Foot & Ankle Focus: Midfoot Arthritis: The Challenges, Solutions, and Unmet Needs

AGENDA

• Introduction – Moderator, Judith Baumbauer, MD, MS, MPH
• Treatment (need for compression, bone graft, which joints to do etc)– Mark A. Glazebrook, MD, MSc, PhD
• Outcomes – Timothy R. Daniels, MD
• Diagnosis – Alastair S.E. Younger, MD, MBChB, ChM
• Discussion/Q&A

Commercial Support

2021 webinars are provided free to AOFAS members and orthopaedic residents/fellows with funding from the Orthopaedic Foot & Ankle Foundation, supported in part by a grant from:

Arthrex Inc.

AOFAS Mission Statement
The mission of the American Orthopaedic Foot & Ankle Society is to improve lives through exceptional orthopaedic foot and ankle care.

Target Audience
This course is designed for the experienced foot and ankle surgeon, the generalist orthopaedic surgeon interested in expanding their scope of practice into foot and ankle, post-residency fellows and residents who treat acute and chronic problems of the foot and ankle, and allied health professionals who work in foot and ankle care.

Description
Midfoot arthritis is a common foot problem representing approximately 12% of people over age 50. Due to the diverse presentation of pain, functional limitations, shoe complaints, and swelling, diagnosis targeting the specific joints contributing to the problems can be difficult. The multi-segmental, interdigitating block of related joints poses challenges with fusion treatment as it may impact the load and forces on adjacent joints. In this webinar, faculty will highlight and present solutions to problems and unmet needs surrounding the diagnosis and treatment of midfoot arthritis.

Course Objectives

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

• Describe the anatomy of the midfoot joints
• Identify common patient complaints related to midfoot arthritis
• Employ surgical techniques for midfoot arthritis treatment 
• Discuss the complications of surgery and unmet needs with current surgical treatments

Commercial Support

2021 webinars are provided free to AOFAS members and orthopaedic residents/fellows with funding from the Orthopaedic Foot & Ankle Foundation, supported in part by a grant from:

Arthrex Inc.

AOFAS Mission Statement
The mission of the American Orthopaedic Foot & Ankle Society is to improve lives through exceptional orthopaedic foot and ankle care.

Target Audience
This course is designed for the experienced foot and ankle surgeon, the generalist orthopaedic surgeon interested in expanding their scope of practice into foot and ankle, post-residency fellows and residents who treat acute and chronic problems of the foot and ankle, and allied health professionals who work in foot and ankle care.

Statement of Need
A need for this educational activity has been determined based on previous course/meeting evaluations, practice gap analysis, membership surveys, and the AOFAS educational curriculum. The content of this course was based on current issues and topics provided by AOFAS membership and leadership.

Program
The AOFAS attests that the person(s) responsible for the development of this educational activity did so independently and were not influenced by commercial supporters.

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.

Credit Designation Statement
The AOFAS designates this live activity for a maximum of 1 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.

CME Certificates
Participants are required to listen to the podcast, answer the evaluation and claim CME at the end of the webinar.

This webinar was reviewed and re-approved by the on-demand education committee for three years on 5/7/2024.

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.

Webinar Faculty Disclosures
    
Judith F. Baumhauer, MD, MS, MPH
Nextremity Solutions - Royalties, Paid Consultant, Stock or Stock Options
Stryker - Paid Consultant
Wright Medical Group N.V. – Paid Consultant
Endo Pharmaceuticals Inc – Paid Consultant
Active Life - Paid Consultant
subioMed – Paid Consultant
Carbon22 – Stock or Stock Options
Journal of Bone and Joint Surgery – American, Royalty, Financial or Material Support from Publishers
PROMIS Health Organization – Board member/committee appointments for a society
AOFAS - Board member/committee appointments for a society

Mark A. Glazebrook, MD, MSc, PhD
Invatec - Speaker’s Bureau/Presenter
Stryker - Speaker’s Bureau/Presenter, Paid Consultant, Research Support
Bioventous - Speaker’s Bureau/Presenter, Paid Consultant
KCI - Speaker’s Bureau/Presenter, Paid Consultant
FORTIS – Paid Consultant
Submedio – Paid Consultant
Axolotl – Stock or Stock Options
CONMED Linvatec – Stock or Stock Options
Zimmer – Stock or Stock Options
Canadian Orthopaedic Association - Board member/committee appointments for a society

Timothy R. Daniels, MD, FRCSC
Smith & Nephew – Royalties, Research Support
Integra – Speaker’s Bureau/Presenter
Wright Medical Group N.V. – Speaker’s Bureau/Presenter, Paid Consultant
Stryker – Paid Consultant, Research Support
Biomet – Paid Consultant, Other Financial or Material Support
Foot and Ankle International - Medical/Orthopaedic publications editorial/governing board
American Orthopaedic Foot and Ankle Society - Board member/committee appointments for a society
Canadian Orhtopaedic Association - Board member/committee appointments for a society

Alastair S. Younger, MB ChB, ChM, FRCSC
Zimmer – Speaker’s Bureau/Presenter
Wright Medical Group N.V. - Speaker’s Bureau/Presenter, Paid Consultant
CONMED Linvatec - Speaker’s Bureau/Presenter
Acumed LLC - Speaker’s Bureau/Presenter, Paid Consultant
Axolotyl – Paid Consultant
Biocomposites – Paid Consultant
Precision OS – Paid Consultant

EDUCATION COMMITTEE DISCLOSURES (Planners)

Mohamed Abd-Ella, MD
This individual reported nothing to disclose

Jonathon D. Backus, MD
American Orthopaedic Foot and Ankle Society: Board or committee member
Foot and Ankle International: Editorial or governing board
Medline UNITE: Paid Consultant

Daniel C Farber, MD
AAOS: Board or committee member
American Orthopaedic Foot and Ankle Society: Board or committee member
DJ Orthopaedic Foot and Ankle Society: Board or committee member
Foot and Ankle Online: Editorial or governing board
JMEA: Stock or stock Options
Trace Medical Concepts: Paid consultant

Alena Frey
Staff
This individual reported nothing to disclose

Lauren Elizabeth Geaney, MD 
American Orthopaedic Foot and Ankle Society: Board or committee member 
Arthrex, Inc: Research support
Connecticut Orthopaedic Society: Board or committee member Paragon 28: Paid consultant
Techniques in Orthopaedics: Editorial or governing board

Thomas M Hearty, MD
American Orthopaedic Foot and Ankle Society: Board or committee member 
Orthobullets: Editorial or governing board

Kelly K. Hynes, MD
This individual reported nothing to disclose

Carroll Jones, MD
Acumed, LLC: Research support
American Orthopaedic Foot and Ankle Society: Board or committee member
Artelon: IP royalties, Paid consultant, Paid presenter or speaker
Arthrex, Inc: IP royalties
BoneSupport: Paid consultant
Bone Support(Cerament): Paid presenter or speaker
Celling Biosciences: Paid presenter or speaker
Nuvasive: Paid consultant
Osteoremedies: Paid consultant
Smith & Nephew: Paid consultant
Wright Medical Technology, Inc: IP royalties, Paid consultant, Paid presenter or speaker,, Research                support

James Robert Lachman, MD
This individual reported nothing to disclose

Elizabeth Martin, MD
American Orthopaedic Foot and Ankle Society: Board or committee member 

James Meeker, MD
This individual reported nothing to disclose

Jennifer Moore
Staff
This individual reported nothing to disclose

Julie Murkowski
Staff
This individual reported nothing to disclose

Irvin Oh, MD
Innomed: IP royalties

Christian A. Ortiz, MD
This individual reported nothing to disclose

Vinod Kumar Panchbhavi, MD, FACS
AAOS: Board or committee member
American Orthopaedic Foot and Ankle Society: Board or committee member
Foot and Ankle InternationalTechniques in Foot & Ankle SurgeryOrthopedia.com: Editorial or governing board 
Stryker: Paid presenter or speaker
Wolters Kluwer Health - Lippincott Williams & Wilkins: Publishing royalties, financial or material support

Charles Saltzman, MD
This individual reported nothing to disclose

João Filipe Vide, MD
American Orthopaedic Foot and Ankle Society: Board or committee member
European Federation of National Associations of Orthopedics and Traumatology: Board or committee member

Brian M Weatherford, MD
BESPA Global: Paid consultant 
Orthobullets: Paid consultant 
Synthes: Paid presenter or speaker

Richard Zell, MD
This individual reported nothing to disclose

Jacob Rothschild Zide, MD
Orthofix: Paid consultant