the only conference that focuses on orthopaedics in texasa cadaver workshop and subspecialty...

The Only Conference That Focuses on

Orthopaedics in Texas

Texas Orthopaedic Association’s

ANNUAL CONFERENCE

2019 SYLLABUS

2 Texas Orthopaedic Association

present:

TOA’s Annual ConferenceFebruary 1-2, 2019

Four Seasons Houston

Table of ContentsPresident’s Message . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

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

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

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

Floor Plans of Meeting Rooms . . . . . . . . . . . . . . . . . . . . . . . . . . 8

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

Public Policy Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

CME Credit, Disclaimer, Disclosure, Meeting Objectives . 13

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

2018-2019 OfficersPresident . . . . . . . . . . . . . . . . Andrew J . Palafox, MD

El Paso, TX

First President-Elect . . . . . . Adam J . Bruggeman, MD San Antonio, TX

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

Immediate Past President David E . Haynes, MD Waco, 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

Andrew J . Palafox – TOA President

B . Christian, Balldin, MD – TSSM President

Adam J . Bruggeman, MD – TOA First 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 .

2019 Annual Meeting Syllabus 3

President’s Message Greetings:

When participating in AAOS meetings, I often hear from orthopaedic surgeons from other states who cite TOA as the “model state organization .” They are amazed by TOA’s numerous advocacy victories and high level of member engagement .

TOA’s success is a direct result of the volunteer effort put forth by the dozens of orthopaedic surgeons and practice administrators who put together these conferences and spearhead TOA’s public policy efforts .

A special “thank you” goes out to Vinod Panchbhavi, MD for the countless hours that he dedicated to leading this conference . In addition, thank you to the dozens of speakers who you will see over the next two days who spent many hours to prepare for their presentations . I wish that I could personally thank each one of them in this letter .

Unfortunately, it is impossible to list every orthopaedic surgeon and practice administrator whose behind-the-scenes efforts make TOA an effective voice for Texas orthopaedic surgeons and their patients . We created the TOA Leadership Council last year to serve as a sounding board for orthopaedic surgeons and practice administrators to provide their input . In addition to serving as a sounding board for our profession, the Council serves as a leadership track to develop TOA’s future leaders . I am pleased to note that many of our younger orthopaedic surgeons have expressed an interest in TOA leadership .

While many medical societies are struggling to determine what their futures hold, TOA is actually growing stronger every year . As the only organization that dedicates 100 percent of its efforts to the public policy issues for Texas orthopaedic surgeons, TOA plays a unique role in our profession .

Sincerely,

Andrew J . Palafox, MDTexas Orthopaedic Association President, 2018-2019

Program Chair’s MessageDear TOA Member:

As the Program Chair, I am de-lighted to welcome you to this 2019 TOA conference . You will love the venue, which is dubbed “Houston’s Living Room .” Houston has something to of-fer for everyone – from museums and theaters to cui-sines that can tickle every palate . This conference’s pro-gram similarly has something to offer everyone . It has been created to address the needs that are inclusive of all orthopaedic surgeons and their staff members . The program has a variety of formats, including lively de-bates on hot topics, fire-side chats, case presentations, a cadaver workshop and subspecialty symposiums .

I am grateful to Omer Ilahi, MD for putting forth my name for this task . It is an honor to serve as Program Chair . I am also grateful to Andrew J Palafox, MD – TOA’s President – Adam J . Bruggeman, MD – TOA’s President-Elect – and the TOA leadership for this opportunity . This could not have been possible without the tremendous support and guidance from the Bobby Hillert – TOA’s Executive Director – and from many of my mentors and colleagues . There has been a lot of thought and plan-ning put into the different formats that would have a broad appeal, and I am grateful to the session modera-tors and faculty for all of their efforts . I am hoping for these sessions to be interactive and looking forward to your active participation . I have no doubt you will not only contribute during the discussions, but also take back something valuable .

Wishing you all a very interactive, stimulating and productive conference .

Sincerely,

Vinod K . Panchbhavi, MDTOA Program Chair


TEXAS ORTHOPAEDIC ASSOCIATION'S 2019 ANNUAL CONFERENCE MEETING SCHEDULE

Friday, February 1, 2019 – CLINICAL GENERAL SESSION – Ballroom A & B

Friday, February 1, 2019 – BUSINESS GENERAL SESSION – Ballroom A & B

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

Registration, Breakfast and Exhibit Visitation Ballroom Foyer

7:30 a .m . -8:00 a .m .

Paper Presentations See Page 6 for Presentations

8:00 a .m . -8:15 a .m .

Welcome & Announcements Program Chair Vinod K . Panchbhavi, MD & Andrew J . Palafox, MD

8:15 a .m . - 9:15 a .m .

Spine: Which Comes First, the Total Hip Replacement or the Spine Fusion? A Discussion of Current Advances and Controversies Surrounding Spinopelvic Alignment and its Potential Relationship to THA .

Christopher D . Chaput, MD - ModeratorMark D . Rahm, MDMarc M . DeHart, MD

9:15 a .m . - 10:15 a .m .

Hip & Knee Symposium Michael W . Britt, MD; Terry A . Clyburn, MD; Melvyn A . Harrington, MD; Stephen J . Incavo, MD & Kenneth B . Mathis, MD

10:15 a .m . - 10:45 a .m .

Break & Exhibitor Visits

10:45 a .m . - 11:45 a .m .

Sports Medicine Symposium B . Christian Balldin, MD - Moderator; Omer A . Ilahi, MD;Clayton W . Nuelle, MD; Paul C . Chin, MD, PhD; Michael C . Greaser, MD & Kevin L . Kirk, DO

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

Lunch Presentation: What Physicians Need to Know About the Tax Cuts and Jobs Act (TCJA)

Tim Gilliam, CPA

Time Event Speaker12:45 p .m . -1:00 p .m .


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

Trauma Symposium Animesh Agarwal, MD - Moderator; James A . Blair, MD; Drew T . Sanders, MD; David C . Teague, MD & Boris A . Zelle, MD

2:00 p .m . -2:30 p .m .

Health Care in 2025: What About Value-Based Payments

Karl M . Koenig, MD

2:30 p .m . -3:00 p .m .


3:00 p .m . -4:30 p .m .

Business & Public Policy Symposium* Adam J . Bruggeman, MD - ModeratorSee Page 9 for Details

4:30 p .m . -5:00 p .m .

Orthopaedic Compensation Models & Benchmarking*

Adam J . Bruggeman, MD - Moderator; Kenneth J . Kaminski, MD & Anthony Brooks

4:50 p .m . -5:00 p .m .

TOA Business Meeting Andrew J . Palafox, MD - TOA President

5:00 p .m . -6:00 p .m .

Cadaver Lab Fairfield(See Page 8 for Details)

5:00 p .m . -7:00 p .m .

Texas Whiskey Tasting Reception Exhibit Foyer (See Page 7 for Details)

1:00 p .m . -10:00 p .m .

Topgolf Swing Suites Hotel Lobby (See Page 7 for Details)


Program Faculty

SaturdayRonald W. Lindsey, MDGalveston, TexasMark A. Foreman, MD Galveston, TexasScott Hecox, MD Waco, TexasT. Bradley Edwards, MD Houston, TexasMichael C. Cusick, MD Humble, TexasNicholas D. Iagulli, MDHurst, TexasMarc R. Labbe, MDHouston, TexasBrent J. Morris, MDHouston, TexasAnup A. Shah, MDHouston, TexasJeremy S. Somerson, MDGalveston, Texas

Thomas J. Oliverson, MDState RepresentativeVinod K. Panchbhavi, MDGalveston, TexasCory F. Janney, MDSan Diego, CAKevin L. Kirk, DOSan Antonio, TexasJohn S. Early, MDDallas, TexasJ. Speight Grimes, MDLubbock, TexasAndrew M. Ebert, MDAustin, TexasKyle F. Dickson, MDHouston, Texas

Time Event Speaker7:30 a .m . -8:15 a .m .

Registration, Breakfast and Exhibit Visitation

7:30 a .m . -8:00 a .m .


8:00 a .m . -8:15 a .m .

The Case for Case Studies Ronald W . Lindsey, MD

8:15 a .m . - 9:15 a .m .

Lessons Learned from My Field: Hot Topics from Different Specialties

See Page 10 for Details

9:15 a .m . - 10:15 a .m .

Management of Rotator Cuff Tears: Advances and Controversies

T . Bradley Edwards, MD - Moderator; Michael C . Cusick, MD; Nicholas D . Iagulli, MD; Marc R . Labbe, MD; Brent J . Morris, MD; Anup A . Shah, MD & Jeremy S . Somerson, MD

10:15 a .m . - 10:45 a .m .


10:45 a .m . - 11:30 a .m .

Case Studies with the Experts See Page 10 for Details

11:30 a .m . -12:30 p .m .

The Future of Health Care in America**denotes ethics

State Rep . Thomas J . Oliverson, MD

12:30 p .m . -1:15 p .m .

Foot & Ankle Symposium Vinod K . Panchbhavi, MD - Moderator; Cory F . Janney, MD; Kevin L . Kirk, DO; John S . Early, MD; J . Speight Grimes, MD & Andrew M . Ebert, MD

1:15 p .m . -1:50 p .m .


1:50 p .m . -2:45 p .m .

Resident Quiz Bowl Kyle F . Dickson, MD - Emcee

2:45 p .m . Meeting Adjourned

Saturday, February 2, 2019 – CLINICAL GENERAL SESSION – Ballroom A & B

FridayChristopher D. Chaput, MDSan Antonio, TexasMark D. Rahm, MDTemple, TexasMarc M. DeHart, MDSan Antonio, TexasMichael W. Britt, MDGalveston, TexasTerry A. Clyburn, MDHouston, Texas Melvyn A. Harrington, MDHouston, TexasStephen J. Incavo, MDHouston, Texas Kenneth B. Mathis, MDHouston, TexasB. Christian Balldin, MDSan Antonio, TexasOmer A. Ilahi, MDHouston, TexasClayton W. Nuelle, MDSan Antonio, TexasPaul C. Chin, MD, PhDSpring, Texas

Michael C. Greaser, MDSugar Land, TexasJennifer KinmanAustin, TexasKevin L. Kirk, DOSan Antonio, TexasTim Gilliam, CPAGilliam & Associates, P.C.Midhat Patel, MDGalveston, TexasScott D. McKay, MDHouston, TexasSteven B. Singleton, MDFort Wort, TexasAnimesh Agarwal, MDSan Antonio, TexasJames A. Blair, MDTempe, ArizonaDrew T. Sanders, MDDallas, TexasDavid C. Teague, MDOklahoma City, OklahomaBoris A. Zelle, MDSan Antonio, Texas

Karl M. Koenig, MDAustin, TexasAdam J. Bruggeman, MDSan Antonio, TexasMichael BerkowitzHouston, TexasJoseph MathewsAdvanced Orthopaedics & Sports MedicineJosh WeaverWeaver Johnston & Nelson, PLLCAshley JohnstonWeaver Johnston & Nelson, PLLCKenneth J. Kaminski, MDTyler, TexasAnthony BrooksAzalea OrthopedicsAndrew J. Palafox, MDEl Paso, Texas


Scientific Presentations: Five Minute Abstract Presentations

Friday February 1 - 7:30 – 8:00 a.m.

Presenter SubjectRose Ann Huynh Effect of Clubfoot Casting on Breastfeeding Practices

Junho Ahn Comparison of Patient Factors and Post-Operative Outcomes in Diabetic and Non-Diabetic Patients with Pilon Fractures

Kathryn Gallaway Thirty-day Readmission, Reoperation, and Mortality in Surgical Management of Metastatic Bone Disease of the Extremities

J . Riley Martinez The Association of Hip Osteoarthritis and Sleep Quality

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

Presenter SubjectMidhat Patel, MD Subscapularis Repair In Reverse Total Shoulder Replacement Using Subscapularis Peel And A Novel Through-Implant Suture

Technique: Early Clinical Outcomes

Scott D . McKay, MD Single-Center Review of Combined Intraoperative Approach for Treatment of Intra-Articular Knee Venous Malformations

Steve B . Singleton, MD Patient Factor Influence on the Composition of Platelet-Rich Plasma and Bone Marrow Concentrate Preparations for Non-Surgi-cal Treatment of Orthopedic Conditions

Saturday February 2 - 7:30 – 8:00 a.m.Presenter Subject

Nathan Boes, MD Can Combined Trans-Physeal and Lateral Extra-Articular Pediatric ACL Reconstruction Techniques Be Employed to Reduce ACL Re-Injury While Allowing for Growth?

Brandon Stein, MD Distribution of High-Volume Ankle Replacement Surgeons in United States Metropolitan Areas: Data from the Medicare Provider Utilization and Payment Release from 2012-15

Chideraa Ikenna Nwafor Effect of Regional Anesthesia on Hospital Length of Stay After Ankle Fracture Fixation in Patients with and Without Diabetes Mellitus

David Neal, MD Bilateral Distal Femur Replacement for Traumatic Distal Femur Fractures

Kshitij Manchanda, MD Effectiveness of Hydrogen Peroxide on the Treatment and Eradication of Cutibacterium (Propionibacterium) Acnes Biofilm

Brandon Hull, MD Inappropriate Pediatric Orthopaedic Emergency Department Transfers: A Burden on the Healthcare System

Saturday February 2 - 1:15 - 1:45 p.m. Presenter Subject

Nisha Reddy Sleep Disturbance in Patients with Femoroacetabular Impingement and Acetabular Dysplasia

Taylor Johnson Impact of Insurance Status on Timing to Evaluation and Treatment of Meniscus Tears in Children, Adolescents, and College Aged Athletes .

Adnan Zubair, MD Quadruple vs . Double FIMNs for Distal Tibial Fractures

Garen Collett, MD Novel Fixation Technique for a Bernese Periacetabular Osteotomy for Immediate Weight Bearing: A Biomechanical Study

Mohammed Abdullah Elucidating Concerns of Patients with Anterior Cruciate Ligament Injuries: What Are Patients Discussing Online in the Reddit Community?

Shawn Okpara Effect of Regional Anesthesia on Hospital Length of Stay After Ankle Fracture Fixation in Patients with and Without Diabetes Mellitus

Jennifer Liu Comparison of Complication Rates Following Ankle Fracture Surgery in Patients with and Without Diabetes


Topgolf Swing Suites9:00 a .m . to 10:00 p .m . | Hotel Lobby

Regardless of your golfing ability, all attendees will enjoy the Topgolf Swing Suites in the hotel’s lobby on Friday . TOA has reserved the Suites for all day and evening on Friday for TOA’s attendees .

Simply drop by at any time to play . Light food and drinks will be served throughout the afternoon and evening . The drink tickets can be found in your badge .

Networking Events

Friday Networking:

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 – To be determined

17th Annual Resident Quiz Bowl1:50 p .m . – 2:45 p .m . Ballroom A & BThe conference will wrap up with the 17th Annual Resident Quiz Bowl . Kyle Dickson, MD will once again serve as the emcee .

Texas Whiskey Tasting Reception5:00 p .m . to 7:00 p .m . | Exhibit Foyer

Join the Four Seasons’ mixologists for the Texas Whiskey Tasting at the end of the day on Friday . Your drink tickets can be found in your name badge .

For attendees who don’t like whiskey, other drinks and light food will be available .


Announcements/Meeting Rooms

CME ReportingComputers are available in the foyer to register your attendance and fill out the CME evaluation form . You may also fill out the form by using your personal device . The link can be found on TOA’s conference page: www .toa .org/2019

Friday & Saturday LunchesDon’t miss TOA’s lunch presentations on Friday and Saturday . The buffet lines will be set up in the Austin room . Bring your lunch back into the Ballroom to listen to the lunch presentations .

WifiVisit TOA’s conference home page - www .toa .org/2019 - to view the presentations, speaker biographies, and CME evaluation forms . Free wifi is provided .

Photography NoticeBy attending TOA’s 2019 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 .

2ND FLOOR

3RD FLOOR

Four Seasons HotelHouston

1300 LAMAR STREET, HOUSTON

+1 (713) 650-1300

Strategic Planning Session

Coding Course

General Sessions

Cadaver LabExhibit

Area

Cadaver LabPreservation to Replacement: Stryker’s Full Patient Treatment Offering5:00p .m .- 6:00p .m . | Friday

Fairfield Room (Adjacent to the Texas Whiskey Tasting in the Exhibit Foyer)

• Join Stryker at 5:00pm for two education experiences: a hands-on demonstration of Mako for total knee arthroplasty and a cadaveric knee arthroscopy lab with Henry Ellis, MD

• At 5:45pm, hear a short 10-minute presentation from Stryker Performance Solutions on how robotic assisted TKA results in an overall lower 90-day episode of care cost and how that relates to your practice in the context of recently proposed bundled payments for hip and knee procedures .


Symposium Breakout Highlights

Sports MedicineFriday, February 1 | 10:45 a .m . – 11:45 a .m .

Speaker Topic

B. Christian Balldin, MD Moderator Omer A. Ilahi, MD MPFL Repair Versus ReconstructionClayton W. Nuelle, MD Endoscopic Proximal Hamstring RepairPaul C. Chin, MD, PhD Open Proximal Hamstring RepairMichael C. Greaser, MD Percutaneous Achilles RepairKevin L. Kirk, DO Open Achilles RepairClayton W. Nuelle, MD All Inside ACL Reconstruction with Suspensory FixationPaul C. Chin, MD, PhD Traditional ACL Reconstruction with Complete Tibial Tunnel

Trauma SymposiumFriday, February 1 | 1:00 p .m . – 2:00 a .m .

Speaker Topic

Animesh Agarwal, MD Moderator James A. Blair, MD Hip Fractures – Use of the Short Cephalomedullary NailDrew T. Sanders, MD Hip Fractures – Use of the Long Cephalomedullary NailBoris A. Zelle, MD Femoral Neck Fractures – Management UpdateDavid C. Teague, MD The Orthopaedic Trauma Association Ipsilateral Femoral Neck and Shaft Fracture

Business & Public PolicyFriday, February 1 | 3:00 p .m . – 4:30 p .m . Adam J . Bruggeman, MD - Moderator

TelemedicineAshley Johnston and Joshua Weaver

• What is it?• How do I do it?• How is it reimbursed?• Hardware and Software Issues.

AncillariesMichael Berkowitz, Ashley Johnston, Joseph Mathews, Joshua Weaver and Jennifer Kinman

• DME.• Imaging.• Physical Therapy.• Ancillaries and Congress.• Ancillary boundaries.• Best practices in orthopaedic practices.

Orthopaedic “Super Groups”John S. Early, MD, Ashley Johnston, Ken J. Kaminski, MD and Joshua Weaver

• “Super groups.”• Private equity in orthopaedics.

Out-of-NetworkMichael Berkowitz and Joseph Mathews

• Where Are We?• Where Is It Going?

Hip & KneeFriday, February 1 | 9:15 a.m. – 10:15 a.m.

Speaker

Stephen J. Incavo, MD Abductor Muscle Tears of the Hip

Other Topics

Patient Optimization, The “Super Path” THA, Cementless Knees, TKA Without Tourniquet, Robotic Instrumentation & Custom Blocks and Navigated KneesOther Speakers:

Michael W. Britt, MD, Terry A. Clyburn, MD, Melvyn A. Harrington, MD, & Kenneth B. Mathis, MD

Orthopaedic Compensation Models & BenchmarkingFriday, February 1 | 4:30 p.m. – 5:00 p.m.

Topics

• Orthopaedic Revenue: Surgery vs. Clinic• PAs & NPs: Financial Considerations• Ancillaries• Physician Employment: Medicare’s Site Neutral Payment Policies• Options for Bringing in New Surgeons• Pros and Cons of Hospital Contracts


Symposium Breakout Highlights

Case Studies with the ExpertsSaturday, February 2 | 10:45 a.m. – 11:30 a.m.

Topics

TraumaSports MedicineUpper Extremity and HandHip and KneesSee program insert and screens in the General Ballroom for locations.

Foot & AnkleSaturday, February 2 | 12:30 p.m. – 1:15 p.m.

Speaker Topic

Vinod K. Panchbhavi, MD Moderator Cory F. Janney, MD Foot and Ankle Injuries in the MilitaryKevin L. Kirk, DO Fixing Lisfranc Injuries Is the Way to GoJohn S. Early, MD Fusing Lisfranc Injuries Is the Way to GoJ. Speight Grimes, MD Deltoid Ligament Doesn’t Require Repair When Fixing Ankle FracturesAndrew M. Ebert, MD Deltoid Ligament Rupture Needs Fixing in Ankle Fractures

Lessons Learned from My Field: Hot Topics from Different SpecialtiesSaturday, February 2 | 8:15 a.m. – 9:15a.m.

Speaker Topic

Vinod K. Panchbhavi, MD ModeratorChristopher D. Chaput, MD Lessons Learned from Clinical Use of BMP-2: The Good, the Bad & the UglyMark A. Foreman, MD Lessons Learned from Fixing Extra-Capsular Hip FracturesMichael C. Greaser, MD Lateral Ankle Ligament Reconstruction: The Role of the Internal BraceScott E. Hecox, MD Lessons Learned from Hand and Wrist

Management of Rotator Cuff Tears: Advances and ControversiesSaturday, February 2 | 9:15 a.m. – 10:15 a.m.

Speaker Topic

T. Bradley Edwards, MD Moderator Michael C. Cusick, MD Reverse Shoulder Arthroplasty for Rotator Cuff TearsNicholas D. Iagulli, MD Superior Capsular ReconstructionMarc R. Labbe, MD Augmented Rotator Cuff RepairBrent J. Morris, MD Infection and Rotator Cuff Insufficiency After Rotator Cuff Repair - So What Now?Anup A. Shah, MD Biceps Pathology with Cuff TearsJeremy S. Somerson, MD Rotator Cuff Tear in the Elderly - When to Repair?

Coding CourseOrthopaedic Coding and Reimbursement - It’s Not Your First Rodeo!

Friday, February 1 | 9:00 a .m . – 4:00 p .m .

HighlandMargi Maley of Karen Zupko and Associ-ates will present the course, which features a separate registration fee . The workbook is included with your registration fee .

How to Create Strategy in Three HoursFriday, February 1 | 9:00 a .m . – 12:00 p .m .

WhitneyThis seminar is included with your registration . However, due to space limitations, registration prior to the event is required .

This breakout session is designed for practice administrators and orthopaedic surgeons who lead their practices . The workshop will teach you:

• How to use “quick start” to set pace and create momentum .• How to make complex goals simple .• How to increase accountability for follow-through by 100 .

At the conclusion of the workshop, participants will be pro-vided tools to lead their own strategic planning sessions for their orthopaedic practices .

Breakout Sessions


Austin, TexasThe 86th Texas Legislature features a number of un-knowns: a new Speaker of the House, new committee chairs in the House, and a new Senate Health Committee chair . Once the Legislature concludes on Memorial Day, it will have considered hun-dreds of health-related bills .

OpioidsThe state’s mandate for physicians to check the prescrip-tion monitoring program (PMP) database before prescrib-ing certain drugs will go into effect on September 1, 2019 . TOA is encouraging its members to ensure that their EHRs connect to the PMP through Appriss .

TOA is working with lawmakers on the mandate on potential amendments . You will be asked to engage your lawmakers .

Commercial InsuranceOnce again, out-of-network insurance will be in the spot-light . There will be a push to ban balance billing at both the state and federal level .

In addition, lawmakers will take a look at network issues, such as prior authorization .

Scope of PracticeAs always, the Legislature will be dominated by scope of practice debates . For example, physical therapists are making another push for 30 days of direct access without an appropriate referral . In addition, after an unsuccess-ful lawsuit, chiropractors will pursue legislation to define their scope of practice .

Workers’ CompensationThe Texas Sunset Commission is scheduled to examine the future of the state’s Workers’ Compensation program following this Legislature, and that will create the oppor-tunity to make changes to every aspect of the program .

Stay EngagedThis is a small sample of the issues that TOA will follow in the Texas Legislature . TOA worked on several dozen issues in 2017, including these issues and scoliosis, patient-re-ported outcomes, team physicians, and more . Watch your e-mail for updates .

Washington, DCWith Democrats now in control of the U .S . House, bills will have a harder time going to the president for consider-ation . However, we are still expecting the Trump admin-istration to roll out major initiatives through Medicare’s regulatory process .

Will Mandatory Bundles Return?HHS Secretary Alex Azar hinted that Medicare may restore mandatory bundles for musculoskeletal care .

Physician Ownership of Ancillary ServicesA past Democrat-controlled Congress made a push to ban the Stark in-office ancillary exemption . Will the new Congress make a similar effort?

A Deeper Look at Balance BillingThe federal government regulates ERISA plans, which represent the majority of the insurance sold in Texas . Con-gress has expressed an interest in taking a deeper look at balance bills associated with out-of-network care .

Continued Success for ASCs?2018 was a banner year for ASCs and Medicare policy . Medicare finally granted the same annual payment update to both ASCs and HOPDs . HHS unveiled a price transparency tool for consumers that highlights ASC and HOPD prices . Medicare has hinted that it will continue to recognize ASCs .

More Looks at Physician Employment?Both Republicans and Democrats in Congress and Medi-care have favored site neutral payment policies that affect physician employment . Will Medicare continue to add new site neutral payment proposals in 2019?

This Summer’s Medicare ProposalsMedicare releases its payment proposals for the Physician Fee Schedule, ASC, and HOPD payment policies every summer . The 2017 proposal featured a heated debate over THA and TKA in Medicare ASCs . We may witness a return to that debate this summer .


James K . Baker, MDGeorge W . Brindley, MDAdam J. Bruggeman, MD*Jeffrey E Budoff, MDCraig C . Callewart, MDJose R . Carreras, MDCharles E . Cook, MDFred G. Corley, MD*Kevin Crawford, MD*Stephen De Young, MDKyle F . Dickson, MDStephen C . Drukker, MDJohn P. Duggan, MD*

John S . Early, MDDouglas R . Elenz, MDHenry B . Ellis, MDStephen I . Esses, MDJohn A . Evans, MDDaniel E . Fuentes, DOGerard T . Gabel, MDJohn T . Gill, MDAdam I . Harris, MDDavid E . Haynes, MDKeith J . Hill, MDJohn W. Hinchey, MD*Omer A . Ilahi, MD

Robert L . Jones, MDMichael G . Kaldis, MDAndrew P. Kant, MD*Larry M . Kjeldgaard, MDLawrence L . Lenderman, MDDavid R . Lionberger, MDDavid J . Mansfield, MDKenneth B . Mathis, MDRichard F . McKay, MDR. Mills Roberts, MD*Scott T . Orth, MDK. Kip Owen, MD*Andrew J . Palafox, MD

Scott O . Paschal, MDTodd M . Raabe, MDJohn A . Ribeiro, MDJose E . Rodriguez, MDWilliam E. Schreiber, MD*Nicholas P . Souder, MDLorence W . Trick, MDLuis H . Urrea, MDRobert E . Urrea, MDJames C . Walter, MDRobert E . Wolf, MD

Dear Colleague:

TOPAC serves as the voice of Texas orthopaedic surgeons in the state’s political process . It gives orthopaedic surgeons a seat at the table at the state Capitol . This allows us to speak with candidates and elected officials to educate them about the musculoskeletal issues that affect our patients and profession . Many of our colleagues at this conference have hand delivered TOPAC checks to candidates and started important relationships with lawmakers .

TOPAC continues to make great strides . Thanks to your support, TOPAC donated almost $60,000 to candidates in the 2017-18 political cycle . I am pleased to report that 100 percent of your donations went directly to candidates who demonstrated an interest in learning more about musculoskeletal issues .

TOPAC is your Political Action Committee. We donated all funds to our candidates to ensure that our voice was heard in November’s election . As a result, this conference is a great time to begin building TOPAC’s treasury and preparing for the March 2020 primary election, which is only 12 months away .

Please donate today. Simply fill out the TOPAC donation form and return it to the registration table . Or visit www .toapac .com to make an online contribution .

A special “thank you” goes out to all of the orthopaedic surgeons listed below who donated $500 or more to TOPAC in 2018 .

Thank you for your support .

Paid Political Advertising by the Texas Orthopaedic Political Action Committee.

Thank You to our 2018 $500+ TOPAC Contributors!

*Denotes $1000 Contributors

“If you’re not at the table, you’re on the menu.”

Sincerely,

Luis H . Urrea II, MD

Chair, TOPAC


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 14 .25 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity .

Attendees can possibly receive a total of 14 .25 AMA PRA Category 1 Credits™ if attending the Coding Course and all meeting events both before and after the Coding Course on Friday in addition to attending all day Saturday which includes 3 .0 hours which will count as Ethics (see #6 under Global Learning Objectives) . The Coding Course on Friday offers 6 .50 AMA PRA Category 1 Credits™, Friday’s General Session offers 6 .75 (14 .25 if attending all plus Coding Course) AMA PRA Category 1 Credits™, Saturday’s General Session offers 6 .75 AMA PRA Category 1 Credits™ .

Possible CME per AttendeeFriday General Session CME

Friday Coding Course CMESaturday General Session CME

Possible CME Credit CombinationsTwo Day General Session Total

Fri Coding Course + Fri Gen Session

7 .506 .506 .75

14 .257 .5

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): Business & Public Policy Symposium (1 .5 hours), Ortho-

paedic Compensation Models & Benchmarking ( .5 hours) & The Future of Health Care in America (1 hour) = total 3 .0 Ethics

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 Planner Disclosures

Name Commercial Interest

Vinod Pachbnavi

AAOS | American Orthopedic Foot and Ankle Society| Foot and Ankle International Techniques in Foot & Ankle SurgeryOrthopedia.com | Stryker | Wolters Kluwer Health - Lippincott Williams & Wilkins

Board or committee member | Board or committee member | Editorial or governing board | Paid presenter or speaker | Editor – Techniques in Foot & Ankle Surgery

B. Christian BalldinAmerican Orthopaedic Society for Sports Medicine | Smith & Nephew | Texas Society for Sports Medicine

Board or committee member | Paid consultant | Board or committee member

Adam Bruggeman Exactech, Inc | Texas Medical Association | Texas Orthopaedic Association | Titan Spine

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

Andrew PalafoxAAOS Board of Councilors | Del Sol Medical Center | Texas Orthopedic Association

Board or committee member | Chief of Staff (elect) Board or committee member | Board or committee member

Quiz Bowl Participant Disclosures

Name Commercial Interest

Andrew Murtha AAOS | Society of Military Orthopaedic Surgeons

Board or committee member | Board or committee member

The speakers listed below have nothing to disclose.

Program Faculty Paper Presenter Quiz Bowl participants

Michael Britt Mohammed Abdullah Griffin Biedron

Paul Chin Junho Ahn Jie Chen

Michael Cusick Nathan Boes Nathan Franklin

Andrew Ebert Garen Collett Justin “J.K.” Fritz

Mark Foreman Kathryn Gallaway Varan Haghshenas

Tim Gilliam Brandon Hull Skyler Hoelscher

Michael Greaser Rose Ann Huynh Dylan Homen

Scott Hecox Taylor Johnson Derek Klavas

Nicholas Iagulli Jennifer Liu Jacob Murphree

Cory Janney Kshitij Manchanda David Neal

Ken Kaminski, Jr J. Riley Martinez Scott Nimmons

Karl Koenig David Neal James Showery

Joseph Mathews Chideraa Ikenna Nwafor Cody Tillinghast

State Rep. Thomas Oliverson Shawn Okpara Nicholas Zarkadis

Vinod Panchbhavi Midhat Patel Adnan Zubair

Nisha Reddy

Brandon Stein

Adnan Zubair

Financial Disclosures (continued)First Name Last Name Commercial Interest For What Role

Ronald LindseyCo-Editor, JBJS Case Connector: | Co-Editor, Texas Orthopaedic Journal |Journal of Bone and Joint Surgery - American | Journal of Orthopaedic Trauma | Journal of Trauma | Springer

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

Margaret Maley Karen Zupko & Associates Employee

Kenneth Mathis Joint Development | Zimmer Paid consultant | IP royalties

Scott McKay Pediatric Orthopaedic Society of North America Board or committee member

Brent Morris DJ Orthopaedics | Saunders/Mosby-Elsevier | Tornier | Wright Medical Technology, Inc.

Other financial or material support | Publishing royalties, financial or material support | Paid consultant; Research support | Paid consultant

Clayton Nuelle Arthroscopy | Arthroscopy Association of North America Editorial or governing board | Board or committee member

Vinod PachbnaviAAOS | American Orthopedic Foot and Ankle Society| Foot and Ankle International Techniques in Foot & Ankle SurgeryOrthopedia.com | Stryker | Wolters Kluwer Health - Lippincott Williams & Wilkins

Board or committee member | Board or committee member | Editorial or governing board | Paid presenter or speaker | Editor – Techniques in Foot & Ankle Surgery

Andrew Palafox AAOS Board of Councilors | Del Sol Medical Center | Texas Orthopedic Association

Board or committee member | Chief of Staff (elect) Board or committee member | Board or committee member

Mark Rahm K2M | Link Orthopaedics | Pfizer | SpineSmith | Texas Orthopaedic Journal

Research support | Research support | Research support | IP royalties | Editorial or governing board

Drew Sanders Smith & Nephew Paid consultant

Anup Shah Arthrex, Inc | Medacta | Regeneration Technologies, Inc. Research support | Paid consultant | Research support

Steven Singleton American Orthopaedic Society for Sports Medicine | Ossur Board or committee member | Paid presenter or speaker

Darren Smith Cima Strategic Services Employee

Jeremy Somerson Arthrex, Inc | Biedermann Medtech | Encore Medical | Medinc of Texas Other financial or material support | Other financial or material support | Other financial or material support | Other financial or material support

David Teague Journal of Orthopaedic Trauma | Orthopaedic Trauma Association Board or committee member

Joshua Weaver Weaver Johnson & Nelson PLLC Salary / Ownership Interest

Boris ZelleAAOS | DePuy, A Johnson & Johnson Company | International Orthopaedics | Journal of Bone and Joint Surgery – American | Journal of Orthopaedic Trauma

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

Officers 2018-2019

TOA Office

Board of Councilors, AAOS

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

First President-Elect:Adam J. Bruggeman, MD San Antonio, TX

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

Immediate Past President:David E. Haynes, MD Waco, 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

Thank You To Our 2019 Sponsors!

Title SponsorTexas Medical Liability Trust

Platinum SponsorStryker

Gold SponsorsAudXMDAvanos MedicalFlexion TherapeuticsGap-FlexMedInc of Texas / ArthrexModernizing MedicinePhysicians Realty TrustZimmer Biomet

Silver SponsorsAllscriptsAtticus Medical BillingBiocompositesCumberland PharmaceuticalsDePuy SynthesDJO Surgical / DJO GlobalExamWorksFusion5FX Shoulder USA Inc .Globus MedicalGreenway Health, LLCHorizon PharmaKonica Minolta HealthcareMedtronic

mtfbiologics | ConMedPartners SurgicalP-LEASESmith & Nephew, Inc .SYNERGEN Health, LLCVericel CorporationZipline Medical, Inc .

Texas Orthopaedic Association401 West 15th Street, Suite 820

Austin, Texas 78701

Westin Riverwalk | San Antonio

February 7-8, 2020

ANNUAL CONFERENCE

the only conference that focuses on orthopaedics in texasa cadaver workshop and subspecialty...

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