This course includes the recording of a live Instructional Course from the 2024 AOSSM Annual Meeting which took place in Denver, CO.

IC 305: My Worst Day in the Operating Room: Navigating and Preventing Pitfalls and Complications Associated with Arthroscopic and Open Knee Surgery

Course Description:

If you are an orthopedic surgeon, it is only a matter of time before you will encounter a challenging scenario in the operating room, complex patient situation, or be faced down by a complication. The aim of this instructional course lecture is to provide education regarding some of the more common complexities, as well as more extraneous complications and scenarios that a sports medicine knee surgeon may encounter. A panel for four complex knee surgeons from academic institutions will present cases in which a complexity or a complication significantly impacted their routine of patient care. They will discuss the measures taken to rectify the problem, in addition to the values they took from their case and how it impacted their future approach to prevention and mitigation of such instances. Topics covered will include fracture and hardware failures due to implants, graft harvest, and/or tunnel malposition in ACL reconstruction, neurologic injury in the setting of meniscus repair and multiligamentous knee injuries, fracture, and failure perioperatively in the setting of osteotomies around the knee, amongst others. Case examples will include those ranging from straight forward primary ACL reconstructions to more complex osteotomies and reconstructions around the knee. Time will be given for panel discussion as well as audience interaction to fully dissect each case from multiple perspectives and experiences.

Learning Objectives:

• Identify strategies in ACL reconstruction that prevent common perioperative complications such as fracture, hardware failure, impingement, and residual laxity.
• Develop problem solving strategies that mitigate risk in the setting of proximal tibial and distal femoral osteotomy for sports medicine issues around the knee.
• Understand risks factors for iatrogenic common peroneal nerve injury at the time of orthopedic knee surgery, and how to mitigate said risk factors based on a thorough understanding of lateral knee anatomy.
• Identify preoperative patient factors that may increase the risks associated with arthroscopic and open knee surgeries such as multi-ligamentous reconstruction, ACL reconstruction, and osteotomy.
• Prepare for challenges that may present in the setting of resident and fellow education that could lead to intra- or postoperative identification of pitfalls and complications.

Often, the first instinct to run away from a complication/challenging scenario. By embracing and discussing others' pitfalls, this IC will provide surgeons with strategies and tools to mitigate risks and expect the unexpected in their own practice.

Faculty:

• Justin J. Ernat, MD
• Aaron J. Krych, MD
• Travis G. Maak, MD
• Armando F. Vidal, MD