Moderator: Constantine Demetracopoulos, MD
Faculty: Jensen Henry, MD; William McGarvey, MD; David Pedowitz, MD; Karl Schweitzer, MD, Brian Weatherford, MD

This webinar will address the challenges of bone loss in primary and revision total ankle replacement (TAR). Our experts will share how they evaluate patients, plan for surgery, and manage complications that can arise when performing TAR in patients with bone loss on the tibia and talus.

Agenda

1. Intro and Welcome  - Constantine Demetracopoulos, MD
2. Tibial Bone loss in Primary TAR - Karl Schweitzer, MD
3. Talar Bone loss in Primary TAR - Brian Weatherford, MD
4. Revision TARs are coming – Outcomes in the Literature - Jensen Henry, MD
5. Tibial Bone Loss in Revision TAR - David Pedowitz, MD
6. Talar bone loss in Revision TAR – William McGarvey, MD
7. Q&A and Case Discussion 

At the conclusion of this webinar, you will be able to:

• Properly assess patients undergoing primary and revision TAR for adequate bone stock on the tibial and talar side

• Develop treatment strategies to overcome the challenges imposed by bone loss on the tibia and talus and gain insight into the technical aspects, pearls, and pitfalls of performing these surgeries

• Identify the common complications that can arise in these cases and how to manage them postoperatively

Credit Designation Statement

The AOFAS designates this enduring activity for a maximum of 1.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn credit toward the CME requirements of the American Board of Orthopaedic Surgery’s Maintenance of Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABOS credit.

Constantine Demetracopoulos, MD

Dr. Demetracopoulos received his medical degree from the Johns Hopkins School of Medicine in Baltimore, MD, and completed his orthopedic training at Hospital for Special Surgery. As a resident, he was awarded the Joseph M. Lane Research Grant for his work in the biomechanics laboratory. Following residency, he completed a fellowship in foot and ankle surgery at the Duke University Medical Center. He serves as the Director of the Total Ankle Replacement Center at the Hospital for Special Surgery and has been awarded the IFFAS Award and the Roger Mann Award for his basic science and clinical research on ankle replacement.

Jensen Henry, MD

Dr. Henry is an Assistant Attending Orthopedic Surgeon at the Hospital for Special Surgery (HSS) and an Instructor at Weill Cornell Medical College in New York. After graduating from NYU School of Medicine, she completed both orthopaedic residency and foot and ankle fellowship at HSS.

William McGarvey, MD

Dr. William McGarvey is Professor and Vice Chair in the Department of Orthopaedic Surgery at The University of Texas Health Science Center at Houston. He serves as the Residency Program Director, as well as the Foot and Ankle Fellowship director for the department. Certified by the American Board of Orthopaedic Surgery, Dr. McGarvey specializes in Foot and Ankle surgery. Dr. McGarvey received his undergraduate degree from Temple University in Philadelphia, Pennsylvania. He attended medical school at Thomas Jefferson University Medical College in Philadelphia, Pennsylvania. Following a General Surgery internship and Orthopaedic Surgery residency at Union Memorial Hospital in Baltimore, Maryland, Dr. McGarvey went on to complete a fellowship in Foot and Ankle surgery at Baylor College of Medicine in Houston, Texas. Dr. McGarvey is an active member of several professional associations, including the American Academy of Orthopaedic Surgeons and the American Orthopaedic Foot and Ankle Society.

David Pedowitz, MD
Dr. Pedowitz is Professor of Orthopaedic Surgery at Thomas Jefferson Sidney Kimmel Medical College in Philadelphia and is the Chief of the division of Foot & Ankle Surgery at Rothman Orthopaedics, which is one of the largest foot and ankle programs in the nation. Dr. Pedowitz has authored numerous peer reviewed scientific papers and book chapters and has lectured throughout the world, presenting his research nationally and internationally. He is actively involved in the development and engineering of total ankle replacements and other technology used by foot and ankle surgeons. He holds memberships with the American Academy of Orthopaedic Surgeons and the American Orthopaedic Foot and Ankle Society.

Karl M Schweitzer, Jr., MD, FAAOS

Karl M. Schweitzer, Jr MD grew up in Mechanicsburg, PA and attended Franklin & Marshall College, followed by Jefferson Medical School. He completed his orthopaedic surgery residency training at Duke and foot and ankle fellowship at OrthoCarolina. He has been faculty at Duke since 2014 and is involved in the Duke foot and ankle fellowship and research. He performs a variety of reconstructive procedures, but has particular interest in total ankle replacement, including revision opportunities. He enjoys spending time with his family including his wife, Sam, who is a nurse practitioner, their two children (Addi - 6yo and Dawson - 3yo), and their Jack Russell 'Jack'.

Brian M Weatherford, MD

Dr. Brian Weatherford is an Orthopaedic Surgeon with fellowship training in both Orthopaedic Trauma as well as Foot and Ankle Surgery. He is dedicated to the treatment of patients with foot and ankle disorders as well traumatic injuries. His areas of special interest include deformity correction, ankle replacement surgery and complex fracture care. He graduated cum laude from Vanderbilt University with undergraduate degrees in both molecular biology and Spanish. A native of Texas, Dr. Weatherford attended medical school at The University of Texas Health Science Center in San Antonio. He continued his medical education in Chicago, completing an Orthopaedic Surgery residency at Northwestern University’s Feinberg School of Medicine. Dr. Weatherford then completed a one year fellowship in Orthopaedic Trauma Surgery at the R Adams Cowley Shock Trauma Center. This was followed by an additional one year fellowship in Foot and Ankle Surgery at Orthopaedic Associates of Michigan. Currently he is a partner at Illinois Bone and Joint Institute, Clinical Assistant Professor at the University of Illinois Chicago, and Residency Site Director for Advocate Lutheran General Hospital.

Statement of Need

A need for this educational activity has been determined based on previous course evaluations and the AOFAS educational curriculum. The content of this course was based on current issues and topics provided by AOFAS membership and leadership. For more information on the AOFAS CME mission, visit aofas.org/education.

Accreditation

The American Orthopaedic Foot & Ankle Society (AOFAS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education (CME) for physicians.

Disclaimer

The material presented in this continuing medical education activity has been made available by the American Orthopaedic Foot & Ankle Society (AOFAS) for educational purposes only. This material is not intended to represent the only, nor necessarily the best, methods or procedures appropriate for the medical situation discussed, but rather is intended to present an approach, view, statement, or opinion of the authors or presenters, which may be helpful or of interest to other practitioners. Methods, techniques, and procedures demonstrated and views and opinions expressed by speakers, presenters, and faculty are their own, and do not necessarily represent those of AOFAS, nor does presentation on the program represent or constitute endorsement or promotion by AOFAS. AOFAS expressly disclaims any warranties or guarantees, expressed or implied, and shall not be liable for damages of any kind in connection with the material, methods, information, techniques, opinions, or procedures expressed, presented, or demonstrated.

Disclosure of Conflict of Interest

Disclosure Statement
AOFAS mandates all instructors, planners, and other individuals in a position to control or influence the content of an educational activity to disclose all financial relationships that you have had in the past 24 months with ineligible companies. An "ineligible company" is one whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

All identified conflicts must be mitigated, and the education content vetted by the AOFAS for fair balance, scientific objectivity, and appropriateness. All disclosures will be provided in this final program distributed at the meeting to all program participants.

FDA Statement
Some drugs or medical devices demonstrated at this 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 wishes to use in clinical practice. AOFAS policy provides that "off label" uses of a drug or medical device may be described in its 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 products approval label.

Faculty/Planner Disclosure Declaration
As an Accreditation Council for Continuing Medical Education (ACCME) provider, AOFAS has the obligation to ensure the delivery of education that is balanced and free of commercial bias. To achieve this, it is the policy of the AOFAS that all CME-related Board, committee members ("planners"), faculty, and appropriate staff disclose in writing to the learners all financial relationships that you have had in the past 24 months with ineligible companies. An "ineligible company" is one whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

In addition to faculty members, commentators from the floor are charged with verbally disclosing any interests immediately prior to speaking. All disclosures are provided in this final program distributed at the meeting to all program participants.

In accordance with AOFAS policy:
Faculty participation in this educational activity will be predicated upon timely submission and review of AOFAS disclosure. An individual who refuses to disclose relevant financial relationships will be disqualified from being a planning committee member, a teacher, or an author of CME, and cannot have control of, or responsibility for, the development, management, presentation, or evaluation of the CME activity. Non-compliance will result in a faculty member being stricken from the program.

An indication of the participant's disclosure appears after his or her name as well as the commercial company or institution that provided the support. AOFAS does not view the existence of these disclosed interests or commitments as necessarily implying bias or decreasing the value of the author's participation in this activity. In addition to ensuring that presentations be free of bias, faculty members are required to ensure that all material presented and discussed will be based on best-available evidence.

DISCLOSURE OF CONFLICT OF INTEREST

Disclosure Statement

AOFAS mandates all instructors, planners, and other individuals in a position to control or influence the content of an educational activity to disclose all financial relationships that you have had in the past 24 months with ineligible companies. An “ineligible company” are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

All identified conflicts must be mitigated, and the education content vetted by the AOFAS for fair balance, scientific objectivity, and appropriateness. All disclosures will be provided in this final program distributed at the meeting to all program participants.

FDA Statement

Some drugs or medical devices demonstrated at this 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 wishes to use in clinical practice. AOFAS policy provides that “off label” uses of a drug or medical device may be described in its 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 products approval label.

Faculty/Planner Disclosure Declaration

As an Accreditation Council for Continuing Medical Education (ACCME) provider, AOFAS has the obligation to ensure the delivery of education that is balanced and free of commercial bias. To achieve this, it is the policy of the AOFAS that all CME-related board members, committee members (“planners”), faculty, and appropriate staff disclose in writing to the learners’ all financial relationships that you have had in the past 24 months with ineligible companies. An “ineligible company” are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

In addition to faculty members, commentators from the floor are charged with verbally disclosing any interests immediately prior to speaking. All disclosures are provided in this final program distributed at the meeting to all program participants.

In accordance with AOFAS policy:

Faculty participation in this educational activity will be predicated upon timely submission and review of AOFAS disclosure. An individual who refuses to disclose all financial relationships will be disqualified from being a planning committee member, a teacher, or an author of CME, and cannot have control of, or responsibility for, the development, management, presentation, or evaluation of the CME activity. Non-compliance will result in a faculty member being stricken from the program.

An indication of the participant’s disclosure appears after his or her name as well as the ineligible company that provided the support. AOFAS does not view the existence of these disclosed interests or commitments as necessarily implying bias or decreasing the value of the author’s participation in this activity. In addition to ensuring that presentations are free of bias, faculty members are required to ensure that all material presented and discussed will be based on best- available evidence.

Faculty Disclosures

All of the relevant financial relationships listed for these individuals have been mitigated.

Constantine Demetracopoulos, MD

American Orthopaedic Foot and Ankle Society - Fiduciary Officer

Artelon - Consultant

Arthrex - Consultant

Enovis - Consultant

HS2, LLC - Stock

In2Bones USA, LLC - Consultant

Responsive Arthroscopy LLC - Consultant

restor3d, inc. - Consultant

RTI Surgical, Inc -Consultant

Simulate Technologies - Consultant

Treace Medical Concepts, Inc. - Consultant

Exactech, Inc - IP Royalties

Wolters Kluwer Health - Lippincott Williams & Wilkins - Publishing Royalties

In2Bones - IP Royalties, Paid Consultant

Jensen Henry, MD

Arthritis Foundation - Grant / Contract

Exactech, Inc - Other Professional Activities - Consultant

Stryker Corporation - Grant / Contract

William McGarvey, MD

Extremity Medical - Stock Option

Stryker – Consultant

David Pedowitz, MD

Thermaquil - Stock Option

Arthrex - Intellectual Property

OSSIO LTD - Stock Option

actics medical - Stock Option

Smith and Nephew - Intellectual Property

Arthrex - Consultant

MiRus, LLC - Stock Option

Karl Schweitzer, MD

Stryker - Consultant

Ibex, Inc - Stock Option

Ibex, Inc - Consultant

Tayco Brace, Inc - Stock Option

Tayco Brace, Inc - Consultant

Restor3d, inc. - Stock Option

Brian Weatherford, MD

DePuy Synthes Products LLC - Consultant

Stryker - Consultant