Knee Deep – all that’s new from the Warsaw Joint Congress 2023

Professor Mackay was delighted to be invited recently to join The Faculty at the 10th Anniversary Congress of Joint Preservation in Warsaw. Once again organised by Konrad Slynarski and Jacek Walawski it pulled together the experiences not only of International experts but also from a local Faculty as well.

The anterior knee and patellofemoral joint was the initial focus with concerns relating to instability, and predisposing factors explored by Jacek Walawski and Lars Blond who also shared his expertise regarding repositioning of the joint surface with a technique called ‘Trochleoplasty’. He also demonstrated a patellar-stabilisation technique using the InternalBrace to minimise donor (graft) morbidity and improve outcomes.

International cartilage expert, Mats Brittberg took us through what he sees as the current gold standards in cartilage repair and optimal management of cartilage defects. Then the team from the Aspetar Clinic in Qatar, led by Dr Emmanouil Papakostas explained their approach to cartilage management in elite athletes, before Kostas Epaminontidis talked through the concerns and challenges of rehabilitation and harnessing the latest monitoring technology – this last bit raising some interesting questions. (Listen to our podcast for more on this!).

Also fascinating was an update from from Konrad on Biologics, including the role of monocytes (a type of white blood cells) and Dr Suresh Sudula’s look at the role of ultrasound-guided injection

Osteotomy was another meeting hot topic – with expert presentations from Ronald van Heerwaarden and Jörg Dickschas as well as Adrian Wilson. These emphasised the importance of planning in terms of alignment, accurate measurement, and also soft tissue balancing to optimise outcomes.

At the meeting Prof Mackay was delighted to present his experience of ACL reconstruction using the InternalBrace as well as augmentation of the anterolateral ligament (ALL). Demonstrating not only how it has helped accelerate recovery but importantly has significantly reduced revision rates. It also afforded an opportunity to explain how this approach can be applied to any repair or reconstruction.

Prof Mackay then carried out a cadaveric demonstration of ACL preservation and repair with InternalBrace reconstruction using a reduced-size graft and showing retainment of the natural ACL fibres. (Working with the bodie’s own biology). He then showed how quick and easy it is to protect an ACL repair with an InternalBrace augmentation of the ALL. He regards this as the current gold standard in ACL management and preservation.

Prof Mackay concluded by sharing some of the lessons learned from InternalBrace research over the last 10 years as it applies to shoulder, knee, elbow, and ankle, in terms of both repair and reconstruction. Sharing some of the challenges, as well as successes, much of this information comes from collaboration with fellow members of the newly formed InternalBrace International Study Group (IBISG).

Other interesting sessions were approaches to meniscal repair and our understanding of the latest research regarding biologics in particular fat stem cell injections. It was clear that there is still a long way to go before definitive answers and indications will be available.

Finally of note were presentations on ACL injury prevention especially concentrating on minimising children’s injury rates. This aligns with the ACL Angel Programme supported by ESKA, the European Sports Medicine Association which has proved successful in modestly reducing the risk of ACL injury in young athletes.

You can hear more of Professor Mackay’s thoughts on the latest techniques and research discussed at the Congress on our latest podcast

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