2025 Kappa Delta Ann Doner Vaughn Award Winner Recognized for 25-Year Shoulder Instability Research

The 2025 Kappa Delta Ann Doner Vaughn Award was presented to Matthew T. Provencher, MD, MBA, CAPT MC USNR (Ret.), FAAOS, and his military orthopaedic colleagues for their work in understanding and treating anterior shoulder instability among U.S. military members. Spanning 25 years, this research has had a worldwide impact on treatment options, indications, and surgical techniques, leading to what is now considered by many to be a gold-standard technique for arthroscopic shoulder stabilization.

The team’s research highlighted the heightened prevalence of shoulder instability in military populations, initially identifying a six-fold incidence and an 18-fold increase in anterior shoulder instability at U.S. military academies. “Once our research team became keenly aware of the high incidence rates among military members who suffered from anterior shoulder instability, we knew we had to take a closer look at identifying why this patient population is so susceptible to this injury and evaluate short- and long-term treatment outcomes for both nonoperative and operative care,” said Dr. Provencher, who is a professor of orthopaedics and an orthopaedic surgeon at the Steadman Clinic in Vail, Colorado.

Advancing treatment
After more than 2 decades of research, the team evolved how first-time shoulder instability is managed in young, active patients by studying military populations. Together, they shifted the treatment philosophy from nonoperative management as a first-line treatment to “right surgery for the right patients, and to get it right the first time.”

Although there were some previous improvements with arthroscopic Bankart repair over nonoperative management, the team was concerned with the failure rates of that procedure and the consequences it can have for those on active duty. “Our early attempts at arthroscopic stabilization showed unacceptably high failure rates,” said coauthor COL Brett D. Owens, MD, USN (Ret.), FAAOS, chief of sports medicine and professor of orthopaedic surgery at the Warren Alpert Medical School of Brown University in Providence, Rhode Island. “While we were not the first group to examine the failure rates with this procedure, we were able to examine these results in the highest-risk population in the world, allowing for a robust failure analysis to scrutinize the outcomes.”

Addressing bone loss
One of the most significant factors contributing to arthroscopic treatment failures is glenoid bone loss, the amount of bone missing in the shoulder-blade socket. The team made the following innovations and discoveries from military centers all over the world:

• establishing a glenoid and humeral head bone-loss model to predict outcomes in patients indicated for arthroscopic Bankart repair using age, sex, duration of shoulder instability, symptoms, and radiographic images of the anatomy of the lesions
• defining the amount of bone loss to determine the type of surgery patients receive
• improving outcomes by reconstructing the anatomy of the shoulder with a novel osteochondral allograft solution for glenoid bone loss by taking the distal tibia to fit the anterior glenoid, thereby providing important biomechanical and matching data, as well as in vivo clinical follow-up

The research also catalyzed the Military Orthopaedic Tracking Injuries Outcomes Network (MOTION), established in 2016, an initiative developed in collaboration with military colleagues. Now the world’s largest military outcomes database, MOTION has more than 10,000 patients enrolled and is pivotal in tracking long-term outcomes of instability-related injuries.

“It’s difficult for the civilian world to understand the profound sense of responsibility felt by military surgeons, particularly those who have served in wartime,” said coauthor COL John M. Tokish, MD, MC, USAR, FAAOS, professor of orthopaedic surgery at Mayo Clinic in Phoenix, Arizona. “There is a tremendous and palpable sense of legacy, paid for by those who came before us, that we are committed to honoring and passing on to future generations.”

In addition to Dr. Owens and Dr. Tokish, the following coauthors contributed to the research: COL Jonathan F. Dickens, MD, MC, USAR, FAAOS; Eoghan T. Hurley, MD, PhD; CAPT Lance E. LeClere, MD, USNR, FAAOS; LTC Andrew J. Sheean, MD, USAF; COL Jeanne C. Patzkowski, MD, USA, FAAOS; CAPT Robert A. Waltz, MD, USN, FAAOS; and LTC Stephen Parada, MD, USA, FAAOS.