The Shelbourne Knee Center Podcast

Patients Place: Graft Choice for ACL Reconstruction

In this third Patients Place episode, we shift focus to sports medicine, specifically exploring graft choices following an ACL injury.
Dr. Benner walks listeners through the essential conversation about graft options, covering the pros and cons of allografts, hamstring grafts, quadriceps tendon grafts, and the highly recommended patellar tendon graft. Understand the decision-making process behind ACL reconstruction and learn why the patellar tendon graft is often considered the superior choice for long-term stability and recovery.
The episode also addresses common patient concerns, such as healing times, retear risks, and the innovative approach of harvesting the graft from the contralateral knee to optimize rehabilitation. Whether you're a high-level athlete or a weekend warrior, this episode offers valuable insights to empower your surgical decisions and recovery journey.
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Patients Place: Managing a Painful Total Knee Replacement

On this episode of Patients Place, we discuss the challenging topic of painful total knee replacements. This episode aims to provide valuable educational content for patients experiencing difficulties after knee surgery, as well as for healthcare providers seeking to better understand these issues.
We discuss common symptoms and concerns patients face, such as persistent pain, instability, and reduced mobility. We highlight the importance of a thorough physical examination and the role of imaging in diagnosing potential problems, including infection, implant loosening, and malrotation.
The episode also covers the emotional impact of unsuccessful knee surgeries and the significance of having a clear treatment plan. Dr. Benner emphasizes the importance of ruling out infections, assessing ligament stability, and considering advanced imaging if necessary.
Listeners will gain insights into the potential causes of knee replacement failure, including metal allergies and extrinsic factors like hip or back issues. Dr. Benner outlines both non-surgical and surgical treatment options, offering hope for patients seeking to improve their quality of life.
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Patients Place: Knee Osteoarthritis

Welcome to the inaugural episode of "Patients Place," a new segment designed specifically for patients seeking to understand knee problems. This episode delves into the complexities of osteoarthritis, one of the most common diagnoses among patients experiencing knee pain.
The conversation begins with a detailed explanation of the signs and symptoms that lead patients to seek medical advice. Dr. Benner categorizes patients into two groups: those at "time zero," who are newly experiencing knee pain, and those seeking second opinions after previous diagnoses.
The episode covers the potential causes of osteoarthritis, including normal aging, post-traumatic cases, and genetic factors. Dr. Benner explains the importance of x-rays and physical examinations in diagnosing the severity and location of arthritis, which can significantly influence treatment options.
Listeners will gain valuable knowledge about non-surgical treatment options, such as medication, physical therapy, and the role of injections. Dr. Benner emphasizes the importance of patient involvement in the decision-making process, highlighting that surgery is not the only path to relief.
Whether you're a patient at the Shelbourne Knee Center or anywhere else, this episode aims to provide practical advice and reassurance about managing osteoarthritis effectively. Join us on this journey to better understand knee health and explore various treatment avenues.
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Multiligament Knee Injuries

On this episode, we discuss the topic of ACL reconstruction with multiligament involvement and how the outcomes compare to those with isolated ACL tears.
The episode begins with an overview of the mechanisms, ligaments involved, and treatment options for multiligament knee injuries. Dr. Benner highlights the unique approach at the Shelbourne Knee Center, emphasizing the importance of avoiding complications, particularly stiffness, over achieving perfect stability.
Scot details the study's methodology and results, which included data from over 5,000 patients. The discussion covers the treatment goals of converting multiligament injuries to resemble isolated ACL tears and the outcomes measured, such as range of motion, postoperative laxity, scar resection rate, graft tear rate, and IKDC scores.
The results reveal no significant differences in key outcomes between patients with isolated ACL tears and those with additional medial or lateral ligament involvement. 
Additionally, the episode touches on the importance of maintaining range of motion, avoiding stiffness, and the potential benefits of non-surgical treatment for certain ligament injuries. The discussion concludes with a call to the orthopedic community to consider these findings and the positive outcomes achieved through these methods.
Don't miss the exciting announcement about the upcoming launch of "Patients Place," a new segment geared towards patients, offering accessible and informative content on various knee injury topics.
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Visual Cognitive Progression in ACL Rehab (with Meredith Chaput, PhD, PT, DPT, SCS)

On this episode, we dive into a different side of ACL rehabilitation with our esteemed guest, Meredith Chaput, PhD, PT, DPT, SCS, from the University of Central Florida. Meredith, a physical therapist with a PhD in translational biomedical science from Ohio University, shares her extensive knowledge and research on the visual cognitive progression during recovery from ACL reconstruction.
We explore a range of topics, including:
The integration of neurocognitive training in ACL rehab
The importance of early intervention and maintaining traditional rehab principles
How to effectively measure and implement dual-task exercises
The role of cross-modal brain regions in recovery
Future directions in neurocognitive research and its implications for physical therapy
This episode is packed with valuable insights for clinicians and anyone interested in cutting-edge rehabilitation techniques. Don't miss the fascinating discussion on how blending cognitive and physical training can enhance recovery outcomes.
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We hope you enjoy the episode and look forward to your feedback!

Cost Effectiveness of Computer Assisted TKA (with Hassan Ghomrawi, PhD, MPH)

On this episode, we explore the cost effectiveness of computer assisted versus conventional total knee arthroplasty. Joined by special guest Dr. Hassan Ghomrawi, surgical outcomes researcher/health economist and associate professor at the Orthopedic Surgery Department of the University of Alabama at Birmingham, the discussion delves into the economic incentives and outcomes associated with these advanced surgical techniques.
Dr. Ghomrawi shares his unique journey from pharmaceutical economics to orthopedic research, offering insights into how different healthcare models impact cost and patient care. The conversation also touches on the broader implications of technology in orthopedics, including wearable devices, robotics, and artificial intelligence.
Listeners will gain a comprehensive understanding of the study's methodology, including the use of markov models to simulate patient outcomes and costs over a lifetime. The discussion includes the potential for increased utilization of computer assisted surgery, the role of insurance payers, and the future of cost effective healthcare solutions.
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Patellofemoral Instability (with Elizabeth Arendt, MD)

On this episode, we delve into the topic of patellofemoral instability. We are honored to welcome Dr. Liza Arendt, a renowned expert in orthopedic sports medicine and a professor at the University of Minnesota. Dr. Arendt shares her journey into the field, her experiences as a trailblazing female physician, and her extensive knowledge on knee conditions.
The episode covers a wide range of topics, including the evaluation and treatment of patellofemoral instability, the importance of detailed patient history, physical examination techniques, and the role of imaging in diagnosis. Dr. Arendt also discusses her approach to nonoperative treatments, the use of various physical therapy modalities, and the decision-making process for surgical interventions.
Listeners will gain valuable insights into the nuances of treating patellofemoral instability, the significance of body movement patterns, and the evolving paradigms in orthopedic surgery. Whether you're an orthopedic surgeon or physical therapist, this episode offers a comprehensive overview and expert guidance on managing this complex condition.
Don't miss out on this opportunity to learn from one of the leading voices in orthopedics. Tune in, and if you find the content helpful, be sure to leave a five-star review and a comment. You can also follow the SKC Podcast on Twitter and Instagram @theskcpodcast, visit our YouTube and Facebook pages, or contact us via email at theskcpodcast@gmail.com.

Aspirin is Safe and Effective in Preventing VTE After TKA (with Atul Kamath, MD, MBA)

In this episode, we delve into the critical topic of VTE prophylaxis in knee replacement surgeries. Special guest Dr. Atul Kamath from the Cleveland Clinic joins the discussion to share insights from a recent JBJS article advocating for low-dose aspirin as the safest and most effective prophylaxis for VTE after total knee arthroplasty across all patient risk profiles.
Dr. Kamath, a seasoned orthopedic surgeon with an impressive academic and clinical background, provides an in-depth analysis of the study's methodology, results, and implications. The conversation touches on key points such as the rising trends in aspirin use, the comparative efficacy of different anticoagulants, and the cost benefits of using aspirin.
Listeners will gain valuable knowledge on how this study could potentially shift clinical practices towards using aspirin for DVT prophylaxis, the importance of rapid recovery protocols, and the overall impact on patient outcomes. This episode promises to be a comprehensive guide for orthopedic professionals interested in the latest advancements in knee replacement surgery and DVT prevention.
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Ethical Considerations of Declining Surgical Intervention in Orthopedics (with Claudette Lajam, MD)

In this episode, we delve into the topic of ethical considerations in orthopedic surgery. Departing from our usual focus on surgical techniques and physical therapy, we explore the delicate balance between patient autonomy and fiduciary responsibility.
The episode features a special guest, Dr. Claudette Lajam from NYU, a distinguished joint replacement surgeon and professor in the Department of Orthopedic Surgery at NYU School of Medicine. Dr. Lajam shares her insights from a recent article in the Journal of Bone and Joint Surgery, discussing ethical challenges such as declining surgical interventions for high-risk patients and the importance of informed consent.
Listeners will gain valuable perspectives on medical ethics, including beneficence, nonmaleficence, patient autonomy, and justice. The conversation also covers practical aspects like the role of risk calculators, the impact of obesity on joint replacement outcomes, and the importance of communication in patient care.
Join us for an engaging and educational discussion that sheds light on the ethical dimensions of orthopedic practice, offering valuable takeaways for both medical professionals and patients.
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Intraosseous Medication Administration in Total Knee Arthroplasty (with Katharine Harper, MD)

On this episode, we discuss intraosseous administration of medications in total knee arthroplasty with Dr. Katharine Harper, an orthopedic surgeon specializing in joint reconstruction at the Washington, D.C. VA Medical Center.
Dr. Harper discusses her current role, and provides an in-depth exploration of intraosseous medication administration. During the conversation, she gives insights into the recent technique paper she had published in JBJS this year. Discover how this technique, backed by research from Houston Methodist, shows promise in reducing periprosthetic joint infections. Learn about the technical procedure, potential benefits, and considerations for integrating this method into your practice.
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