The Sports Docs Podcast

In Part II of our conversation with Dr. Ken Hunt, orthopaedic foot and ankle surgeon at the University of Colorado, we explore two important diagnoses that can complicate ankle injuries: syndesmotic injuries (high ankle sprains) and osteochondral lesions of the talus (OLTs).

This episode of The Sports Docs Podcast is brought to you by BraceLab. Whether you are recovering from an injury, managing everyday discomfort, or just trying to stay active and move confidently, BraceLab has you covered with high-quality, innovative support solutions. 

We’ll tell you a bit more about how they are changing the game for ankle instability later in the show, but for now, you can learn more at BraceLab.com.

For free samples, email [email protected] and mention The Sports Docs.

We begin with the anatomy and biomechanics of the distal tibiofibular syndesmosis, highlighting how high ankle sprains differ from traditional lateral ankle sprains in their mechanism, clinical presentation, and recovery. Dr. Hunt discusses the importance of distinguishing syndesmotic ligament injury from true mechanical instability, the role of physical examination and advanced imaging, and when surgical stabilization is indicated.

We then review the evolution of syndesmotic fixation, including the transition from traditional screw fixation toward dynamic suture-button constructs such as TightRope. We discuss the evidence supporting suture-button fixation, including improved functional outcomes, lower rates of implant removal, and reduced malreduction rates in some comparative studies.

Next, we shift our focus to osteochondral lesions of the talus, an important consideration in athletes with persistent deep ankle pain, swelling, or mechanical symptoms following an ankle sprain. Dr. Hunt shares his approach to diagnosis, including the complementary roles of MRI and CT, and explains how lesion stability, size, location, subchondral bone involvement, and prior treatment influence management.

We explore the expanding surgical treatment options for talar cartilage injuries, from arthroscopic debridement and bone marrow stimulation to osteochondral grafting and emerging cartilage restoration techniques. Dr. Hunt also discusses how he approaches return-to-play decisions and the importance of evaluating more than symptom resolution alone.

Topics covered include:

• High versus low ankle sprains: anatomy, mechanism, and recovery
• Diagnosing syndesmotic instability with physical examination, radiographs, MRI, and weight-bearing imaging
• Indications for operative versus nonoperative management of syndesmotic injuries
• Syndesmotic screw fixation versus dynamic suture-button stabilization
• Recognizing osteochondral lesions after ankle sprains
• MRI and CT findings that guide talar cartilage treatment
• Nonoperative management of stable osteochondral lesions
• Arthroscopic versus open approaches to talar cartilage restoration
• Bone marrow stimulation, osteochondral grafting, and emerging cartilage repair techniques
• Return-to-play considerations following ankle injury and surgery

Clinical takeaway: An ankle sprain is not a single diagnosis. Successful treatment depends on identifying the injured structures, determining whether mechanical instability or cartilage damage is present, and selecting a treatment strategy that addresses the athlete's pathology and functional demands.

Join Drs. Ashley Bassett and Catherine Logan for the second half of this evidence-based discussion on modern ankle injury management.

Listen to Part I for our discussion of acute lateral ankle sprains, chronic lateral ankle instability, and contemporary ligament treatment strategies.

Find the research articles discussed in this episode and more from The Sports Docs Podcast at www.thesportsdocspod.com.

This video is about Ken HuntOn today’s episode of The Sports Docs Podcast, we’re joined by Dr. Kenneth Hunt, Professor of Orthopedic Surgery and Chief of Foot and Ankle Surgery at the University of Colorado, Director of the UCHealth Foot and Ankle Center, and team physician for University of Colorado Athletics and the Denver Nuggets.

This episode of The Sports Docs Podcast is brought to you by BraceLab. Whether you are recovering from an injury, managing everyday discomfort, or just trying to stay active and move confidently, BraceLab has you covered with high-quality, innovative support solutions. 

We’ll tell you a bit more about how they are changing the game for ankle instability later in the show, but for now, you can learn more at BraceLab.com.

For free samples, email [email protected] and mention The Sports Docs.

In Part I, we take a comprehensive look at lateral ankle sprains and chronic ankle instability. We discuss how to evaluate the athlete with an acute ankle injury, red flags that should prompt consideration of associated pathology, and when advanced imaging is warranted.

Dr. Hunt walks us through his approach to early treatment, including the role of bracing, progressive weight bearing, and rehabilitation. We discuss what makes an effective ankle brace, when athletes should continue bracing after returning to sport, and why bracing should complement—not replace—proprioceptive and neuromuscular training.

We also review the factors that may predict progression from a first-time ankle sprain to chronic ankle instability, including impaired jumping and landing ability and persistent deficits in dynamic balance.

The conversation then shifts to management of chronic instability. Dr. Hunt explains when persistent instability becomes a surgical problem and how the Broström procedure has evolved from traditional anatomic repair to modern techniques incorporating arthroscopy, contemporary anchor technology, and, in selected patients, internal brace augmentation.

We discuss:

• Evaluation of the acute lateral ankle sprain
• Red flags for associated ankle pathology
• When to obtain MRI or other advanced imaging
• Bracing during acute recovery and return to sport
• Proprioception, balance, and neuromuscular rehabilitation
• Risk factors for chronic ankle instability
• Return-to-play considerations and the PAASS framework
• Indications for surgery in chronic lateral ankle instability
• Modern Broström repair
• Internal brace augmentation: who may benefit and whether every Broström needs it

Part II: High Ankle Sprains & Osteochondral Lesions of the Talus

In Part II, we will continue our conversation with Dr. Hunt and turn our attention to syndesmotic—or “high”—ankle sprains and osteochondral lesions of the talus.

We examine the evolving management of syndesmotic injuries, including evidence comparing suture-button fixation with traditional syndesmotic screws. We discuss the potential advantages of dynamic fixation, including improved functional outcomes, fewer implant-related complications and hardware removals, and lower rates of malreduction.

Finally, we tackle osteochondral lesions of the talus, reviewing diagnosis and treatment options ranging from nonoperative management to microfracture, cartilage and bone grafting, and newer cartilage-restoration strategies.

Articles Discussed

Recovery From a First-Time Lateral Ankle Sprain and the Predictors of Chronic Ankle Instability
American Journal of Sports Medicine, 2016

Brace for Impact: A Retrospective Analysis of the Modified Broström-Gould Procedure With and Without Internal Brace Augmentation
Cureus, 2023

Suture Button Versus Syndesmotic Screw for Syndesmosis Injuries: A Meta-analysis of Randomized Controlled Trials
American Journal of Sports Medicine, 2019

Evaluation and Management of Osteochondral Lesions of the Talus
Cartilage, 2017

Modified Broström vs Suture Tape Augmentation: A Systematic Review
Journal of Foot and Ankle Surgery, 2025

Internal Brace Augmentation Versus Modified Broström-Gould Procedure for Chronic Lateral Ankle Instability: A Systematic Review and Meta-analysis of Functional and Radiographic Outcomes
Journal of Orthopaedic Surgery and Research, 2026

Subscribe to The Sports Docs Podcast on Apple Podcasts, Spotify, Amazon Music, and YouTube. You can also find us on Instagram @thesportsdocspod or reach us at [email protected].

www.cloganmd.com

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

On today’s episode of The Sports Docs Podcast, we’re joined by Dr. Kenneth Hunt, Professor of Orthopedic Surgery and Chief of Foot and Ankle Surgery at the University of Colorado, Director of the UCHealth Foot and Ankle Center, and team physician for University of Colorado Athletics and the Denver Nuggets.

In Part I, we take a comprehensive look at lateral ankle sprains and chronic ankle instability. We discuss how to evaluate the athlete with an acute ankle injury, red flags that should prompt consideration of associated pathology, and when advanced imaging is warranted.

Dr. Hunt walks us through his approach to early treatment, including the role of bracing, progressive weight bearing, and rehabilitation. We discuss what makes an effective ankle brace, when athletes should continue bracing after returning to sport, and why bracing should complement—not replace—proprioceptive and neuromuscular training.

We also review the factors that may predict progression from a first-time ankle sprain to chronic ankle instability, including impaired jumping and landing ability and persistent deficits in dynamic balance.

The conversation then shifts to management of chronic instability. Dr. Hunt explains when persistent instability becomes a surgical problem and how the Broström procedure has evolved from traditional anatomic repair to modern techniques incorporating arthroscopy, contemporary anchor technology, and, in selected patients, internal brace augmentation.

We discuss:

• Evaluation of the acute lateral ankle sprain
• Red flags for associated ankle pathology
• When to obtain MRI or other advanced imaging
• Bracing during acute recovery and return to sport
• Proprioception, balance, and neuromuscular rehabilitation
• Risk factors for chronic ankle instability
• Return-to-play considerations and the PAASS framework
• Indications for surgery in chronic lateral ankle instability
• Modern Broström repair
• Internal brace augmentation: who may benefit and whether every Broström needs it

Part II: High Ankle Sprains & Osteochondral Lesions of the Talus

In Part II, we will continue our conversation with Dr. Hunt and turn our attention to syndesmotic—or “high”—ankle sprains and osteochondral lesions of the talus.

We examine the evolving management of syndesmotic injuries, including evidence comparing suture-button fixation with traditional syndesmotic screws. We discuss the potential advantages of dynamic fixation, including improved functional outcomes, fewer implant-related complications and hardware removals, and lower rates of malreduction.

Finally, we tackle osteochondral lesions of the talus, reviewing diagnosis and treatment options ranging from nonoperative management to microfracture, cartilage and bone grafting, and newer cartilage-restoration strategies.

Articles Discussed

Recovery From a First-Time Lateral Ankle Sprain and the Predictors of Chronic Ankle Instability
American Journal of Sports Medicine, 2016

Brace for Impact: A Retrospective Analysis of the Modified Broström-Gould Procedure With and Without Internal Brace Augmentation
Cureus, 2023

Suture Button Versus Syndesmotic Screw for Syndesmosis Injuries: A Meta-analysis of Randomized Controlled Trials
American Journal of Sports Medicine, 2019

Evaluation and Management of Osteochondral Lesions of the Talus
Cartilage, 2017

Modified Broström vs Suture Tape Augmentation: A Systematic Review
Journal of Foot and Ankle Surgery, 2025

Internal Brace Augmentation Versus Modified Broström-Gould Procedure for Chronic Lateral Ankle Instability: A Systematic Review and Meta-analysis of Functional and Radiographic Outcomes
Journal of Orthopaedic Surgery and Research, 2026

Subscribe to The Sports Docs Podcast on Apple Podcasts, Spotify, Amazon Music, and YouTube. You can also find us on Instagram @thesportsdocspod or reach us at [email protected].

www.cloganmd.com

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

On today’s episode of The Sports Docs Podcast, we’re discussing the 2026 Orthopaedic Journal of Sports Medicine article, “The Impact of Lateral Extra-Articular Tenodesis on Knee Range of Motion After Pediatric Anterior Cruciate Ligament Reconstruction,” by Hamad and colleagues from UCLA.

The use of lateral extra-articular tenodesis (LET) alongside ACL reconstruction continues to increase, particularly in young athletes at high risk for reinjury. While growing evidence suggests that LET can improve rotational stability and reduce ACL graft failure, questions remain about whether adding an extra-articular restraint may increase the risk of postoperative stiffness.

In this retrospective cohort study, the authors evaluated 412 pediatric ACL reconstructions, including 167 patients who underwent ACL reconstruction with LET. The primary outcome was restricted range of motion at three months, defined as a ≥5° extension deficit or ≥15° flexion deficit compared with the contralateral knee.

We discuss several key findings:

• Restricted range of motion at three months occurred in 16.8% of ACLR + LET patients compared with 10.2% following isolated ACL reconstruction.
• After adjustment for patient and surgical factors, LET was associated with approximately twice the odds of restricted postoperative motion.
• Female sex was the strongest predictor identified, with more than four times the odds of restricted motion.
• Most motion deficits involved flexion rather than extension.
• Although most patients with early motion loss did not require another procedure, 4.2% of the LET group underwent manipulation under anesthesia and/or lysis of adhesions compared with 0.4% of the isolated ACL group.

We also discuss why these findings should not discourage surgeons from performing LET in appropriately selected athletes. 

Instead, the study highlights a potential trade-off between graft protection and early postoperative motion, reinforcing the importance of appropriate patient selection, careful LET positioning and tensioning, early restoration of knee motion, and close postoperative surveillance.

Finally, we review the limitations of this retrospective study and discuss how evolving LET indications, graft selection, fixation techniques, rehabilitation adherence, and surgical technique may influence these findings.

The takeaway: LET provides meaningful protection for the ACL graft in young, high-risk athletes—but surgeons and rehabilitation teams should remain vigilant about restoring motion and identifying patients who begin to fall behind early in recovery.

Article

Hamad et al. The Impact of Lateral Extra-Articular Tenodesis on Knee Range of Motion After Pediatric Anterior Cruciate Ligament Reconstruction. Orthopaedic Journal of Sports Medicine. 2026.

Thanks for listening to The Sports Docs Podcast!

Subscribe on Apple Podcasts, Spotify, Amazon Music, and YouTube to stay up to date on the latest developments in sports medicine.

If you enjoy the podcast, please consider leaving us a review or comment.

Email: [email protected]
Instagram: @thesportsdocspod

In this special Athlete Highlight episode, we are back with Cub Swanson & Dr. Sohrab Gollogly - bringing together two sides of the surgical experience: the athlete who underwent surgery and the surgeon who performed it.

Professional mixed martial artist and UFC Hall of Famer Cub Swanson joins his surgeon, orthopedic spine specialist Dr. Sohrab Gollogly, for a conversation about endoscopic spine surgery—from the athlete’s perspective and the surgeon’s point of view.

In This Episode: Part Two

In the next episode, we’ll continue the discussion and shift our focus to postoperative recovery and return to play following endoscopic spine surgery.

What does recovery look like for a professional fighter? When can an athlete begin training again? And what does it take to get back to the highest level of competition?

Meet Our Guests

Cub Swanson

Cub Swanson is a veteran professional mixed martial artist and one of the most respected featherweights of his generation.

Swanson turned professional in 2004 and became a standout in the WEC before making his UFC debut in 2011. Known for his exciting and aggressive fighting style, he has faced many of the biggest names in MMA and has built a professional career spanning more than two decades.

He was inducted into the UFC Hall of Fame’s Fight Wing in 2022.

Outside the Octagon, Cub is a father of three and is passionate about mentoring the next generation of fighters and giving back to the sport that helped transform his life.

Dr. Sohrab Gollogly

Dr. Sohrab Gollogly is a fellowship-trained, board-certified orthopedic spine surgeon with more than 20 years of experience treating spinal disorders.

Based in Monterey, California, Dr. Gollogly specializes in minimally invasive and endoscopic spine surgery, with particular interests in motion preservation and avoiding unnecessary fusion surgery.

He completed his medical training at the University of Washington, orthopedic surgery residency at the University of Utah, and advanced fellowship training in adult spine surgery in Lyon, France, as well as pediatric spine surgery in San Diego.

Dr. Gollogly is also a founding member of the EndoSpine Academy at Balgrist University Hospital in Zurich, where he is involved in surgeon education and the advancement of endoscopic spine techniques.

Why This Conversation Matters

Endoscopic spine surgery continues to evolve, and for athletes, the potential advantages of minimally invasive approaches extend beyond the operating room.

For a professional fighter, the goals may include more than relieving pain or treating a structural problem. Motion, strength, function, recovery time, and the ability to return to a high-demand sport all matter.

By hearing directly from both the athlete and surgeon, this episode explores what happens when those goals intersect—and what the decision-making process looks like when the stakes are a professional career.

The Sports Docs Podcast

Hosted by Dr. Ashley Bassett and Dr. Catherine Logan

Subscribe on Apple Podcasts, Spotify, Amazon Music, and YouTube to stay up to date on the latest in sports medicine.

If you enjoy the podcast, please consider leaving us a review or comment—it helps other sports medicine professionals and athletes find the show.

Have feedback or a topic you'd like us to cover?

Email: [email protected]
Instagram: @thesportsdocspod

In this special Athlete Highlight episode, we’re bringing together two sides of the surgical experience: the athlete who underwent surgery and the surgeon who performed it.

Professional mixed martial artist and UFC Hall of Famer Cub Swanson joins his surgeon, orthopedic spine specialist Dr. Sohrab Gollogly, for a conversation about endoscopic spine surgery—from the athlete’s perspective and the surgeon’s point of view.

In This Episode

• Why spinal injuries can be particularly challenging for professional combat athletes
• Cub Swanson’s experience with a spinal condition that threatened his ability to continue competing
• What led to the decision to pursue endoscopic spine surgery
• How minimally invasive endoscopic techniques may offer an alternative to more traditional spine procedures
• The surgeon’s perspective on patient selection, motion preservation, and avoiding unnecessary fusion
• What it is like to make a surgical decision when your career depends on your physical performance
• The importance of balancing surgical treatment with an athlete’s goals, expectations, and desire to return to competition
• The evolving role of endoscopic techniques in sports medicine and spine care

Meet Our Guests

Cub Swanson

Cub Swanson is a veteran professional mixed martial artist and one of the most respected featherweights of his generation.

Swanson turned professional in 2004 and became a standout in the WEC before making his UFC debut in 2011. Known for his exciting and aggressive fighting style, he has faced many of the biggest names in MMA and has built a professional career spanning more than two decades.

He was inducted into the UFC Hall of Fame’s Fight Wing in 2022.

Outside the Octagon, Cub is a father of three and is passionate about mentoring the next generation of fighters and giving back to the sport that helped transform his life.

Dr. Sohrab Gollogly

Dr. Sohrab Gollogly is a fellowship-trained, board-certified orthopedic spine surgeon with more than 20 years of experience treating spinal disorders.

Based in Monterey, California, Dr. Gollogly specializes in minimally invasive and endoscopic spine surgery, with particular interests in motion preservation and avoiding unnecessary fusion surgery.

He completed his medical training at the University of Washington, orthopedic surgery residency at the University of Utah, and advanced fellowship training in adult spine surgery in Lyon, France, as well as pediatric spine surgery in San Diego.

Dr. Gollogly is also a founding member of the EndoSpine Academy at Balgrist University Hospital in Zurich, where he is involved in surgeon education and the advancement of endoscopic spine techniques.

Why This Conversation Matters

Endoscopic spine surgery continues to evolve, and for athletes, the potential advantages of minimally invasive approaches extend beyond the operating room.

For a professional fighter, the goals may include more than relieving pain or treating a structural problem. Motion, strength, function, recovery time, and the ability to return to a high-demand sport all matter.

By hearing directly from both the athlete and surgeon, this episode explores what happens when those goals intersect—and what the decision-making process looks like when the stakes are a professional career.

Up Next -- Part Two

In the next episode, we’ll continue the discussion and shift our focus to postoperative recovery and return to play following endoscopic spine surgery.

What does recovery look like for a professional fighter? When can an athlete begin training again? And what does it take to get back to the highest level of competition?

Stay tuned for Part Two!

The Sports Docs Podcast

Hosted by Dr. Ashley Bassett and Dr. Catherine Logan

Subscribe on Apple Podcasts, Spotify, Amazon Music, and YouTube to stay up to date on the latest in sports medicine.

If you enjoy the podcast, please consider leaving us a review or comment—it helps other sports medicine professionals and athletes find the show.

Have feedback or a topic you'd like us to cover?

Email: [email protected]
Instagram: @thesportsdocspod

Live from the Arthrex Team Physician Controversies Conference

(& Happy Labor Day!)

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

Stay Connected

Apple Podcasts

Spotify

YouTube

Follow us on Instagram for more insights on cutting-edge sports medicine, athlete recovery, and performance

https://www.instagram.com/thesportsdocspod/

Our Hosts:

Catherine Logan, MD, MBA

https://www.cloganmd.com/

Ashley Bassett, MD

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

www.thesportsdocspod.com

High ankle sprains and syndesmosis injuries can be some of the most challenging ankle injuries to diagnose and manage—particularly when instability requires surgical intervention.

In this special episode of The Sports Docs Podcast LIVE from the AOSSM Annual Meeting in Seattle, hosts Ashley Bassett, MD, and Catherine Logan, MD, sit down with Kevin Martin, DO, Orthopaedic Surgeon at The Ohio State University, to discuss modern approaches to syndesmosis stabilization.

The conversation explores how surgical management has evolved from traditional rigid screw fixation toward dynamic stabilization strategies and what that evolution means for reduction accuracy, rehabilitation, and return to sport.

Dr. Martin shares his approach to determining when a syndesmosis injury requires surgery and walks listeners through important technical considerations for achieving and maintaining an anatomic reduction. The discussion covers practical surgical pearls and pitfalls, including reduction techniques, clamp positioning, tunnel placement, button seating, and avoiding syndesmotic malreduction.

The group also discusses how surgeons determine when additional fixation may be beneficial, including the decision to use one versus two dynamic fixation constructs in athletes, high-energy injuries, and more rotationally unstable patterns.

Later in the episode, the conversation turns to postoperative rehabilitation and return-to-sport progression, including how injury severity and associated fractures influence decisions surrounding range of motion, weightbearing, running, cutting, and return to competition.

Finally, the episode explores modern options for managing syndesmosis injuries associated with distal fibula fractures, including intramedullary fibular fixation and how implant design continues to evolve to support minimally invasive fracture fixation and syndesmosis stabilization.

In This Episode, We Discuss:

• When syndesmosis injuries can be treated nonoperatively—and when surgery is indicated
• Identifying syndesmotic instability in athletes
• The evolution from rigid fixation to dynamic syndesmosis stabilization
• Advantages and limitations of traditional syndesmotic screw fixation
• Why anatomic reduction remains the most important step in successful syndesmosis surgery
• Surgical pearls for avoiding syndesmotic malreduction
• Clamp positioning and the risks of over-compression
• Tunnel placement and implant positioning considerations
• One versus two fixation constructs: when is additional stabilization necessary?
• Managing rotational instability and high-energy injury patterns
• Postoperative rehabilitation and return-to-sport progression
• Treating syndesmosis injuries associated with distal fibula fractures
• Intramedullary fibular fixation as an alternative to traditional plate fixation
• Emerging technology and the future of syndesmosis stabilization

Key Takeaway

Successful treatment of syndesmosis injuries starts with recognizing instability and achieving an accurate anatomic reduction. As fixation technology and surgical techniques continue to evolve, surgeons have more options to balance stability, physiologic motion, rehabilitation, and return to sport.

This episode of The Sports Docs Podcast was recorded LIVE at the AOSSM Annual Meeting in Seattle and is sponsored by Arthrex.

Stay Connected

If you enjoyed this episode, be sure to subscribe, rate, and review on:

Apple Podcasts:

https://podcasts.apple.com/us/podcast/the-sports-docs-podcast/id1557160983

Spotify:

https://open.spotify.com/show/01LSRvAWnz2gk8qyPd1Qbw?si=13cc745f43b740c0

Amazon Music: 

https://music.amazon.com/podcasts/f15121d5-cc57-4201-9f2f-d6c2b26a3800/the-sports-docs-podcast

YouTube: https://www.youtube.com/channel/UCw48o9AbLmOoQk5fHfhsXFA

Follow us on Instagram for more insights on cutting-edge sports medicine, athlete recovery, and performance

https://www.instagram.com/thesportsdocspod/

Our Hosts:

Catherine Logan, MD, MBA

https://www.cloganmd.com/

Ashley Bassett, MD

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

www.thesportsdocspod.com

What if treating the throwing athlete’s elbow could mean seeing more while disrupting less?

In this special LIVE episode from the AOSSM Annual Meeting in Seattle, Dr. Catherine Logan and Dr. Ashley Bassett sit down with Christopher Ahmad, MD, renowned sports medicine surgeon and longtime New York Yankees team physician, to explore the evolution of elbow arthroscopy and the emerging role of nano-arthroscopy in treating throwing athletes.

Elbow arthroscopy has become an important tool for addressing mechanical intra-articular pathology, including loose bodies, posterior impingement, osteophytes, synovitis, chondral injuries, OCD lesions, and stiffness. But the elbow’s small working space and proximity of critical neurovascular structures make precision essential.

Dr. Ahmad discusses how advances in visualization and instrumentation—including the Arthrex NanoNeedle Scope—are expanding the surgeon’s toolbox and potentially allowing selected procedures to be performed with even less soft-tissue disruption.

The conversation also examines the growing interest in accelerated return-to-play timelines, including the much-discussed return of MLB pitcher Tarik Skubal following nano-arthroscopy and loose-body removal.

In This Episode

• The most common elbow pathologies treated arthroscopically in throwing athletes
• How to distinguish mechanical intra-articular pathology from ligamentous insufficiency
• Why accurate diagnosis and appropriate indications remain critical
• The evolution of elbow arthroscopy over the past two decades
• Why the elbow presents unique technical challenges for arthroscopic surgery
• Traditional arthroscopes vs. the Arthrex NanoNeedle Scope
• How smaller visualization platforms may reduce surgical morbidity
• Potential benefits of less fluid extravasation, smaller portals, and less capsular disruption
• What nano-arthroscopy could mean for postoperative pain, swelling, ROM, and rehabilitation
• Traditional recovery timelines following loose-body removal
• What professional athletes can—and cannot—teach us about accelerated return to play
• Whether emerging technologies could influence in-season surgical decision-making
• The future of nano-arthroscopy and whether it could transform sports medicine
• Why the future is likely not “nano vs. traditional,” but the right technology for the right patient

Key Takeaway

Technology doesn’t replace surgical judgment—it expands the toolbox.

For appropriately selected patients, nano-arthroscopy may offer an opportunity to accomplish established surgical goals while minimizing disruption to surrounding tissues. But as Dr. Ahmad emphasizes, the foundation remains the same: accurate diagnosis, sound indications, meticulous technique, and individualized patient care.

The future of sports medicine may not be about replacing traditional arthroscopy. It may be about having more precise options—and knowing exactly when to use each one.

Featured Technology

Arthrex NanoNeedle Scope

The NanoNeedle Scope represents an ultra-small visualization platform designed to provide direct visualization through a dramatically smaller diameter than traditional arthroscopes. In the elbow, where working space is limited and critical structures are nearby, this technology may offer new possibilities for minimally invasive evaluation and treatment.

Dr. Christopher Ahmad is a renowned orthopaedic sports medicine surgeon and longtime team physician for the New York Yankees. His clinical and research work has focused extensively on sports medicine, throwing athletes, elbow and shoulder pathology, and the advancement of surgical techniques.

Hosts

Catherine Logan, MD
Ashley Bassett, MD

The Sports Docs Podcast brings together leading sports medicine physicians to discuss the latest advances in orthopaedics, sports science, injury prevention, rehabilitation, and athlete performance.

Disclaimer

This episode is sponsored by Arthrex. The discussion focuses on the clinical application and evolving role of Arthrex technology in sports medicine. Surgical techniques and treatment decisions should be individualized based on patient-specific pathology, surgeon experience, and current evidence.

Rotator cuff repair continues to evolve—not only in how surgeons fix the tendon, but in how we think about healing, biomechanics, tissue quality, and augmentation.

In this episode of The Sports Docs Podcast LIVE from the AOSSM Annual Meeting in Seattle, Dr. Albert Lin and Dr. JT Tokish join Dr. Ashley Bassett and Dr. Catherine Logan to discuss strategies for optimizing rotator cuff repair outcomes.

The conversation begins with the evolution of the SpeedBridge repair construct and the emergence of the FiberTak SpeedBridge, including the potential advantages of smaller all-suture medial anchors, bone preservation, independent tensioning, and rip-stop techniques.

The discussion then moves into one of the most rapidly evolving areas in rotator cuff surgery: biologic and structural augmentation. The group explores how surgeons identify patients at increased risk for failed healing, the role of the Rotator Cuff Healing Index, and the expanding options for augmentation—including the use of the long head of the biceps as an autograft and dermal allograft augmentation with CuffMend.

In This Episode

Evolving the SpeedBridge

The SpeedBridge technique has become one of the most established approaches to arthroscopic rotator cuff repair, with more than 15 years of clinical experience supporting its durability.

The group discusses:

• How SpeedBridge has changed arthroscopic rotator cuff repair
• Footprint restoration and broad tendon-to-bone compression
• Load distribution across the repair construct
• Long-term clinical outcomes and survivorship
• Why reproducibility may be one of the technique's greatest advantages

FiberTak SpeedBridge: The Next Evolution

The conversation then turns to the FiberTak SpeedBridge, which incorporates smaller all-suture anchors in the medial row.

There are several potential advantages:

• Smaller drill holes and reduced bone removal
• Preservation of greater tuberosity bone stock
• Potential advantages in revision surgery
• Additional fixation points with less disruption of the footprint
• Strong fixation and straightforward tensioning
• Increased flexibility when treating complex tear patterns

The smaller 2.6-mm FiberTak RC anchor may allow surgeons to maximize fixation while minimizing disruption of the tuberosity footprint.

Tensionable Knotless Anchors and Delaminated Tears

One of the challenges in rotator cuff surgery is that many tears are not simply a single layer of retracted tendon.

In delaminated tears, the articular and bursal layers may retract differently.

The team discuss how independently tensionable knotless medial-row anchors allow surgeons to:

• Evaluate the entire repair before final tensioning
• Independently tension individual limbs
• Better reduce different layers of the tendon
• Improve control of tissue reduction
• Avoid simply forcing multiple layers into one fixed position

The conversation also explores the role of a medial pulley rip-stop, which can distribute forces across a larger area of tendon and potentially decrease suture cut-through in compromised tissue.

Who Should Have an Augmented Repair?

Not every rotator cuff repair requires augmentation.

The group discusses how surgeons can identify patients at increased risk for failed healing based patient, tear and surgical factors. 

The Rotator Cuff Healing Index

The discussion includes the Rotator Cuff Healing Index (RoHI), a scoring system designed to predict the likelihood of healing following rotator cuff repair.

The guests discuss how risk stratification can help surgeons determine when the additional cost and complexity of augmentation may be justified.

Biceps Smash: Turning the Long Head of the Biceps Into an Autograft

One of the most fascinating concepts discussed is the use of the long head of the biceps tendon as an autologous scaffold for rotator cuff augmentation.

Dr. Tokish discusses the development of the Biceps Smash, in which the harvested proximal long head of the biceps tendon is compressed into a flattened graft that can be incorporated into the rotator cuff repair.

Potential advantages include:

• Readily available autologous tissue
• No additional donor-site morbidity
• No immunologic concerns associated with allograft tissue
• Highly organized parallel collagen architecture
• Potential biologic activity from viable tenocytes
• Ability to potentially serve as a carrier for additional biologic therapies

The group also discusses emerging clinical data examining healing and patient-reported outcomes following biceps autograft augmentation.

Dermal Allograft and Other Scaffold Options

The conversation then expands to other augmentation strategies, including:

• Dermal allograft
• Xenograft
• Synthetic scaffolds
• Autograft tissue

The guests discuss the differences between structural support and biologic integration, as well as the importance of understanding how different scaffold materials interact with the host tissue.

Dermal allograft has accumulated substantial clinical evidence supporting its use in selected rotator cuff repairs, particularly larger and higher-risk tears.

The discussion also addresses concerns surrounding xenograft and synthetic materials, including inflammatory and foreign-body responses.

CuffMend: Simplifying Dermal Allograft Augmentation

For surgeons who elect to augment a repair with dermal allograft, the procedure itself can add complexity and operative time.

Dr. Tokish discusses how the CuffMend system is designed to streamline graft handling and delivery.

The conversation focuses on how improvements in instrumentation and graft preparation can potentially:

• Reduce operative time
• Simplify graft handling
• Improve procedural efficiency
• Reduce technical variability
• Make augmentation more accessible to surgeons

SpeedFlex and Graft Preparation

The guests also discuss SpeedFlex, which uses pre-sized and pre-sutured ArthroFlex grafts.

Available graft configurations include:

• 20 × 25 mm and 25 × 30 mm
• 1-mm and 2-mm thicknesses

Rather than requiring surgeons to prepare and load the graft intraoperatively, the pre-sutured configuration is designed to streamline preparation and reduce variability.

FiberStitch RC Simple

Another innovation discussed is the FiberStitch RC Simple implant for medial graft fixation.

Dr. Tokish explains how the system can facilitate a "sandwich stitch," allowing the graft to be compressed between fixation points on the superior and inferior surfaces.

Available straight and reverse-curved options provide additional flexibility for medial graft fixation.

Key Takeaways

1. The repair construct matters.
SpeedBridge has established a strong clinical track record, while FiberTak SpeedBridge builds on that foundation with smaller all-suture medial anchors and additional flexibility.

2. Bone preservation may be particularly important in complex and revision cases.
Smaller all-suture anchors can minimize bone removal and preserve the greater tuberosity footprint.

3. Not every rotator cuff repair needs augmentation.
Patient characteristics, tear morphology, tissue quality, and repair mechanics should all factor into the decision.

4. The biceps may be more than a pain generator.
The long head of the biceps can potentially serve as a readily available autologous scaffold for rotator cuff augmentation.

5. Dermal allograft remains an important augmentation option.
Clinical evidence supports its use in selected higher-risk repairs, particularly larger or compromised tears.

6. Making augmentation easier may increase adoption.
Streamlined graft preparation, delivery, and fixation can reduce operative complexity while maintaining the principles of sound repair.

7. The ultimate goal is healing—not simply repair.
Modern rotator cuff surgery increasingly focuses on creating the biologic and biomechanical environment necessary for durable tendon-to-bone healing.

Featured Research

Millett PJ, et al. Long-term outcomes following arthroscopic rotator cuff repair using the SpeedBridge technique. The study demonstrated approximately 94% survivorship at 10 years, highlighting the durability of the construct.

Colbath G, Murray A, Siatkowski S, et al. Autograft long head biceps tendon can be used as a scaffold for biologically augmenting rotator cuff repairs. Arthroscopy. 2022.

Kwon J, et al. The Rotator Cuff Healing Index: A New Scoring System to Predict Rotator Cuff Healing After Surgical Repair. American Journal of Sports Medicine. 2019.

Tokish JM, et al. Recent clinical work evaluating the use of a compressed long-head-of-biceps autograft for rotator cuff augmentation demonstrated promising healing rates and clinical outcomes at early follow-up.

This episode of The Sports Docs Podcast was sponsored by Arthrex.