Albert Lin1, Jin Ye Yeo2
1Department of Orthopedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA; 2AOJ AME Publishing Company
Correspondence to: Jin Ye Yeo. AOJ Editorial Office, AME Publishing Company. Email: aoj@amegroups.com
This interview can be cited as: Lin A, Yeo JY. Meeting the Editor-in-Chief of AOJ: Dr. Albert Lin. Ann Joint. 2024. Available from: https://aoj.amegroups.org/post/view/meeting-the-editor-in-chief-of-aoj-dr-albert-lin.
Expert introduction
Dr. Albert Lin (Figure 1) is Professor and Vice Chair of Education, Residency Program Director, Chief of Shoulder Surgery, Co-Director of the Pittsburgh Shoulder Institute, and Associate Chief of Sports Medicine at the University of Pittsburgh. Dr. Lin specializes in the care of athletes and shoulder conditions and has extensive experience with shoulder arthroscopy, shoulder arthroplasty, and complex reconstructive and open surgery of the shoulder. He is a graduate of Harvard Medical School and completed his residency in Orthopaedic Surgery at the Harvard Combined Orthopaedic Residency Program, as well as fellowships in Sports Medicine at the University of Pittsburgh Medical Center and Shoulder Surgery at Harvard University. He is a founding board member of the international Rotator Cuff Study Group and is a regularly invited faculty member for AAOS, ASES, AOSSM, AANA, ISAKOS, and MASES. He was the co-chair of the ASES Fellows’ Day 2021 and 2022, and is the current co-chair of the shoulder and elbow program of the OSET Summit Meeting since 2022. He is also an inducted member of the Neer Circle of ASES, the Herodicus Society, and AOA.
Dr. Lin has currently published 150 peer-reviewed papers and over 300 abstracts and book chapters related to clinical and basic science research on shoulder instability, rotator cuff pathology, shoulder arthroplasty, and complex shoulder conditions, and regularly presents his research at international and national meetings. His papers have received numerous awards from ASES, AOSSM, AANA, The Arthroscopy Journal, OSET, Shoulder360, and MASES.
Figure 1 Dr. Albert Lin
Interview
AOJ: What motivated you to pursue a career in shoulder surgery and sports medicine?
Dr. Lin: I have always enjoyed sports, and sports medicine afforded me the possibility to remain involved with athletics, athletes, and the care of sports-related injuries. Shoulder surgery overlaps significantly with sports medicine, particularly regarding arthroscopy, but also involves the complete care of all shoulder-related pathology. In addition to a wide mix of both soft tissue and bony pathology, I was drawn to shoulder surgery as a sports medicine surgeon because it allows me the opportunity to take care of all shoulder issues from the simple to the complex, the young to old, athletes to non-athletes, and arthroscopic surgery to complex shoulder reconstruction including arthroplasty. I would describe my practice as a “cradle to grave” shoulder practice and I love that I am equipped to take care of any shoulder pathology, including my own complications.
AOJ: What are some of the most challenging and common conditions you encounter in shoulder surgery, and how do you approach their management?
Dr. Lin: As with any specialty there are many. A few that come to mind immediately include shoulder instability in the young, athletic population, especially contact athletes, and how to improve outcomes with surgical stabilization, maximizing healing for rotator cuff repairs, optimal treatments for patients with massive, irreparable rotator cuff tears, and complex shoulder arthroplasty with significant bone loss, both in the primary and revision settings. There are of course many others. Approaching the management of challenging conditions starts with individualizing treatment to each specific patient, understanding their goals and expectations, and then tailoring the best treatment to meet those goals using the best evidence-based approach.
AOJ: Could you provide a brief overview of the current publications in shoulder biomechanics and/or surgery?
Dr. Lin: Some of the hottest topics in shoulder surgery which are the subject of many biomechanic and clinical research include understanding humeral and glenoid bone loss in shoulder instability and optimizing the best surgical treatments to address, including the timing of surgery, the use of biologics and biologic patches to augment healing in rotator cuff repairs, the most appropriate reconstructive options in the young patient with irreparable rotator cuff tears, and advanced technology in shoulder arthroplasty including preoperative 3D planning, custom 3D printing for both instrumentation and implants, mixed reality, robotics, smart-tools, and artificial intelligence.
AOJ: How do you see advancements in shoulder biomechanics and instability research impacting clinical practice in the near future? What are some examples of current/emerging trends or technologies that hold significant promise?
Dr. Lin: I feel that we are just scratching the surface regarding our understanding of shoulder instability. There have been many recent advancements from a biomechanical and clinical research perspective. For instance, we have gained a better understanding of the importance of the Hill-Sachs contribution to instability, what constitutes worrisome bone loss on the glenoid, the importance of bipolar bone loss with the glenoid track concept, in addition to many factors that contribute to instability and surgical outcomes which include age, type of sports, the number of dislocations and contribution to capsular deformation, and the overall laxity of the shoulder. We have been very fortunate to contribute to the literature from a biomechanical and clinical research perspective. Recent advancements in these domains have led to emerging technologies that have certainly impacted my practice currently including the addition of the remplissage to arthroscopic Bankart for expanded indications and alternative bone grafting techniques and sources for the glenoid, including new arthroscopic approaches and fixation methods. These techniques hold significant promise in terms of improving outcomes, and minimizing risks, but also require a thoughtful, value-based, approach to determine appropriate indications. Continued scrutiny through research is necessary to inform our decisions and to continue improving the care for our patients. There are further domains that I believe will hold significant promise in the future including the ability to evaluate instability in a 3D and dynamic manner, 3D preoperative planning and intraoperative execution analogous to technology currently available for shoulder arthroplasty, and the use of artificial intelligence that will help predict outcomes following nonoperative or operative treatment with the of use big data that incorporates all relevant demographic and anatomic risk factors that are unique and specific to each patient.
AOJ: As the Vice Chair of Education and Director of the Residency Program, what are your priorities for training the next generation of orthopedic surgeons?
Dr. Lin: It is my hope that the next generation of orthopedic surgeons leave a lasting impact that outshines the current generation of surgeons, myself included. With an evolving medicolegal environment, financial and time pressures, and work hour restrictions that squeeze each generation of trainees more than the last, it is important that we continue to provide every opportunity for our trainees to become the best possible versions of themselves as orthopaedic surgeons. This includes optimizing their surgical training with faculty educators and mentors who prioritize teaching and trainee development, providing infrastructure and funding for development in domains of leadership, education, research, and personal growth, providing a supportive environment during a very formative period of time, and modeling behavior that we desire to see in our future leaders. We also need to prioritize flexibility in our training approaches such as with virtual reality training to supplement hands-on training. All of us in the business of education and training want to provide every single opportunity for our trainees to be successful.
AOJ: As the head orthopedic team physician for Duquesne University and Pittsburgh Central Catholic High School, how do you integrate sports medicine principles into your practice with athletes?
Dr. Lin: As a team physician, interpersonal relationships and communication are critical for the care of athletes. This network includes the athlete, the family, the athletic trainer, coaches, and other physician specialists and is critical to understanding the needs and expectations of my athletes. These are universal principles that extend into my practice and are critical to individualizing care for all of my patients.
AOJ: As the Editor-in-Chief, what are your expectations for AOJ?
Dr. Lin: It is a tremendous honor to serve as the Editor-in-Chief of AOJ, and I am proud to continue a legacy that was started by my late mentor, Dr. Freddie Fu. As we grow as a journal and continue to share impactful research from world experts, I would love to see AOJ PubMed-indexed in the near future and become a leading journal for high-quality research. It has been exciting to be a part of this process. The sky is the limit and we have all the right building blocks to make this happen!