Sports Knee Curriculum 2018

Transcription

1 Sports Knee Curriculum 2018 ACL Revision Course Soft Tissue Three Conveners: Mr Andrew Davies and Mr Adil Ajuied Expert Connect Centre, Croxley Park, UK Tuesday 4 September Wednesday 5 September 2018

2 Page 2 Description The ACL revision course is a fun, stimulating and hands on cadaveric course that is delivered by a faculty of high volume soft tissue knee revision surgeons, with an established track record in training and education. Delegates are experienced soft tissue knee surgeons with established primary ACL practices, and wishing to progress to revision ACL surgery. Delegates will be equipped with the clinical decision making and surgical skills necessary for them to become accomplished and advanced ACL revision surgeons Conveners Mr Andrew Davies Consultant Specialist Knee Surgeon, Senior Honorary Lecturer, Fortius Clinic, and Guy s & St Thomas Foundation Trust Mr Davies specialists in reconstructive surgery and sports injury to the knee. Mr Andrew Davies undertook two fellowships in reconstructive knee surgery at the leading Sports Medicine Clinic in Sydney and Perth, Australia. His surgical interests include ligament repair and joint replacement and he has particular expertise in reconstructive surgery and sports injury. Mr Adil Ajuied, BSc(Hons) MSc FRCSEd(Tr&Orth) Consultant Specialist Knee Surgeon, Senior Honorary Lecturer, Fortius Clinic, and Guy s & St Thomas Foundation Trust Mr Adil Ajuied is a Consultant Knee Surgeon specialising in soft tissue knee surgery. His fellowship training saw him work and train in Johannesburg, Cape Town and London. His current areas of interest include new options in graft choice and revision ACL surgery. Scope Causes of ACL failure, Tunnel positioning, Tunnel management, Graft options, Peripheral lesions and their assessment and reconstruction. Aim To aid delegates with their clinical decision making and give them all the surgical skills necessary for them to become accomplished and advanced ACL revision surgeons.

3 Page 3 Education goals At the end of this course, you will be able to: Assess and identify surgical candidates for ACL revision Consent and counsel patients for ACL Revision Assess and manage tunnels mal-position, and dilation o Single stage revision o Two stage revision Graft choice in ACL Revision Assess for and manage o ALC insufficiency o PLC insufficiency o Ramp lesions Faculty Mr Giles Heilpern MA FRCSEd(Tr&Orth) Divisional Director Specialist Services Fortius Clinic and Kingston Hospital NHS Foundation Trust Mr Sanjay Anand MB ChB MRCSEd, MSc FRCS (Tr & Orth) Consultant Orthopaedic Surgeon, Stepping Hill Hospital, Stockport, BMI Alexandra Hospital, Cheadle and Spire Hospital, Manchester Mr Ian Corry Consultant Orthopaedic Surgeon The Belfast Knee Clinic Mr Paul Gibb FRCS, FRCS (Orth) Consultant Orthopaedic Surgeon, Kent and Sussex Hospital, Tunbridge Wells Professor Martyn Snow Consultant Orthopaedic Surgeon The Royal Orthopaedic Hospital, Birmingham Honorary Professor, Birmingham University Industry partners Smith & Nephew Hospital Innovations

4 Page 4 Tuesday 4 th September :30 Registration 10:30 Faculty briefing 11:00 Welcome, Introduction of Faculty and Disclosures Adil Ajuied Session 1: Chair Andrew Davies 11:15 ACL Failure Mechanisms of failure Risk factors for failure (fixed and modifiable) Epidemiology 11:30 ACL Deficient knees, clinical assessment Goals of assessment History, examination and investigations informing decision making 11:45 ACL Tunnel position Footprint Referencing/landmarks Journey from trans Tib to trans AM, then Double bundle, then Anatomic, then mid-am bundle Link of tunnel position to failure 12:00 Tunnel management Mal-positioned o Ignore and re-drill o Off setting Graft and re-drill Graft with offset bone block Blocking bio-screw Dilated o Combined suspension and interference (for aperture closure) o Stage revision 12:15 Demo Femoral bone grafting (dowel and soft) Wet demo Telecast Tibial bone grafting (dowel and soft) Wet demo Telecast Martyn Snow Adil Ajuied Sanjay Anand Sanjay Anand Martyn Snow Sanjay Anand 13:00 Course photograph 13:10 Lunch 14:00 Hands on: Session 1 Femoral Lab Tasks Femoral over ream Femoral dowel graft Femoral mastercard re-drill Soft graft/pack new femoral tunnel Blow out proximal femoral cortex and use Ext endobutton All faculty Tibial Lab Tasks Tibial over ream Tibial dowel graft Tibial re-drill with offset Soft graft/pack tibial tunnel Tibial bone graft harvest Back up graft fixation (Staple and footprint)

5 Page 5 Session 2: Chair Adil Ajuied 15:30 Graft options and fixation in Revision ACL Auto ipsilateral Auto contra-lateral Allograft Need to fill tunnels Backing up fixation/hybrid fixation Ian Corry 15:45 Demo BTB Harvest Paul Gibb 16:05 Demo Quads Harvest Ian Corry 16:25 Hands on: Session 2 BTB harvest Quads harvest Bone block cross drill Position block for offset Pass BTB Allo and interference fix 17:30 Close All faculty 19:30 Course dinner Wednesday 5th September 2018 Session 3: Chair Andrew Davies 09:00 ACL Ant Lat Complex Biomechanics ALL vs ITB philosophy Surgical principles for ALL/McIntosh tenodesis Paul Gibb 09:15 Demo McIntosh Wet demo Telecast Adil Ajuied 09:35 Demo ALL Recon Wet demo Telecast Paul Gibb 09:55 Ramp lesion Giles Heilpern Biomechanics Diagnosis Assessment Repair surgical technique 10:10 PLC Andrew Davies Biomechanics Diagnosis Assessment Larson vs Laprade Surgical technique for reconstruction 10:25 Demo Ramp Wet demo Telecast Giles Heilpern 10:45 Demo PLC Wet demo Telecast Andrew Davies 11:05 Hands on: Session 3 All faculty 12:30 Lunch Session 4: Chair Adil Ajuied

6 Page 6 13:30 Debate All ACL Revision must be performed as a Single stage Sanjay Anand Single GA, episode off work, rehab, etc. Can always make the tunnels work Less use of resources Any literature 13:40 Debate All ACL Revision must be performed as Two stage Ian Corry Patient has certainty Easy second stage No compromises on tunnel position, fixation etc Patient deserves best possible revision having failed once Any literature 13:50 Retort Sanjay Anand 13:53 Retort Ian Corry 13:56 Vote 14:00 My revision experience Tips, tricks and what I ve learnt Andrew Davies 14:20 Roundtable discussion All faculty How do you rehab your revision Locked knee with ACL single/two stage Who should be doing ACL Revision 14:45 Case studies Difficult/interesting cases 15:20 Hands on: Session 4 McIntosh ALL Recon Create RAMP lesion via PM Portal Create RAMP via Trans AM portal approach PLC Reconstruction 17:00 Close All faculty All faculty

7 Page 7 Course fees Registration fee covers course dinner, accommodation (one night), instructional course attendance, course materials and refreshments. Hotel Holiday Inn London - Watford Junction Clarendon Rd, Watford WD17 1DS Course venue Smith & Nephew Expert Connect Centre (ECC) Croxley Park Building 5 Hatters Lane Watford WD18 8YE Course dinner To be confirmed Organiser Jordanne Cummings Professional Education Specialist Jordanne.Cummings@smith-nephew.com D +44 (0) M +44 (0)

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