Foot & Ankle Focus: The Use of Biologics in Foot and Ankle Surgery

Moderators: Sheldon S. Lin, MD, and Rick Brown, MD
Faculty: Samuel B. Adams, Jr., MD, James D. Calder, MD, MBBS, FFSEM, FRCS(Tr&Orth), PhD, Rod Jaques, MD

This is the first in a brand new series of webinars involving a unique collaboration between the American and British Orthopaedic Foot and Ankle Societies. Each interactive webinar seeks to challenge the status quo around complex or topical issues in our surgical discipline. We hear the differing viewpoints of respected experts from both sides of the Atlantic and both sides of the argument, brought to life through case discussion and jointly moderated Q&A sessions. This time the question is whether we should be using Biologics in our surgical practices.

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

• Understand the mechanism of action and rationale behind the common modern Biologics
• Appreciate the evidence base and controversies relating to the use of Biologics in foot and ankle surgery
• Learn the practical applications of these surgical adjuncts 

The American Orthopaedic Foot & Ankle Society (AOFAS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The AOFAS designates this live activity for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

For more information on AOFAS accreditation and education policies, visit the Program Overview page.

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.

AOFAS requires all instructors, planners, and other 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 (any entity producing, marketing, re-selling, or distributing healthcare goods and services consumed by, or used on patients). All identified conflicts of interest must be resolved and the education content vetted by AOFAS for fair balance, scientific objectivity, and appropriateness. AOFAS also requires faculty to disclose when off-label/unapproved uses of a product are discussed in a CME activity. AOFAS attests that the persons responsible for the development of this educational activity did so independently and were not influenced by commercial supporters. All financial disclosures will be provided to meeting attendees in the final program materials.

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.

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 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

Rick Brown, MD
British Orthopaedic Foot and Ankle Society – Board member/committee appointment for a society

James D. Calder, MD, MBBS, FFSEM, FRCS(Tr&Orth), PhD
Arthrex Inc – Speaker’s Bureau/Presenter, Research Support
Stryker – Speaker’s Bureau/Presenter
Innovate Ltd – Stock or Stock Options
Journal of Bone and Joint Surgery – British – Medical/Orthopaedic publications editorial/governing board

Sheldon Lin, MD
Treace Medical – Speaker’s Bureau/Presenter
Bioventus – Unpaid Consultant
Found of Cre Osso – Stock or Stock Options
Foot and Ankle International – Medical/Orthopaedic publications editorial/governing board

Samuel Adams, MD
Orthofix Inc. – Speaker’s Bureau/Presenter
Conventus. – Speaker’s Bureau/Presenter, Paid Consultant
Stryker – Speaker’s Bureau/Presenter, Paid Consultant
DePuy a Johnson and Johnson Company – Speaker’s Bureau/Presenter, Paid Consultant
Exactech – Speaker’s Bureau/Presenter, Paid Consultant, Research Support
Medshape – Speaker’s Bureau/Presenter, Paid Consultant, Stock or Stock Options
Restor3D – Stock or Stock Options
ON Foundation – Board member/committee appointments for a society

Rod Jaques, MD
This individual reported nothing to disclose

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
Arthrex Inc: Speaker’s Bureau/Presenter
Medline UNITE: Paid Consultant
Marrow Access Technologies: Stock or Stock Options

Callum Clark, MD
This individual reported nothing to disclose

M. Truitt Cooper, MD
This individual reported nothing to disclose

Daniel C Farber, MD
This individual reported nothing to disclose

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
Smith & Nephew: Paid consultant
Vilex: Paid consultant
Techniques in Orthopaedics: Editorial or governing board
Techniques in Foot and Ankle Surgery: Editorial or governing board
Foot and Ankle International: Editorial or governing board

Daniel Guss, MD
American Orthopaedic Foot and Ankle Society: Board or committee member 
Arthrex Inc: Research Support
Butterfly, Inc: Research Support
Ossio: Paid Consultant, Stock or Stock options
DJO/AOFAS Traveling Fellowship: Other Financial or Material Support
AOFAS Traveling Fellowship 2019: Other Financial or Material Support

Tracy Harig, MD
This individual reported nothing to disclose

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

Casey Humbyrd, MD
American Orthopaedic Foot and Ankle Society: Board or committee member 
AAOS: Board or committee member 
Oxford University Press: Royalties, Financial or Material Support from Publishers

Kelly K. Hynes, MD
Acumed LLC: Speaker’s Bureau/Presenter, Paid Consultant
BoneSupport: Speaker’s Bureau/Presenter

James Robert Lachman, MD
American Orthopaedic Foot and Ankle Society: Board or committee member 
Arthrex Inc: Speaker’s Bureau/Presenter
FlowFX: Unpaid Consultant
Foot and Ankle International: Editorial or governing board
Oxford University Press: Royalties, Financial or Material Support from Publishers

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

James Meeker, MD
American Orthopaedic Foot and Ankle Society: Board or committee member 

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
Synthes, Gmreis: Speaker’s Bureau/Presenter, Paid Consultant
STEPS2walk: Editorial or governing board
IFFAS: Board or committee member

Charles Saltzman, MD
Zimmer: Royalites
Smith & Nephew: Paid Consultant
Lima: Unpaid Consultant
Crossroads Extremities: Stock or Stock Options
Bio2: Stock or Stock Options
Elsevier: Royalties, Financial or Material Support from Publishers

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
Federation of Orthopaedic Trainees in Europe: Board or committee member
Arthrex Inc: Paid Consultant, Speaker’s Bureau/Presenter
Knee Surgery, Sports traumatology, Arthroscopy: Editorial or governing board

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

Richard Zell, MD
American Orthopaedic Foot and Ankle Society: Board or committee member 
This individual reported nothing to disclose

Jacob Rothschild Zide, MD
American Orthopaedic Foot and Ankle Society: Board or committee member 
Orthofix: Paid consultant