignment).
• Describe treatment of chronic varus knees with PLC injuries and valgus knees with MCL injuries and use of bracing to screen for symptom relief prior to surgery (osteotomy = +/- first stage ligament reconstruction).

by Dr. Ciara Stevenson

Q&A / Break for Lunch - faculty mingle with attendees to review morning sessions

Primary ACLR with increased slope considerations with a case.

• When to add in anterolateral complex surgery
• Consider ACL Rebound brace (complex only; pediatric ACLR with hamstrings case)
• What is the slope cutoff for a first stage primary ACW-PTO?

by Dr. Gilbert Moatshe

Revision ACLR with a case

• Slope decreasing PTO (primary or staged?) with PTS >16 degrees
• Add in ACL Rebound brace to protect concurrent meniscal repairs with first-stage slope reducing PTO/tunnel bone grafting and concurrent first stage meniscal repairs - protection of first stage surgery with an ACL deficient knee for 5-6 months until 2nd stage performed -what does the literature report?

by Dr. Jorge Chahla

KSSTA study CPG Systematic review ACL Paper overview and questions; Review next steps to improve delineation of optimized ACL tear/ACLR brace usage - cover concerns about CPG shortcomings.

by Dr. Andy Geeslin

The Science Behind the Utilization of PCL Dynamic Bracing to Prevent PCL Graft Attenuation

• Utilization of PCL Rebound brace to prevent PCL graft attenuation in patients with flat tibial slopes (specially for single bundle PCLR); revision cases, and PTT > 12 degrees

by Dr. Robert LaPrade

Revision PCL & flat tibial slope - what to address - with a case-optimization of outcomes, report how SB PCLR stretch out with flat slopes; indication for DB PCLR =/- anteromedial osteotomy - how can we improve this?

by Dr. Andrew Bernhardson

Summary / Wrap Up / Expectations for Day 2 (review literature or lack of literature and current failure rates and potential reasons for failure; develop potential Delphi questions on topic area)

by Dr. Jorge Chahla/Dr. Andy Geeslin/Dr. Ciara Stevenson/Dr. Darren Johnson/Luke Tollefson

Overview of Day 2 Agenda

by Dr. Robert LaPrade and Mark Tymchenko

Opening with Sveinn Solvason, President & CEO at Embla Medical

Breakouts / Workshops / Consensus build - Review literature on topics, develop Delphi study questions including what is known and what needs to be done for future research to optimize patient outcomes with coronal and sagittal bony malalignment issues

by Dr. Iain Murray/Dr. Andy Geeslin/Dr. Ciara Stevenson/Dr. Darren Johnson

• Breakout Group 1: Unloader Braces for OA and Cartilage Procedures (OCA, OAT, OCD)- by Dr. lain Murray
• Breakout Group 2: Unloader Braces for Medial and Lateral Compartment Meniscus Procedures-Transplants, Root Tears, Radial Tears, Horizontal Cleavage Tears, Vertical Tears- Dr. Andy Geeslin
• Breakout Group 3: Unloader Braces for Collateral Ligament Instability: MCL and FCL instability, acute vs. chronic- Dr. Ciara Stevenson
• Breakout Group 4: rebound Braces for ACL and PCL injuries – ACL acute vs. chronic, PCL acute vs. chronic, PTS cutoffs for both, after osteotomy and bone grafting- Dr. Darren Johnson

Working Lunch / Optional Tour ( 3 groups)

Summary of Breakouts - Review Delphi study questions developed for specific topics for group and receive feedback

by Dr. Iain Murray/Dr. Andy Geeslin/Dr. Ciara Stevenson/Dr. Darren Johnson/Luke Tollefson

Closing / Next Steps - Review modified Delphi study protocol, suggest other faculty, timelines to complete 3 rounds and homework for flights home

by Dr. Robert LaPrade / Mark Tymchenko / Sveinn Solvason, President & CEO at Embla Medical