2025 ASSH On-Demand CME Webinar: Osteochondral Reconstruction-Recording

Video Transcription

Video Summary

In a recent webinar hosted by the American Society of Surgery of the Hand, critical topics surrounding the osteochondral reconstruction of scaphoid non-unions were discussed. Chaired by James Higgins, the session featured experts Jeff Yao and Nina Su, who delved into various techniques and outcomes related to this challenging condition, where traditional methods often face limitations due to factors such as non-salvageable proximal poles, high patient demands, and prior surgical failures.<br /><br />Nina Su elaborated on the use of the hemi-hamate autograft technique, emphasizing its biomechanical suitability due to the congruency and local accessibility of graft materials. She noted its application is particularly considered when conventional graft methods fail, especially in revision surgeries, though it does raise concerns about carpal kinematics long-term.<br /><br />Jeff Yao discussed the osteochondral rib autograft procedure, highlighting its effectiveness in young patients with significant defects. Despite initial fears regarding the thoracic proximity, the method proves to be less invasive than expected and offers a robust alternative when salvage techniques are undesirable.<br /><br />Higgins presented the medial femoral trochlea (MFT) flap, emphasizing the longer-term outcomes and superiority over conventional salvage operations. The research supports its use, indicating promising prognostic values with fewer post-surgical complications, offering another viable strategy, especially for young, active individuals.<br /><br />The webinar emphasized the importance of personalized treatment planning and the potential revisions needed for high-risk cases. The multidisciplinary approach and technological advancements were key to enhancing surgery outcomes, ultimately providing patients with improved quality of life and functional restoration.

Keywords

osteochondral reconstruction

scaphoid non-unions

hemi-hamate autograft

osteochondral rib autograft

medial femoral trochlea flap

surgical techniques

revision surgeries

biomechanical suitability

personalized treatment

multidisciplinary approach

surgery outcomes

functional restoration