The Only Conference That Focuses on Orthopaedics in Texas · 2020-02-05 · conference will also...

The Only Conference That Focuses on

Orthopaedics in Texas

February 7-8, 2020

San Antonio, Texas

ANNUAL CONFERENCE

2020 Syllabus

2 Texas Orthopaedic Association

Present:

TOA’s Annual ConferenceFebruary 7-8, 2020

Westin Riverwalk - San Antonio

Table of ContentsWelcome Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Program & Events Schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-5

Five-Minute Abstract Presentations . . . . . . . . . . . . . . . . . . . . . .6

Important Meeting Announcements . . . . . . . . . . . . . . . . . . . . .7

Meeting Room Map . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Symposium Breakout Highlights . . . . . . . . . . . . . . . . . . . . . 9-10

TOA’s Important Public Policy Work . . . . . . . . . . . . . . . . . . . . 11

CME Credit, Disclaimer, Disclosures & Objectives . . . . . . . . 13

Financial Disclosures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

2019-2020 OfficersPresident . . . . . . . . . . . . . . . . Adam J . Bruggeman, MD

San Antonio, TX

First President-Elect . . . . . . Kenneth J . Kaminski, MD Tyler, TX

Second President-Elect . . . Luis H . Urrea II, MD El Paso

Immediate Past President Andrew J . Palafox, MD El Paso, TX

Secretary-Treasurer . . . . . . Christopher M . Danney, MD, Austin, TX

Historian/Membership Chair . . . . . . . Maureen A . Finnegan, MD,

Dallas, TX

Program CommitteeVinod K . Panchbhavi, MD – TOA Program Chair

Adam J . Bruggeman, MD – TOA President

B . Christian Balldin, MD – TSSM President

Kenneth J . Kaminski, MD – TOA First President-Elect

Luis H . Urrea II, MD – Second President-Elect

About TOAMission and Vision: The Texas Orthopaedic Association (TOA) was founded in 1936 as the united voice of over 1,400 Texas orthopaedic surgeons . Its mission is to ensure outstanding musculoskeletal health for Texans . PurposeTOA’s CME program promotes continuous improve-ment in musculoskeletal care by providing ortho-paedic surgeons and other health care providers with high quality, evidence-based educational ac-tivities that focus on advances in orthopaedics, new technology, biomedical research, and changes in the health care environment . TOA’s CME activities focus on the core competencies of:

• Patient care• Medical knowledge• Interpersonal and communications skills• Practice-based learning and improvement• Professionalism • Systems-based practice

The program’s ultimate goal is to enhance physician competence and performance .

2020 Annual Meeting Syllabus 3

President’s Message

Dear TOA Member:

Welcome to TOA’s 2020 Annual Conference in San Antonio . A special “thank you” goes out to Vinod Panchbhavi for leading the program for the second year in a row . This outstanding conference would not be possible without his hard work .

San Antonio is a special city, and this conference has been designed so that you can experience some of the best parts of the city . On Thursday, a group will visit the San Antonio Military Medical Center’s Center for the Intrepid to witness the state-of-the-world technologies that orthopaedic surgeons and other members of the military team are using to treat and rehabilitate members of the military . In addition, TOA is pleased to hold the Friday night party in the Pearl Brewery’s Pearl Stable, which was the home of the brewery’s draft horses in the late 19th century and now serves as the hub of San Antonio’s entertainment .

In addition to hearing great clinical and business talks, this conference will also review TOA’s important public policy work in both Austin and Washington . In the 2019 Texas Legislature alone, TOA was engaged in over two dozen issues that affected Texas orthopaedic surgeons and their patients .

Thank you for taking time out of your busy schedule to take part in this conference .

Sincerely,

Adam J . Bruggeman, MDTexas Orthopaedic Association President, 2019-2020

Program Chair’s Message

Dear TOA Member:

I want to extend you all a very warm welcome to the 2020 An-nual Conference of the Texas Or-thopedic Association . This year we have something new . We are giving opportunity to our TOA members to present, interact actively through audience re-sponse systems and participate in small group sessions . So, I encourage you to bring your cases, share your knowledge and learn from each other . There are a variety of formats planned for the scientific sessions that will allow you to do so .

Also, this year’s scientific sessions have a theme – complications . We don’t like them, we don’t want them, but we have to deal with them - an unfortunate reality in our trade . It is easier to talk about things when they turn out great and we can learn from suc-cess stories . But we can also learn, perhaps equally or more importantly, from things that don’t go well . How to avoid complications and how to manage them when they occur, is what you will find speakers will share, and we hope you will too . I am grateful to all those who are putting in a lot of thought and effort behind these exemplary scientific sessions in the pro-gram to enrich us through our collective experience .

It is a great time of the year to be in San Antonio and experience all it has to offer . So, we hope that you and your family can unwind, reconnect with friends and make new ones . Enrich and be enriched in this historic and culturally diverse city . I look forward to welcom-ing you all!!

Sincerely,

Vinod K . Panchbhavi MD, FACS, FABOS, FAAOS, FAOATOA Program Chair


TEXAS ORTHOPAEDIC ASSOCIATION'S 2020 ANNUAL CONFERENCE MEETING SCHEDULE

Friday, February 7, 2020 – LEARNING FROM COMPLICATIONS SESSION – Navarro A

Friday, February 7, 2020 – BUSINESS SESSION – Navarro A Time Event Speaker

2:00 p .m . -2:05 p .m .

TOA Policy Update: Commercial Insurance & Workers’ Comp

Bobby Hillert (Texas Orthopaedic Association)

2:05 p .m . -2:45 p .m .

Patient-Centered Care: Is It Just Talk? Mike McCaslin, CPA (Somerset CPAs and Advisors | OrthoForum)

2:45 p .m . -3:15 p .m .

Break & Exhibitor Visits

3:15 p .m . -4:00 p .m .

Changing Your Income Distribution Plan: Does It Have to Be a Zero Sum Game?

Mike McCaslin, CPA (Somerset CPAs and Advisors | OrthoForum)

4:00 p .m . -5:00 p .m .

The Rothman Institute’s Journey to the Bundle Alexander R . Vaccaro, MD, PhD

5:00 p .m . -5:15 p .m .

Paper Presentations See Presentations on Page 6

5:15 p .m . -5:20 p .m .

TOA Policy Update: Opioids Bobby Hillert (Texas Orthopaedic Association)

6:30 p .m . -9:30 p .m .

Pearl Brewery Stable Party Dinner: 6:30 p .m . to 8:30 p .m . | Drinks: 6:30 p .m . to 9:30 p .m .

Time Event Speaker7:15 a .m . -8:00 a .m .

Registration, Breakfast and Exhibit Visitation

7:15 a .m . -7:55 a .m .


7:55 a .m . - 8:00 a .m .

Opening Remarks Vinod K . Panchbhavi, MD

8:00 a .m . - 8:55 a .m .

My Worst Complication: What I Learned From It Vinod K . Panchbhavi, MD – Moderator, Frank A . Buttacavoli, MD, Scott E . Hecox, MD & William M . Weiss, MD

8:55 a .m . - 9:00 a .m .

Low Vitamin D Levels in the Outpatient Orthopaedic Clinic Population

Edward P . Southern, MD

9:00 a .m . - 10:00 a .m .

Complications in Trauma Cases Patrick M . Osborn, MD – Moderator, Ravi A . Karia, MD, Eric G . Verwiebe, MD & John C . Hagedorn II, MD

10:00 a .m . - 10:30 a .m .

Break & Exhibitor Visits

10:30 a .m . - 11:30 a .m .

Sports Medicine: What We Can Learn From Complications

B . Christian Balldin, MD – Moderator, Paul C . Chin, MD, PhD, Robert U . Hartzler, MD, Clayton W . Nuelle, MD & Henry B . Ellis, Jr ., MD

11:30 a .m . -11:45 a .m .

ABOS Update 2020 Gregory A . Mencio, MD

11:45 a .m . -12:45 p .m .

Lunch Presentation: General Orthopaedic Issues Gerhard E . Maale, MD, Rajiv Rajani, MD & Kevin L . Kirk, DO

12:45 p .m . -1:00 p .m .


1:00 p .m . -2:00 p .m .

Hip Preservation: What Can Go Wrong Matthew R . Schmitz, MD – Moderator, John J . Christoforetti II, MD, Henry B, Ellis, Jr ., MD & Casey D . Taber, MD

1:00 p .m . -2:00 p .m .

Breakout Session: Latest Legal Issues for Orthopaedic Practices

Christopher B . Reed, JD (Weaver Johnston & Nelson, PLLC) Villa Room


Program Faculty

Saturday, February 8, 2020 – LEARNING FROM COMPLICATIONS SESSION – Navarro A

Joseph F. Alderete, MDSan Antonio, Texas

B. Christian Balldin, MDSan Antonio, Texas

David P. Brigati, MDFort Worth, Texas

Frank A. Buttacavoli, MDSan Antonio, Texas

Paul C. Chin, MD, PhDSpring, Texas

John J. Christoforetti II, MDAllen, Texas

Fred G. Corley, Jr, MDSan Antonio, Texas

Jesse C. DeLee, MDSan Antonio, Texas

Kyle F. Dickson, MDHouston, Texas

Thomas C. Dowd, MDFort Sam Houston, Texas

John S. Early, MDDallas, Texas

Henry B. Ellis, MDDallas, Texas

Uma E. Erard, DOSan Antonio, Texas

John C. Hagedorn II, MDGalveston, Texas

Robert U. Hartzler, MDSan Antonio, Texas

Scott E. Hecox, MDWaco, Texas

Bobby HillertAustin, Texas

John W. Hinchey, MDSan Antonio, Texas

Ken J. Kaminski, MDTyler, Texas

Ravi A. Karia, MDSan Antonio, Texas

Kevin L. Kirk, DOSan Antonio, Texas

Gerhard E. Maale III, MDPlano, Texas

Margaret M. Maley, BSN, MSHouston, Texas

Kenneth B. Mathis, MDHouston, Texas

Benjamin A. McArthur, MDAustin, Texas

Mike McCaslin, CPAIndianapolis, Indiana

Gregory A. Mencio, MDNashville, Tennessee

Bernard F. Morrey, MDSan Antonio, Texas

Clayton W. Nuelle, MDSan Antonio, Texas

Patrick M. Osborn, MDSan Antonio, Texas

Rajiv Rajani, MDSan Antonio, Texas

Christopher B. Reed, JDDallas, Texas

Hugo B. Sanchez, MD, PhDFort Worth, Texas

Matthew R. Schmitz, MDSan Antonio, Texas

Darren SmithDallas, Texas

Jeremy S. Somerson, MD Galveston, Texas

Eugene F. Stautberg, MD Pearland, Texas

Casey D. Taber, MD San Antonio, Texas

Alexander R. Vaccaro, MD, PhD Philadelphia, PA

Kevin E. Varner, MDHouston, Texas

Eric G. Verwiebe, MDSan Antonio, Texas

William M. Weiss, MDEl Paso, Texas

Time Event Speaker7:15 a .m . -8:00 a .m .

Registration, Breakfast and Exhibit Visitation

7:15 a .m . -7:55 a .m .


7:55 a .m . -8:00 a .m .

TOA Policy Update: Scope of Practice Bobby Hillert (Texas Orthopaedic Association)

8:00 a .m . -8:00 a .m .

Opening Remarks Vinod K . Panchbhavi, MD

8:00 a .m . - 8:45 a .m .

Innovations in My Field Jeremy S . Somerson, MD – Moderator, Frank A . Buttacavoli, MD, Scott E . Hecox, MD, John C . Hagedorn II, MD & Eugene F . Stautberg, MD

8:45 a .m . - 9:30 a .m .

Case Studies by Specialty: BreakoutsSee Page 10 for Details

THA/TKA, Trauma, Sports Medicine & Upper Extremity/Hand

9:30 a .m . - 10:00 a .m .

Break with Exhibitors

10:00 a .m . - 11:00 a .m .

Foot & Ankle: Cases That Didn’t Go as Expected Thomas C . Dowd, MD – Moderator, John S . Early, MD, Kevin L . Kirk, DO, Uma E . Erard, DO & Kevin E . Varner, MD

11:00 a .m . -12:00 p .m .

THA/TKA: Learning From Complications Benjamin A . McArthur, MD & David P . Brigati, MD – Co Moderators, Hugo B . Sanchez, MD, Kenneth B . Mathis, MD & Frank A . Buttacavoli, MD

12:00 p .m . -12:05 p .m .

TOA Policy Update: Medicare Bobby Hillert, Texas Orthopaedic Association

12:05 p .m . -12:45 p .m .

Lunch & TOA Business Meeting Adam J . Bruggeman, MD & Kenneth J . Kaminski, MD

12:45 p .m . -1:15 p .m .


1:15 p .m . -1:45 p .m .

Lessons Learned From a Lifetime of Service John W . Hinchey, MD – Moderator, Fred G . Corley, MD, Bernard F . Morrey, MD & Jesse C . DeLee, MD

1:45 p .m . -2:45 p .m .

18th Annual Resident Quiz Bowl Kyle F . Dickson, MD – Emcee

Conference Wi-FiThe wi-fi name is: Westin Meeting

The password is: toa2020 (lowercase)


Scientific Presentations: Five Minute Abstract Presentations

Friday February 7 - 7:15 – 7:55 a.m.

Presenter SubjectBreann Tisano, MD Early Outcomes of Osteochondral Allograft in the Skeletally Immature Knee

Gregory Sprowls, MD Incision Site Subcutaneous Fat Thickness and 90-day Complications for Direct Anterior and Posterior Approach Total Hip Arthroplasty

Jorge De Leon, MD Early Radiographic Outcomes for Mini-Fragment Fixation of Pilon Fractures

Jorge De Leon, MD Musculoskeletal Oncology: Analysis of Content and Comparison between MSTS Recognized and ACGME Accredited Fellowship Program Websites

Alexis Rounds, MD Osteoporosis and the Female Athlete

Bruno Gross, MD Femoral Tunnel Fixation for Medial Patellofemoral Ligament Reconstruction in the Growing Patient is Safe for Future Growth

Brett Brazier, DO Improved Outcomes in Patients With Positive Metal Sensitivity Following Revision Total Knee Arthroplasty

Friday February 7 - 12:45 - 1:00 p.m.

Presenter SubjectNikhil Shelke, MD New Surface Anatomical Landmarks can Guide Pedicle Screw Placement Using Cortical Bone Trajectory

Jaclyn Kapilow, MD Scoliosis Surgery in Beals Syndrome is More Challenging and Results in Higher Rates of Complications

Kendall Anigian, MD The Utility of Obtaining a CT Scan at 6 Months to Assess Fusion Mass and Impending Pseudoarthrosis Following a Posterior Vertebral Column Resection for Severe Spinal Deformity

Friday February 7 - 5:00 - 5:15 p.m.

Presenter SubjectMidhat Patel, MD Inferior Tilt of the Baseplate Decreases Impingement-Free Range of Motion in Reverse Shoulder Arthroplasty – A 3-D Digital

Motion Analysis

Charlie Wilson, MD Intraoperative Computer Navigation is Associated with Increased Glenoid Baseplate Screw Length and Use of Augmented Baseplates in Reverse Total Shoulder Arthroplasty

Jonathan Dawkins, MD Design and Retrospective Application of a Spine Trauma DVT Prophylaxis Protocol on Level 1 Trauma Center Patient Database

Saturday February 8 - 7:15 – 7:55 a.m.Presenter Subject

Holt Cutler, MD 30-day Readmission and Reoperation After Total Elbow Arthroplasty: A National Database Study

Holt Cutler, MD Increased Articular Exposure of the Lateral Elbow Joint with the Anconeus Approach Compared to the Kocher Approach: A Cadaver Study

Daniel Gelvez, MD Standardized Care Pathway for Total Knee Arthroplasty Improves Outcomes in Minority Patients

Taylor Bates, MD Deep Venous Thrombosis and Analysis of Prophylaxis for Orthopaedic Trauma Patients Admitted to Honduras’ Largest Public Health Care Center

Taylor Bates, MD Outcomes of Failed Lumbar Disk Arthroplasties

Aaron Gebrelul, MD Spinal Balance and Lumbar Curve Stability after Selective Thoracic Fusion in Idiopathic Scoliosis

Daniel Gelman, MD Septic Interphalangeal Joint Secondary to Retained Rattlesnake Fang

Saturday February 8 - 12:45 - 1:15 p.m. Presenter Subject

Wells Stewart, MD Utility of Advanced Imaging in Evaluation of Delirium After Arthroplasty

Lydia Kore, MD Oxidized Zirconium Total Knee Arthroplasty Implant Failure In a Patient With Knee Instability

Brian Page, MD Peri-Implant Subtrochanteric Fracture after Cannulated Screw Fixation of Femoral Neck Fractures: A Case Series and Biomechanical Analysis

Isabel Alvarez, BA Lack of In-Brace X-Rays in Compliant AIS Patients Wearing Full-Time TLSO Braces Associates with Failure

Farzam Farahani, BSA Analyzing the Postoperative Outcomes in Pediatric Orthopaedic Surgery Diabetic Patients


Coding & Billing CourseFebruary 7 | 9:00 a.m. – 4:00 p.m. | Zapata Room

Separate Registration Required

Presented by Margi Maley of Karen Zupko & Associates, the course will cover the latest billing and coding topics for orthopaedic surgeons and staff members .

A separate registration fee is required . A workbook will be provided to those who registered prior to the conference .

Friday’s Events

Strategic Planning SessionFebruary 7 | 9:00 a.m. – 12:00 p.m. | Villa Room

Free with General Registration | No CME Offered

Designed for practice administrators and physician lead-ers, the workshop will help you learn what to do before and after you created a great strategic plan . This will include creating a business frame to achieve alignment, learning how to create buy-in at all lev-els of the organization, and creating accountability for strategy execution .

Dinner at the Pearl Brewery’s Pearl StableFebruary 7 | Dinner: 6:30 p.m. to 8:30 p.m.

Drinks: 6:30 p.m. to 9:30 p.m.

Ticketed Event

Enjoy a catered dinner and drinks by Paloma Blanca in the Pearl Brewery’s Pearl Stable . If you purchased a ticket, it can be found on the back of your name badge .

303 Pearl PkwyAvenue A and Emma KoehlerSan Antonio, TX 78215

Stryker’s TEACH Mobile LabFebruary 7 | 12:00 p.m. – 9:00 p.m. | Pearl Brewery’s Parking LotBuses Leave from the WestinAll Attendees Are Invited | No CME Offered

Stryker’s 18-wheel mobile lab will be parked in the Pearl Brewery’s parking lot (east side of the complex) for attendees to use . Please see the syllabus insert for more details .

12:00 p.m. – 2:00 p.m. Open Lab3:00 p.m. – 5:30 p.m. Women Surgeons Network Orthopaedic Summit MAKO Mini Frag Biologics and Anchorage Extremity Plating

6:00 p.m. – 9:00 p.m. TEACH at Night Station 1 Mako Live Demos THA 6:00 p .m . TKA 8:00 p .m . Station 2 Mini Frag Station 3 Biologics and Anchorage Station 4 Extremity Plating Stations 5 & 6 Sports Medicine


Announcements/Meeting Rooms

CME ReportingComputers are available in Navarro B to register your attendance and to fill out the CME evaluation form . You may also fill out the form by using your personal device by visiting www .toa .org/2020 .

If you attended the 2019 meeting, please fill out the “changes in practice” CME form found in your packet and return it to TOA’s registration table .

Friday & Saturday LunchesFriday Lunch: The buffet line will open at 11:45 a .m . in Navarro B . Please take your lunch into Navarro A to listen to the lunch presentation . The presentation will begin at noon .

Saturday Lunch: The buffet line will open at 11:50 a .m . in Navarro B . Please take your lunch into Navarro A to participate in TOA’s business meeting, which will begin at 12:15 p .m .

WifiVisit TOA’s conference home page (www .toa .org/2020) to view the presentations, speaker biographies, and CME evaluation forms . The hotel’s free conference wifi will take you automatically to TOA’s conference page .

Photography NoticeBy attending TOA’s 2020 Annual Conference, attendees consent to be photographed, filmed, and/or otherwise recorded by TOA and its authorized representatives . Attendees agree that any or all of the material photographed and/or recorded may be used, in any form, as part of any future websites, publications, brochures, or other printed and/or digital materials used to promote TOA, and further that such use shall be without payment of fees, royalties, special credit, or other compensation .

Westin Riverwalk420 W Market St,

San Antonio, TX 78205

Phone: 210-224-6500

Fax: 210-444-6000

Strategic Planning Session/Sports Medicine Breakout

Coding Course/Upper Extremity/Hand

BreakoutGeneral Sessions

Exhibit Area/TOA Registration

Audience Response System• Many of this year’s presentations will include

audience responses to questions through your mobile phone .

• Once it’s time to participate, a speaker’s PowerPoint slide will provide instructions . The system will simply ask you to text a number, and then you will follow up with your answer (1, 2, 3, or 4) .

Friday Buses to the Pearl BreweryA bus will leave from both the Westin and the Pearl Brewery every 30 minutes on the hour and half hour from 2:30 p .m . to 9:30 p .m .

Look for the Elegant Limousine Bus in front of the Westin and parked near the Pearl Stable in the Pearl Brewery parking lot .

Limited parking is available at the Pearl Stable . At-tendees are also encouraged to use ride sharing .




Symposium Highlights

Friday, February 7

My Worst Complication: What I Learned From ItFriday, February 7 | 8:00 a .m . – 8:55 a .m .

Speaker Topic

Vinod K. Panchbhavi, MD Moderator Frank A. Buttacavoli, MD Operating on Other Physicians … What Could Go Wrong!Scott E. Hecox, MD Volar Plates for Everyone? William M. Weiss, MD When Everything That Can Go Wrong with a Knee Dislocation Does … and More Active Shooter: El Paso – When Lessons Are Dictated by the Circumstances

Breakout Session: Latest Legal Issues for Orthopaedic Practices – Villa RoomFriday, February 7 | 1:00 p .m . – 2:00 p .m .

Speaker Christopher B. Reed, JD (Weaver Johnston & Nelson, PLLC) Topics

• Navigating Texas’ New Out-of-Network billing and Patient Collection Law• Telemedicine and Telehealth• Insurance Audits for “Fee Forgiveness”Post-Operative Complications

Sports Medicine: What We Can Learn from ComplicationsFriday, February 7 | 10:30 a .m . – 11:30 a .m .

Speaker Topic

B. Christian Balldin, MD Moderator Paul C. Chin, MD, PhD Complications of Hip Arthroscopy Labral Repair/ ReconstructionPaul C. Chin, MD, PhD Complications of Biologics in OrthopedicsRobert U. Hartzler, MD Complications of Arthroscopic Superior Capsular ReconstructionClayton W. Nuelle, MD Complications of Arthroscopic All Inside ACL ReconstructionsHenry B. Ellis, MD Complications of Adolescent Patellofemoral Surgery

Complications in Trauma CasesFriday, February 7 | 9:00 a .m . – 10:00 a .m .

Speaker

Patrick M. Osborn, MD – Moderator Eric G. Verwiebe, MD Ravi A. Karia, MD John C. Hagedorn II, MD Topics

• Postoperative Infection• Failure of Fixation• Non-Malunions

Lunch Presentations: General Orthopaedic IssuesFriday, February 7 | 11:45 a .m . – 12:45 p .m .

Speaker Topic

Gerhard E. Maale, MD Biofilms: Diagnosis & Treatment Rajiv Rajani, MD Should Orthopaedic Oncologists Manage All Metastatic Disease?Kevin L. Kirk, DO Developing a Secondary Fracture Prevention Program

Hip Preservation: What Can Go WrongFriday, February 7 | 1 p .m . – 2 p .m .

Speakers

• Matthew R. Schmitz, MD – Moderator• John J. Christoforetti II, MD• Henry B, Ellis, MD• Casey D. Taber, MD

Topics

• Wrong Patient Selection• Technical Mistakes in the Surgery• Post-Operative Complications


Symposium Highlights

Innovations in My FieldSaturday, February 8 | 8:00 a.m. – 8:45 a.m.Speaker TopicJeremy S. Somerson, MD Moderator - What’s New in Shoulder and Elbow SurgeryFrank A. Buttacavoli, MD What’s New in Hip and Knee ArthroplastyScott E. Hecox, MD What’s New in Hand SurgeryJohn C. Hagedorn II, MD What’s New in Femoral Neck Fixation, Clavicle Fixation and Fenestrated ImplantsEugene F. Stautberg, MD What’s New in Foot and Ankle Surgery

Case Studies by Specialty: BreakoutsSaturday, February 8 | 8:45 a.m. – 9:30 a.m.Moderator TopicScott E. Hecox, MD Upper Extremity/Hand – (Zapata) Benjamin A. McArthur, MD Hips/Knees – (Navarro A) David P. Brigati, MD B. Christian Balldin, MD Sports Medicine – (Villa)John C. Hagedorn II, MD Trauma – (Navarro A) TOA in Austin

Orthopaedic surgeons around the nation often point to TOA as one of the most effective state orthopaedic societ-ies in the nation, and TOA’s work in the 2019 Texas Legisla-ture confirmed that notion . TOA was engaged in dozens of issues that affect orthopaedic surgeons and their patients .

Many of the new laws and pending issues from 2019 are in the process of being addressed in the state’s regulatory process . Many of the five-minute policy presentations during the conference will address the issues, and they include:

• Opioids: A look at four different opioid-related laws .

• Commercial Insurance: Prior authorization, utilization review, and surprise billing .

• Medicare: New bundled payment models .

• Physical Therapy: A new way to look at direct access .

• Podiatry: What is the foot?

• Workers’ Comp: Designated doctors, an important court case, and more .

• Health Care Costs: The Texas Legislature will examine health care costs and potential containment measures through a special select committee during 2020 .

Saturday, February 8

Foot & Ankle: Cases That Didn’t Go as ExpectedSaturday, February 8 | 10:00 a .m . – 11:00 a .m .Speakers

• Thomas C. Dowd, MD Moderator• John S. Early, MD • Kevin L. Kirk, DO • Uma E. Erard, DO• Kevin E. Varner, MD

Topics• 1MTP Joint Arthrodesis in the Setting of Failed Arthroplasty• Failed Total Ankle Arthoplasty• 5th Metatarsal Fracture Surgical Treatment• Failed Ankle Fracture Nonunion• Failed Ankle Fusion

THA/TKA: Learning From ComplicationsSaturday, February 8 | 11:00 a.m. – 12:00 a.m.Speaker TopicBenjamin A. McArthur, MD Co-Moderator - Hip Instability/DislocationDavid P. Brigati, MD Co-Moderator - Acute Prosthetic InfectionHugo B. Sanchez, MD Periprosthetic Proximal Femur FracturesKenneth B. Mathis, MD Nerve Injury After TKAFrank A. Buttacavoli, MD Extensor Mechanism Failure


A Busy Election Year in WashingtonElection years typically result in light policy workloads in Washington . However, both Congress and Washington are expected to address a number of key ERISA- and Medicare-related issues in 2020 through both the legisla-tive and regulatory arenas:

• Out-of-Network Payments: Congress pushed off its controversial proposal to tie all out-of-network pay-ments to the median in-network rate for ERISA plans until May 2020 .

• New CJR: Medicare is expected to expand its Com-prehensive Center for Joint Replacement (CJR) program in 2020 .

• PFS, HOPD & ASC Policy: Congress will release its annual policy update Medicare proposals for the Physician Fee Schedule, hospital outpatient depart-ments, and ambulatory surgery centers this summer, and orthopaedic surgeons are likely to experience changes .

Past TOA Resident Quiz Bowl Winners

2003 – Brooke Army Medical Center2004 – Brooke Army Medical Center2005 – University of Texas Medical Branch2006 – University of Texas Medical Branch2007 – Brooke Army Medical Center2008 – University of Texas San Antonio2009 – University of Texas Medical Branch2010 – University of Texas Medical Branch2011 – Scott & White2012 – William Beaumont Army Medical Center2013 – John Peter Smith2014 – University of Texas Medical Branch2015 – University of Texas Medical Branch2016 – William Beaumont Army Medical Center2017 – William Beaumont Army Medical Center2018 – William Beaumont Army Medical Center2019 – San Antonio Military Medical Center2020 – To be determined

18th Annual Resident Quiz Bowl1:45 p .m . – 2:45 p .m . Navarro AThe conference will wrap up with the 18th Annual Resident Quiz Bowl .

Kyle Dickson, MD will once again serve as the emcee .

TOA Recycles Name Badges/LanyardsPlease consider returning your name badge and lanyard to TOA’s registration desk before you leave . TOA will recycle them .


Dear Colleague:The Texas Orthopaedic Political Action Committee (TOPAC) is the only PAC that is dedicated to Texas orthopaedic sur-geons in the state’s political process for the Texas Legisla-ture and statewide offices. The state’s government actions affect every aspect of your medical practice, and TOPAC literally gives orthopaedic surgeons a seat at the table to educate candidates about how their actions affect muscu-loskeletal policy.Forty Texas orthopaedic surgeons have donated to TOPAC so far in 2019, and 27 donated $500 or more. Please help TOPAC finish the year in a strong way by donating to TOPAC today: Any amount is appreciated. Please keep in mind that TOPAC can only accept donations from indi-viduals or unincorporated partnerships.Online donations can be made at www.toapac.com or by sending a check to:Texas Orthopaedic PAC401 W. 15th | Suite 820Austin, Texas 78701TOPAC is a good steward of your donations. One hundred percent of your donation will go directly to candidates. TOPAC will not siphon off your donation to pay for consul-tants or other expenses. Texas’ primary election is just around the corner on March 3, and it is critical for TOPAC to engage with lawmakers prior to the election. A special “thank you” goes out to all of the orthopaedic surgeons who donated $500 or more to TOPAC in 2019.Thanks in advance for considering an important donation to TOPAC.

Thank you for your support,

Luis H. Urrea II, MD TOPAC Chair

Thank You to Our 2019 $500+ TOPAC Contributors!

James K. Baker, MD George W. Brindley, MDAdam J. Bruggeman, MD* Jeffrey E. Budoff, MDStephen De Young, MD Kyle F. Dickson, MD David W. Edelstein, MD John S. Early, MD Douglas R. Elenz, MD Stephen I. Esses, MD Hugh A. Frederick, MD Spencer J. Frink, MDGerard T. Gabel, MDJohn T. Gill, MD

John W. Hinchey, MD*Omer A. Ilahi, MDMichael G. Kaldis, MDAndrew P. Kant, MD* Richard F. McKay, MDScott T. Orth, MDVinod K. Panchbhavi, MDKarl E. Rathjen, MD*William E. Schreiber, MD*Eugene F. Stautberg, MDLuis H. Urrea II, MDJames C. Walter II, MDRobert E. Wolf, MD

Paid Political Advertising by the Texas Orthopaedic Political Action Committee.

*Denotes $1000 Contributors


Description: This meeting is designed to identify areas of recent research in orthopaedics and sports medicine relevant to physicians, surgeons, and allied health professionals . This information will be transmitted through scientific paper presentations, question and answer sessions, spotlights on surgical tech-niques, current concepts and symposiums .

Statement of Need: A need for this educational activity has been determined based on previous TOA course evaluations, AAOS CME curriculum and medical journals . TOA leadership and program committee members also identified pro-gram needs based on current orthopaedic topics and sports medicine issues .

Target Audience: The target audience will be orthopaedic surgeons, residents, fellows, and physicians with an interest in orthopaedic treatment . Athletic train-ers, coaches, and orthopaedic clinic administrators/technical staff may also be interested in the program .

Program: The Texas Orthopaedic Association attests that the person(s) respon-sible for the development of this educational activity did so independently and were not influenced by commercial support .

Educational Method: Lecture presentations, case studies, and hands-on work-shops .

ACCREDITATION STATEMENT: The Texas Orthopaedic Association is accredited by the Texas Medical Association to provide continuing medical education for physicians .

The Texas Orthopaedic Association designates this live activity for a maximum of 18 .25 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity .

Possible CME per AttendeeVisit the Center for the Intrepid

Friday General Session CMEFriday Coding Course CME

Saturday General Session CME

CME Ethics Hours:Friday Latest Legal Issues

Friday Changing Your Income Distribution Friday + Saturday Policy Updates

Commercial Insurance & Workers’ Comp (Friday)Scope of Practice (Friday)

Medicare (Saturday)

Possible CME Credit CombinationsTwo Day General Session Total

Intrepid + Two Gen Session TotalFriday General Session + Coding Course

2 .009 .256 .507 .00

1 .000 .75

0 .25

16 .2518 .25

9 .25

Global Learning Objectives

Upon completion of this meeting, learners should be able to:1 . Examine and apply basic scientific information and technical skills in ortho-

paedic surgery . 2 . Update knowledge regarding state-of-the-art advances in orthopaedic sur-

gical treatment . 3 . Evaluate the current evidence base for diagnosis and clinical management

of orthopaedic injuries, conditions, and disorders .4 . Review their current practice management expertise and develop a plan to

increase their expertise . 5 . Develop new clinical and technical skills to improve the everyday practice

of orthopaedic surgery .6 . Ethics Hour(s): Friday’s “Latest Legal issues for Orthopaedic Practices” (1 .00

hour), “Changing Your Income Distribution Plan: Does It Have to Be a Zero Sum Gain?” (0 .75 hour), “TOA Policy Update: Commercial Insurance & Work-ers’ Comp” and “TOA Policy Update: Scope of Practice” or Saturday’s “TOA Policy Update: Medicare” ( .25 hour) .

Disclosure Statement: TOA mandates all instructors, planners, spouses and oth-er individuals in a position to control or influence the content of an educational activity to disclose all relevant financial relationships or affiliations during the past 12 months with any commercial interest . All identified conflicts of interest must be resolved and the education content vetted by the TOA for fair balance, scientific objectivity and appropriateness . Any and all disclosures will be pro-vided in the Final Program, which will be distributed to all program participants .

Each program participant as well as their spouses in the Annual Meeting has been asked to disclose if he or she has received something of value from a commercial company or institution, which relates directly or indirectly to the subject of their presentation. Participants must disclose if research or in-stitutional support has been received; miscellaneous non-income support (e .g . equipment or services); royalties; stock or stock options; or consultant or employ-ee and disclosed nothing of value received . An indication of the participant’s disclosure appears after his or her name as does the commercial company or institution that provided the support . TOA does not view the existence of these disclosed interests or commitments as necessarily implying bias or decreasing the value of the author’s participation at the meeting .

FDA Statement: Some drugs or medical devices demonstrated at the Annual Meeting have not been cleared by the FDA or have been cleared by the FDA for specific purposes only . The FDA has stated that it is the responsibility of the physician to determine the FDA clearance status of each drug or medical devices he or she wished to use in clinical practice .

TOA policy provides that “off label” use of a drug or medical device may be de-scribed in the TOA’s CME activities so long as the “off label” use of the drug or medical device is also specifically disclosed (i .e . it must be disclosed that the FDA has not cleared the drug or device for the described purpose) . Any drug or medical device is being used “off label” if the described use is not set forth on the product’s approval label .

Disclaimer: The material presented at the Annual Meeting has been made avail-able by the Texas Orthopaedic Association for educational purposes only . This material is not intended to represent the only, nor necessarily best, method or procedure appropriate for the medical situations discussed, but rather is intend-ed to present an approach, view, statement or opinion of the faculty which may be helpful to others who face similar situations . TOA disclaims any and all liability for injury or other damages resulting to any individuals attending a session for all claims, which may arise out of the use of the techniques demonstrated therein by such individuals, whether these claims shall be asserted by a physician or any other person . No reproductions of any kind, including still photography, audio-tapes and videotapes, may be made of the presentation at the TOA Annual Meet-ing . The Association reserves all of its rights to such material, and commercial reproduction is specifically prohibited .

CME Credit, Disclaimer, Disclosure, Meeting Objectives


Program Faculty Relationship Disclosed

First Name Last Name Commercial Interest For What RoleJoseph Alderete Musculoskeletal Transplant Foundation Board or committee member; Research supportDavid Brigati American Joint Replacement Registry Author panel Editorial or governing boardFrank Buttacavoli KCI | Zimmer Paid consultant | Paid consultant

John Christoforetti II Arthrex, Inc | Arthroscopy | Breg | International Society for Hip ArthroscopyIP royalties; Paid consultant; Paid presenter or speaker; Research support | Editorial or governing board | IP royalties; Paid consultant; Paid presenter or speaker | Board or committee member

Jesse DeLee American Orthopaedic Society for Sports Medicine | Gap-flex | Saunders/Mosby-Elsevier

Board or committee member | Research support; Stock or stock Options | Publishing royalties, financial or material support

Kyle Dickson AAOS | AOS | Biomet | Stryker | EPIX | Foundation of Orthopaedic Trauma | Stryker | Texas Orthopaedic Society

Board or committee member | IP royalties; Paid presenter or speaker | Paid consultant | Paid presenter or speaker | Board or committee member; Stock or stock Options; Unpaid consultant | Board or committee member | Paid consultant | Board or committee member

Thomas DowdAAOS | American Orthopaedic Foot and Ankle Society | Journal of Bone and Joint Surgery – American | Medscape | Society of Military Orthopaedic Surgeons

Board or committee member | Board or committee member | Editorial or governing board | Editorial or governing board | Board or committee member

John Early

AAOS | American Orthopaedic Foot and Ankle Society | BESPA Global | BESPA USA | Biomet | CONMED Linvatec | Exactech, Inc | medhab | Medhab Inc | Nextremity medical | Orthofix, Inc. | Osteomed | Stryker | Texas Orthopedic Association | Zimmer

Board or committee member | Board or committee member | Stock or stock Options | Employee; IP royalties | IP royalties | Paid consultant | Paid consultant | Stock or stock Options | Unpaid consultant | Paid consultant | Paid consultant | IP royalties; Paid consultant | IP royalties; Paid consultant; Paid presenter or speaker | Board or committee member | Paid consultant

Henry Ellis AAOS | Pediatric Orthopaedic Society of North America | Pediatric Re-search in Sports Medicine Board or committee member | Board or committee member | Board or committee member

John Hagedorn Abbott: Employee | Current Orthopaedic Practice |Orthopaedic Trauma Association Stock or stock Options | Editorial or governing board | Board or committee member

Robert Hartzler Arthrex, Inc: Paid consultant | Arthroscopy Association of North America | Wolters Kluwer Health - Lippincott Williams & Wilkins

Paid presenter or speaker | Board or committee member | Publishing royalties, financial or material support

John Hinchey DJO Surgical | ROM 3 Rehab Honorarium | StockKenneth Kaminski Fusion5 Physician Advisor Consulting fee

Ravi Karia KCI | Smith & Nephew | Zimmer Paid consultant; Paid presenter or speaker | Paid presenter or speaker; Research support | Paid presenter or speaker

Kevin Kirk American Orthopaedic Foot and Ankle Society | DePuy, A Johnson & Johnson Company | Horizon Pharma Board or committee member | Paid consultant | Paid presenter or speaker

Gerhard Maale Biocomposites | Smith & Nephew IP royalties | IP royaltiesMargaret Maley Karen Zupko & Associates EmployeeKenneth Mathis Joint Development | Zimmer Paid consultant | IP royaltiesBenjamin McArthur DJ Orthopaedics | Journal of Arthroplasty Paid consultant | Editorial or governing board

Mike McCaslin Principal/Owner (5%) of Somerset CPAs and Advisors a CPA and Consulting Firm

This is my employer so i receive my salary/compensation from this company. I have been employed since 1981 and an owner since 1989

Gregory Mencio American Board of Orthopaedic Surgery, Inc. | Saunders/Mosby-Elsevier | Shriner's Hospitals Medical Advisory Board

Board or committee member | Editorial or governing board; Publishing royalties, financial or material support | Board or committee member

Bernard Morrey Saunders/Mosby-Elsevier | Stryker | tenex health | Wolters Kluwer Health - Lippincott Williams & Wilkins | Zimmer

Publishing royalties, financial or material support | Paid presenter or speaker | Employee; Stock or stock Options | Publishing royalties, financial or material support | IP royalties; Paid consultant; Paid presenter or speaker

Clayton Nuelle Arthroscopy | Arthroscopy Association of North America Editorial or governing board | Board or committee memberPatrick Osborn Perspectives in Medical Education | SAMMC Alumni Association Editorial or governing board | Board or committee memberRajiv Rajani AAOS | Musculoskeletal Tumor Society Board or committee member | Board or committee member

Matthew Schmitz

AAOS | American Academy of Pediatrics - Section on Orthopaedics | Elsevier | HitCheck | Journal of Bone and Joint Surgery - American | Pediatric Orthopaedic Society of North America | Pediatric Research in Sports Medicine | Society of Military Orthopaedic Surgeons

Board or committee member | Board or committee member | Publishing royalties, financial or material support | Stock or stock Options | Editorial or governing board | Board or committee member | Board or committee member | Board or committee member

Each program participant as well as their spouse in the Annual Meeting has been asked to disclose if he or she or his or her spouse has received something of value from a com-mercial company or institution, which relates directly or indirectly to the subject of their pre-sentation . Participants must disclose:

• research or institutional support has been received;

• miscellaneous non-income support (e .g . equipment or services);

• royalties; • stock or stock options; • consultant or employee;• and disclose if nothing of value received

An indication of the participant’s disclosure ap-pears after his or her name as does the com-mercial company or institution that provided the support . TOA does not view the existence of these disclosed interests or commitments as necessarily implying bias or decreasing the val-ue of the author’s participation at the meeting .

Financial Disclosures

ANNUAL CONFERENCE

AT&T Conference Center | Austin

The Only Conference That FocusesOn Orthopaedics in Texas

February 5-6, 2021

Officers 2019-2020

TOA Office

Board of Councilors, AAOS

AAOS Board of Councilors Elect

President:Adam J. Bruggeman, MD San Antonio, TX

First President-Elect:Kenneth J. Kaminski, MD Tyler, TX

Second President-Elect:Luis H. Urrea II, MD El Paso

Third President-Elect:John W. Hinchey, MD San Antonio, Texas

Immediate Past President:Andrew J. Palafox, MD El Paso, TX

Secretary-Treasurer:Christopher M. Danney, MD Austin, TX

Historian/Membership Chair:Maureen A. Finnegan, MD Dallas, TX

Executive DirectorBobby Hillert

Director of Operations Ed Berg

Kyle F. Dickson, MDJohn W. Hinchey, MDOmer A. Ilahi, MDKenneth J. Kaminski, MDAndrew J. Palafox, MD

Adam J. Bruggeman, MDHenry B. Ellis, MD

Thank You To Our 2020 Sponsors!

Title SponsorTexas Medical Liability Trust

Platinum SponsorStryker

Gold SponsorsAvanos MedicalCompulink Healthcare SolutionsContegrity Expert Group DePuy Synthes Episode Solutions Fusion5 Medinc of Texas, Inc . Modernizing MedicinePhysicians Realty TrustWright Medical Group

Silver SponsorsAlafair Biosciences, Inc .Atticus Medical Billing SolutionsAudXMDAugmedixCumberland Pharmaceuticals, Inc .DJODoctorConnect .netFlexion TherapeuticsFUJIFILM SonoSite, Inc .FX Shoulder USAGAP-FLEXIlluminOss Medical, Inc .

Konica Minolta HealthcareMedcillaryMTBC, Inc .OsteoCentric TechnologiesQuatris HealthcoRobin HealthcareSharecare, Inc .SYNERGEN Health LLC TDI/DWC The DaVinci Orthopedic PillowVerata HealthVericel Corporataion

Texas Orthopaedic Association401 West 15th Street, Suite 820

Austin, Texas 78701

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