In this episode of The Sports Docs Podcast, Dr. Ashley Bassett and Dr. Catherine Logan sit down LIVE from the Arthrex Team Physician Controversies with foot and ankle expert Dr. Ned Amendola to discuss the modern management of ankle syndesmosis injuries (“high ankle sprains”) in athletes. 

The conversation focuses on when surgery is indicated, the evolution from rigid screw fixation to dynamic stabilization with TightRope technology, surgical pearls, and accelerated return-to-sport strategies for high-demand athletes.

Highlights

When Does a Syndesmosis Injury Need Surgery?

Most isolated, stable syndesmosis injuries can be treated nonoperatively
Surgery is indicated when there is:

• Mortise widening
• Instability on stress imaging
• Associated fibula fractures
• Significant ligament disruption (AITFL, PITFL, interosseous membrane)

Key principle:
Instability—not just diagnosis—drives surgical decision-making

The Shift from Screws to Dynamic Fixation

Traditional screw fixation challenges:

• Screw breakage and loosening
• Frequent hardware removal surgeries
• Restricted physiologic motion
• Longer non-weight-bearing periods

Advantages of TightRope fixation:

• Dynamic stabilization with physiologic micromotion
• Lower risk of malreduction
• Faster rehabilitation
• No routine hardware removal

Key insight:
Dynamic fixation respects normal syndesmotic biomechanics

TightRope Surgical Technique

Critical first step:
Anatomic reduction of the fibula in the incisura

Technique highlights:

• Confirm reduction on AP, mortise, and lateral imaging
• Drill 2–4 cm above joint line, parallel to plafond
• Pass TightRope across all four cortices
• Carefully seat medial button
• Tension laterally while maintaining reduction

Pearls:

• Clamp carefully to avoid malreduction
• Avoid posterior fibular translation
• Ensure proper button seating without soft tissue interposition

One vs Two TightRopes

One construct may suffice for:

• Lower-demand athletes
• Isolated injuries without fracture

Two constructs favored for:

• High-energy injuries
• Athletes
• Fibula fractures
• Rotational instability or Maisonneuve injuries

Key principle:
Persistent rotational instability drives the need for additional fixation

Outcomes with Dynamic Fixation

Benefits seen clinically:

• Lower reoperation rates
• Less stiffness
• Faster functional progression
• Earlier return to sport

Athletes tolerate early motion and rehab particularly well with dynamic fixation

The TightRope PRO System

Improvements include:

• Smaller drill tunnels
• Lower-profile buttons
• Less soft tissue irritation
• Controlled self-tensioning handles

Key insight:
Modern implant design improves precision and preserves bone

Rehabilitation & Return to Sport

Isolated injuries:

• Early ROM within 1–2 weeks
• Progressive weight-bearing by 4 weeks
• Running around 8–10 weeks
• Cutting/pivoting at 10–12 weeks

Elite athletes may return as early as 6–8 weeks in select cases

Return-to-play criteria:

• No syndesmotic tenderness
• Symmetric dorsiflexion
• Negative stress testing
• Functional cutting/acceleration testing
• Psychological confidence in the ankle

Key Takeaways

Surgical treatment is based on instability and biomechanics, not simply imaging findings
Dynamic fixation with TightRope technology has transformed syndesmosis management in athletes
Proper reduction technique remains the most important surgical factor
Modern fixation allows for earlier rehabilitation and faster return to play
Return-to-sport decisions should incorporate both functional and psychological readiness

Featured Guest

Dr. Ned Amendola – Duke University, President of the American Academy of Orthopaedic Surgeons, Head Team Physician and Chief Medical Officer for Duke Athletics

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Arthrex Team Physician Controversies 2026

Our Hosts:

Ashley Bassett, MD & Catherine Logan, MD, MBA / www.cosportsmedicine.com 

In this episode of The Sports Docs Podcast, Dr. Ashley Bassett and Dr. Catherine Logan sit down LIVE from the Arthrex Team Physician Controversies with Stephania Bell to discuss the evolving role of sports injuries in modern media coverage.

As a licensed physical therapist and leading injury analyst for ESPN, Stephania shares how fantasy football, sports betting, visual technology, and audience demand have transformed injuries from simple status updates into complex, high-interest storylines centered around athlete performance, recovery, and long-term health.

We'll chat about:

How Fantasy Football transformed injuries into weekly decision-making currency
 Fans now want:

•  Probability of performance 
•  Risk assessment 
•  Recovery expectations 
•  Long-term outlook 

Fantasy Football Changed Injury Coverage

Sports media shifted from reporting diagnoses to explaining performance implications

Changing the Media Narrative

Early injury reporting was binary:

•  Playing vs not playing 

Modern injury coverage focuses on:

•  Function 
•  Limitation 
•  Risk 
•  Performance impact 

The Power of Medical Animations

Visual tools help bridge medicine and storytelling

Benefits of animations:

•  Improve anatomy understanding 
•  Explain biomechanics and injury mechanisms 
•  Clarify recovery expectations 
•  Translate complex medicine for broad audiences 

Notable NFL Injury Coverage

Joe Burrow

•  Turf toe and wrist injury breakdowns highlighted how subtle injuries impact quarterback mechanics 
•  Visual animations helped explain throwing wrist ligament injuries and recovery 

Brock Purdy

•  Turf toe animations demonstrated the functional impact on movement and push-off mechanics 

Patrick Mahomes

•  Discussions emphasized how injury location and position-specific demands alter performance expectations 

The Future of Injury Coverage

Coverage is becoming more nuanced around:

•  Load management 
•  Athlete longevity 
•  Cumulative wear and tear 
•  Concussion awareness 
•  Recovery strategy 

Common Injury Misconceptions

Playing ≠ fully healthy
 Recovery timelines are ranges—not exact dates
 MRI findings are only one piece of the puzzle
 Position matters enormously when evaluating injury impact

Featured Guest

Stephania Bell – Licensed Physical Therapist, ESPN NFL Injury Analyst, Co-host of Fantasy Focus Football

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Arthrex Team Physician Controversies 2026

Our Hosts:

Ashley Bassett, MD & Catherine Logan, MD, MBA / www.cosportsmedicine.com 

In this episode of The Sports Docs Podcast, Dr. Ashley Bassett and Dr. Catherine Logan sit down LIVE from the Arthrex Team Physician Controversies with orthobiologics expert Dr. Spencer Stein to discuss the real-world application of bone marrow concentrate (BMAC) in sports medicine.

The conversation focuses on how to effectively integrate orthobiologics into clinical and surgical practice, with a deep dive into the ANGEL System and Vortex Needle, emphasizing consistency, technique, and appropriate patient selection.

Where BMAC Fits in Practice

Common applications:

•  Cartilage restoration procedures 
•  Tendon and ligament pathology 
•  Nonunions and osteotomies 
•  Osteochondral and revision cases 

Why Bone Marrow Concentrate?

Delivers:

•  Progenitor cells 
•  Growth factors 
•  Cytokines 

Particularly useful in:

•  Borderline surgical candidates 
•  Revision cases 
•  Biologically compromised environments 

The ANGEL System

Closed, automated centrifuge system
Allows customization of hematocrit and final product

Benefits:

•  Consistency and reproducibility 
•  Ability to “dial in” biologic composition 
•  Reduced variability in outcomes 

The Vortex Needle

Designed for controlled, low-volume aspiration

Advantages:

•  Minimizes peripheral blood dilution 
•  Improves cell concentration and biologic quality 
•  More targeted aspiration technique 

Closed-tip design:

•  Better consistency 
•  Higher quality aspirate 

Pearls:

•  Focus on proper aspiration technique 
•  Use small-volume, targeted draws 
•  Integrate BMAC early in surgical workflow 
•  Train your team for efficiency 

Pitfalls:

•  Poor aspirate technique 
•  Overpromising outcomes to patients 
•  Treating biologics as a cure-all 

Future of Orthobiologics

Moving toward:

•  Indication-specific protocols 
•  Standardized biologic formulations 
•  More targeted applications by tissue type 

Featured Guest

Dr. Spencer Stein – NYU Grossman School of Medicine, sports medicine surgeon specializing in arthroscopy and joint preservation

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Arthrex Team Physician Controversies 2026

Our Hosts:

Ashley Bassett, MD & Catherine Logan, MD, MBA / www.cosportsmedicine.com 

In this The Sports Docs Podcast episode, Dr. Ashley Bassett and Dr. Catherine Logan sit down with foot and ankle experts Dr. David Pedowitz and Dr. Josh Metzl.

From evolving surgical techniques to implant innovation and accelerated return-to-play timelines, this conversation highlights how modern approaches are reshaping outcomes for high-level athletes.

Achilles Tendon Injuries

Who Needs Surgery?

•  Best suited for young, active athletes, especially in explosive or cutting sports 
•  While nonoperative care has improved: 
  • Tendon elongation remains a key concern 
  • Push-off strength deficits can impact performance 
•  Surgical repair offers: 
  •  Faster strength recovery 
  •  More predictable return to sport 

Evolution of Surgical Technique

•  Shift from open surgery → minimally invasive (MIS) and percutaneous approaches
•  Benefits: 
  •  ↓ wound complications 
  •  Improved cosmesis 
  •  Faster rehabilitation 
• Double-row fixation restores native footprint and improves gap resistance 

PARS Technique (Percutaneous Achilles Repair System)

•  Combines precision of open repair with less soft tissue disruption
•  Key features: 
  •  Small incision with percutaneous suture passage 
  •  Reproducible jig-guided technique 
  •  Strong, locking suture construct 
•  Ideal for acute midsubstance ruptures

Pearls:

•  Master jig orientation before live cases 
•  Maintain tension during suture passage 
•  Protect the sural nerve

Pitfalls:

•  Incisions too small → poor visualization 
•  Overtensioning the repair 

Repair Constructs: PARS vs SpeedBridge

• SpeedBridge (double-row, knotless): 
  •  ↓ tendon elongation 
  •  Strong biomechanical construct 
  •  Slight ↑ risk of heel pain 
• PARS: 
  •  Less invasive 
  •  Lower wound complication rates 

Insertional Achilles Pathology

•  Typically treated with open or MIS SpeedBridge techniques
•  MIS FiberTak SpeedBridge advantages: 
  •  Smaller incisions 
  •  Less implant material 
  •  Strong fixation with rip-stop construct
  •  Supports early weight-bearing and mobilization

Return to Play

• 90% return to sport after surgery
•  Typical timeline: 
  • Running: progressive, athlete-specific 
  • Full return: ~6–9 months 

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Arthrex Team Physician Controversies 2026

Our Hosts:

Ashley Bassett, MD & Catherine Logan, MD, MBA / www.cosportsmedicine.com 

In this episode of The Sports Docs Podcast, Dr. Bassett & Dr. Logan sit down LIVE from the Arthrex Team Physician Controversies with shoulder instability expert Dr. Kevin Farmer to discuss the modern management of traumatic anterior shoulder instability in athletes.

The conversation focuses on the instability continuum, including when to operate, how to evaluate bipolar bone loss, and when to add remplissage, with an emphasis on optimizing outcomes in young, high-risk athletes.

Who Needs Surgery?

Young athletes—especially males less than 20—have 70–80% recurrence rates with nonoperative care
Higher risk populations:
Collision athletes
Overhead athletes
Military/tactical athletes

Key insight:
Early surgical stabilization can be career-protective in high-risk athletes

MRI evaluates:

Bankart lesions
Hill-Sachs size and orientation
Capsulolabral quality

Advanced assessment includes:

Percent glenoid bone loss
Hill-Sachs engagement
On-track vs off-track lesions

Arthroscopic Bankart Repair

Remains the workhorse procedure in absence of critical bone loss

Modern advances:

Knotless anchors
Improved efficiency and reproducibility
Better capsular tensioning

Anchor strategy:

Typically 3–4 anchors
Start low (5:30–6 o’clock) and work superiorly
Fewer than 3 anchors associated with higher failure rates
Capsular Management

Capsular shift is critical in:

Young patients
Hyperlax athletes

Goal:

Restore anterior stability
Re-tension IGHL complex

Knotless technology allows fine-tuned tensioning

Remplissage

Traditionally used for off-track Hill-Sachs lesions
Now increasingly used in:

Subcritical glenoid bone loss (~10–15%)
High-risk athletes
Borderline “on-track” lesions

Benefits:

Decreases recurrence rates
Reduces need for revision surgery

Key insight:
Low threshold in young, male contact athletes

Remplissage Technique

Two anchors placed in Hill-Sachs lesion
Sutures passed through capsule and infraspinatus
Secured in subdeltoid space

Pearls:

Use knotless anchors for low-profile fixation
Visualize subacromial space to avoid soft tissue capture
Motion vs Stability

Concern: loss of external rotation

Reality:

Minimal, clinically insignificant loss with modern techniques
Stability benefits outweigh small motion tradeoffs
Postoperative Rehab

Sling: 3–4 weeks
Early passive motion
Strengthening at 6 weeks
Return to sport: ~5–6 months

Return to Sport Testing

Criteria-based return reduces recurrence (5% vs 22%)

Key components:

Full ROM
Greater/equal to 90% strength vs contralateral side
Functional testing (CKCUEST, shot-put, plank taps, etc.)
Patient-reported outcomes (WOSI greater than 90%, KJOC greater than 88%)

Featured Guest
Dr. Kevin Farmer – University of Florida, Team Physician for the Florida Gators

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Arthrex Team Physician Controversies 2026

Our Hosts:

Ashley Bassett, MD & Catherine Logan, MD, MBA / www.cosportsmedicine.com 

Live from the Arthrex Team Physician Controversies Conference

In this episode of The Sports Docs Podcast, Dr. Ashley Bassett and Dr. Catherine Logan sit down LIVE from the Arthrex Team Physician Controversies with two leading ACL experts—Dr. Pat Smith and Dr. Aaron Krych—to discuss strategies to reduce failure after ACL reconstruction.

The conversation highlights the evolution of ACL surgery, focusing on graft selection, fixation, biologic augmentation, and mechanical protection, with an emphasis on optimizing outcomes in young, high-risk athletes.

Graft: Autograft vs Allograft

Strong evidence shows higher failure rates with allograft in young athletes
 MOON data: ~4–6x increased risk of failure in patients <25 years
 

Allograft best for:

•  Older, lower-demand patients 
•  Revision or multi-ligament cases 

Autograft Selection

Graft choice depends on:

•  Age, sex, sport, and anatomy 

BTB:

•  Preferred for high-level pivoting athletes 
•  Strong fixation, less graft elongation 

Quadriceps tendon:

•  Increasingly utilized 
•  Larger graft diameter 
•  Less donor-site morbidity vs BTB 
•  Particularly useful in younger and female athletes 

Key insight:
 Grafts <8 mm are associated with higher failure risk

Internal Brace (IB)

Indications:

•  Young athletes 
•  Hyperlax patients 
•  Revision ACL 

Benefits:

•  Decreased graft elongation and cyclic displacement 
•  Reduced postoperative laxity 
•  Lower rerupture rates (~1% at 5 years in some studies) 
•  Faster return to sport and improved rehab confidence 

Lateral Extra-Articular Tenodesis (LET)

Strong evidence supports reduced failure rates:

•  Primary ACLR: ~11% → 4% (high-risk patients) 
•  Revision ACLR: ~21% → 5% 

Benefits:

•  Decreased pivot shift 
•  Improved return to pre-injury sport 
•  Cost-effective in high-risk populations 

Indications for LET

•  Age ≤25 years 
•  High-grade pivot shift 
•  Knee hyperextension 
•  Return to cutting/pivoting sports 
•  Revision ACL reconstruction 

LET Surgical Technique Pearls

IT band graft (7–8 cm x 1 cm)
 Passed under or near LCL depending on technique
 Fixation near lateral epicondyle

Pearls:

•  Fix in neutral rotation and ~30–60° flexion 
•  Avoid overconstraint 
•  Close IT band defect 

Featured Guests

Dr. Pat Smith – Hospital for Special Surgery Naples

Dr. Aaron Krych – Mayo Clinic, Team Physician for the Minnesota Timberwolves

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Our Hosts:

Catherine Logan, MD, MBA

https://www.cloganmd.com/

Ashley Bassett, MD

https://orthopedicnj.com/physicians/ashley-bassett

www.thesportsdocspod.com

Live from the Arthrex Team Physician Controversies Conference

🎧 Episode Summary

In this episode of The Sports Docs Podcast, Dr. Ashley Bassett and Dr. Catherine Logan sit down LIVE from the Arthrex Team Physician Controversies with cartilage restoration expert Dr. Travis Maak to discuss the modern surgical management of knee cartilage defects.

The conversation focuses on diagnostic workup, surgical decision-making, and cutting-edge cartilage restoration techniques, including Autocart, BioCartilage, and Cartiform.

Diagnostic Imaging - MRI is critical for:

•  Defect size and depth 
•  Subchondral bone integrity and edema 
•  Concomitant meniscal and ligament pathology

Surgical Decision-Making

•  Patient age & activity level 
•  Lesion size, location, & containment 
•  Subchondral bone involvement 
•  Prior surgical history

Autocart (Autologous Minced Cartilage)

Single-stage autograft cartilage restoration technique
Uses patient’s own cartilage with PRP or BMAC
Key advantages:

•  Preserves native chondrocytes & extracellular matrix 
•  Avoids staged procedures 

Ideal for small-to-medium contained lesions

Outcomes:

•  Significant improvements in pain & function at ~5 years 
•  ~75% achieve clinically meaningful outcomes 
•  Low reoperation rates 

BioCartilage

Micronized cartilage extracellular matrix allograft scaffold
Used in combination with microfracture and biologics (PRP/BMAC)
Functions as a biologic bridge to enhance cartilage repair

Best for:

•  Small-to-medium, contained, full-thickness defects 
•  Well-aligned, stable knees 

Outcomes:

•  Improved pain and function at 2 years 
•  Better repair tissue quality compared to microfracture alone 

Cartiform

Cryopreserved osteochondral allograft with viable chondrocytes
 Maintains native cartilage architecture

Indicated for:

•  Larger lesions (>2 cm²) 
•  Defects with subchondral bone involvement 

Advantages:

•  Single-stage procedure 
•  Conforms to irregular defects 

Key Takeaways

• Cartilage restoration success depends on correcting biomechanics first
•  Procedure selection should be lesion-specific and patient-specific
•  Autocart offers a promising autograft solution with strong midterm data
•  BioCartilage fills the gap between microfracture and larger restoration procedures
•  Cartiform is a valuable option for larger defects and requires careful patient selection

Featured Guest

Dr. Travis Maak – University of Utah, Head Team Physician for the Utah Jazz, cartilage restoration and joint preservation specialist

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Modern Surgical Management of Elbow UCL Tears

Live from the Arthrex Team Physician Controversies  

🎧 Episode Summary

In this episode of The Sports Docs Podcast, Dr. Ashley Bassett and Dr. Catherine Logan sit down LIVE from the Arthrex Team Physician Controversies with two leaders in sports medicine—Dr. Neal ElAttrache and Dr. Jeffrey Dugas—to discuss the modern management of ulnar collateral ligament (UCL) injuries in throwing athletes.

Highlights

Changing UCL Injury Landscape

•  Increasing incidence of UCL injuries and surgeries across all levels of play 
•  Notable rise in adolescent and collegiate pitchers
•  Contributing factors include year-round play and high pitch velocity 

Nonoperative Management & Role of PRP

•  Nonoperative treatment remains appropriate for select partial tears 
•  Success varies based on tear grade and location
• PRP discussed as an adjunct to rehab

Indications for Surgery

•  Complete tears—especially in competitive throwers—often require surgical intervention 
•  Tear characteristics (location, tissue quality, chronicity) are critical in decision-making 

UCL Repair with Internal Brace

•  Increasingly utilized in appropriately selected patients
•  Ideal candidates: 
  •  Acute injuries 
  •  Proximal or distal avulsion tears 
  •  Good tissue quality 
•  Advantages: 
  •  High return-to-play (~90%+) 
  • Accelerated recovery timelines (often several months faster) 

UCL Reconstruction (Tommy John Surgery)

•  Remains the gold standard for: 
  •  Chronic degeneration 
  •  Midsubstance tears 
  •  Revision cases 
•  Techniques have evolved over time: 
  •  Docking technique 
  •  Figure-of-eight 
  •  Newer fixation methods (e.g., cortical button techniques) 
•  Autograft (commonly palmaris longus) remains preferred in elite throwers 

Internal Brace Technology

•  Provides added stability and resistance to valgus stress 
•  Supports early rehabilitation while protecting healing tissue 
•  Increasing use in both repair and, selectively, reconstruction 

Key Takeaways

•  UCL injuries are increasing, particularly in younger athletes 
•  Treatment decisions are increasingly personalized based on tear type and athlete profile
•  UCL repair with Internal Brace is shifting the paradigm for select patients 
•  Reconstruction remains essential for more complex or chronic injuries 

Featured Guests

• Dr. Neal ElAttrache – Kerlan-Jobe Orthopaedic Clinic, Head Team Physician for the LA Dodgers & LA Rams 
• Dr. Jeffrey Dugas – Andrews Sports Medicine & Orthopaedic Center, leading expert in UCL repair and reconstruction 

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Live from the 10th Annual Arthrex Team Physician Controversies Conference 

🎧 Episode Overview

In this episode of The Sports Docs Podcast, Dr. Ashley Bassett and Dr. Catherine Logan sit down LIVE from the Arthrex Team Physician Controversies Conference to explore how next-generation arthroscopic imaging is transforming the way orthopaedic surgeons diagnose and treat injuries.

Joined by Dr. James Voos—Chairman of Orthopedics at University Hospitals and Head Team Physician for the Cleveland Browns—the conversation dives into the evolution of nano arthroscopy, panoramic visualization, and integrated imaging systems, and what these advancements mean for surgeons, athletes, and patient outcomes.

What You’ll Learn

1. The Evolution of Nano Arthroscopy

•  From the original Arthrex NanoScope (2019) to NanoNeedle 2.0 
•  Major leap in image resolution (400×400 → 720×720, near 4K) 
•  Less invasive approach and improved patient experience 

2. Seeing What Imaging Can Miss

•  How in-office diagnostic arthroscopy is reducing reliance on equivocal MRI findings 
•  Identifying subtle pathology: 
  •  Partial-thickness rotator cuff tears 
  •  Meniscal ramp lesions 
  •  Early chondral defects 

3. The Power of Panoramic Visualization (Panoscope)

•  Expanded field of view compared to traditional arthroscopy 
•  Seamless transition between 30°, 70°, and ultra-wide 45° views 
•  Reduced “blind spots” in complex anatomy

4. Workflow & Efficiency in the OR

•  How the Synergy Vision System integrates NanoNeedle + Panoscope 
•  Dual-view capability for enhanced intraoperative decision-making 
•  Improved efficiency 

5. Adoption & Learning Curve

•  Designed to be intuitive for surgeons 
•  Importance of training and mentorship 
•  Technology enhances decision-making without adding complexity 

Featured Guest

Dr. James Voos

•  Chairman of Orthopedics, University Hospitals 
•  Medical Director, UH Drusinsky Sports Medicine Institute 
•  Head Team Physician, Cleveland Browns 

Stay Connected

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Welcome to another episode of Ask The Sports Docs. We get a lot questions from our listeners each week and they’re great questions, so rather than responding individually we thought we’d do these mini episodes where highlight some of the best questions and our responses. So, let’s get started!

Today, we’re tackling the question: “Should I have surgery for my type III AC joint
separation?” If you are a sports medicine or shoulder surgeon, you’ve definitely had this conversation with your patients. And if you are an athlete, you’ve probably googled this after landing on your shoulder snowboarding, playing hockey, playing football etc. And the truth is – the answer isn’t black and white. But to try to answer that question, we’re going to review an article titled “Functional, Radiological, and Scapular Motion Evaluation of Surgical Versus Nonsurgical Treatment of Type 3 Acromioclavicular Dislocations.” 

This level 1 RCT aimed to compare the clinical outcomes of surgical and nonoperative treatment of type 3 AC separations.

So, let's dive in!

www.cloganmd.com / www.cosportsmedicine.com / https://orthopedicnj.com/physicians/ashley-bassett