January 25, 2017 | | JFAS | Contact Us

News From ACFAS

Stay Connected to ACFAS 75 with Free Mobile App
Download the free ACFAS 75 mobile app to your device before heading to the 75th Anniversary Scientific Conference, February 27–March 2 at The Mirage in Las Vegas. Use the app to access your personal session schedule along with the full schedule of events, speaker and exhibitor lists, conference news alerts, convention center maps and more.

To download your app:
  1. Search your app store for ACFAS 2017 (iOS and Android).
  2. Type on your mobile device internet browser.
Watch for an email from ACFAS next month with your login information for accessing your personalized schedule.
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Round Out Your ACFAS 75 Experience with Industry Events
Attend industry events during the 75th Anniversary Scientific Conference February 27–March 2 at The Mirage in Las Vegas to make the most of your conference experience. Choose from any of three breakfasts or four after-hours events and get an in-depth look at the newest surgical technologies.

Amniox Medical Breakfast
Establishing a New Healing Paradigm Through the Incorporation of Human Umbilical Cord in F&A Procedures: Application and Evidence from Five Years and 20,000 Patients
Tuesday, February 28
The Mirage, St. Croix Room

Bioventus Breakfast
Clinical Evidence and Outcomes: Low-Intensity Pulsed Ultrasound and Fracture Healing
Tuesday, February 28
The Mirage, St. Thomas Room

Paragon 28 Breakfast
Novel Concepts in Foot and Ankle Repair: Lapidus Intramedullary Nail
Wednesday, March 1
The Mirage, St. Croix Room

DePuy Synthes Evening Event
Tackling Challenging Foot and Ankle Reconstruction Cases: Technique Tips and Pearls for Success
Tuesday, February 28
The Mirage, St. Thomas Room AB

Treace Medical Concepts, Inc. Evening Event
Lapiplasty® Procedure Cadaveric Symposium
Tuesday, February 28
The Mirage, Martinique Room

Zimmer Biomet Evening Event
Unique Solutions to Common Problems in the Foot and Ankle
Tuesday, February 28
The Mirage, St. Croix Room AB

Wright Medical Evening Event
Advanced Surgical Interventions for End-Stage Ankle Arthritis or Advanced Surgical Techniques in Hindfoot and Arthrodesis
Tuesday, February 28
The Mirage, Jamaica Room AB

Download the full conference program at for details.
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Residents & Students: Build Your Network at ACFAS 75
Widen your professional circle and jumpstart your career during the 75th Anniversary Scientific Conference February 27–March 2 at The Mirage in Las Vegas. Job hunt, network, interview with potential employers, update your headshot and also have your resume reviewed at the fourth annual ACFAS Job Fair, sponsored by

On February 27, attend the invitation-only Resident and Student Networking event, sponsored by ABFAS, to meet new colleagues and leaders in the profession while enjoying refreshments and participating in prize drawings.

If you are considering a fellowship after residency, come to the Fellowship Breakfast Fair on March 1 and meet with directors and fellows from 25 different fellowship programs from around the country. Get all of your fellowship questions answered in one room!

Visit for details on all resident and student events at ACFAS 75.
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ACFAS Update Is Your Preferred News Source
Our January poll in This Week @ ACFAS asked readers what resource they use to stay informed of news within the College. Forty-seven percent of respondents turn to ACFAS Update with This Week @ ACFAS coming in second at 33 percent. Thirteen percent rely on, while seven percent check ACFAS' Facebook page.

We appreciate your votes and look forward to receiving your responses to our next poll in the February 1 issue of This Week @ ACFAS. Remember, you can view real-time poll results throughout the month at
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New Associate Member Wins Apple Watch
Congratulations to Alicia Canzanese, DPM, ATC, AACFAS, of Glenside, Pennsylvania! She won an Apple watch in a drawing of new Associate Member applicants. The Membership Committee sponsored the contest to recognize former residents who have recently passed the ABFAS Board Qualifying exam and who have upgraded their membership to Associate Member with ACFAS.

Congrats once again to Dr. Canzanese and welcome to all of our new Associate Members! We hope to see you next month in Las Vegas!
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Foot and Ankle Surgery

Comparison of Compressive Forces Caused by Various Cannulated Cancellous Screws Used in Arthroscopic Ankle Arthrodesis
Internal fixation is performed using bone screws during arthroscopic ankle arthrodesis for end-stage ankle arthritis, but optimal characteristics of bone screws have not been examined in terms of pressure force. A new study aims to determine the feasibility of measuring compressive force changes and inferring screw characteristics using a newly developed measurement device. Three types of screws (S1, S2 and S3) were inserted into the measurement device. Changes in pressure were measured for each 45-degree turn. After reaching the maximum pressure in the simulated bone, screw rotations were accompanied by a gradual pressure decrease. The mean maximum pressure for S1, S2 and S3 were 0.832 MPa, 0.434 MPa and 0.414 MPa, respectively. Pressure slopes to the maximum pressure did not vary significantly between the screws, and the subsequent pressure decrease to 0 MPa was significantly more rapid for S1 than for S2 and S3. Researchers were able to determine the pressure profile characteristics of all three screws.

From the article of the same title
Journal of Orthopaedic Surgery and Research (01/17/17) Kamijo, Satoshi; Kumai, Tsukasa; Tanaka, Shogo; et al.
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Quality of Life in Bilateral vs. Unilateral End-Stage Ankle Arthritis and Outcomes of Bilateral vs. Unilateral Total Ankle Replacement
A retrospective cohort study was performed to compare preoperative health-related quality of life between 53 patients with bilateral end-stage ankle arthritis and 106 patients with unilateral disease. Midterm outcomes in 37 patients who had undergone staged bilateral total ankle replacement (TAR) were also compared with the outcomes in 106 patients treated with unilateral TAR. Preoperatively, patients with unilateral disease had a higher prevalence of posttraumatic arthritis, while patients with bilateral disease had a higher prevalence of primary and secondary arthritis. The mean preoperative Shortform-36 physical component summary score in the unilateral group was higher than the bilateral group’s. Patients who underwent unilateral or staged bilateral TAR showed similar improvement in SF-36 scores between preoperative and postoperative evaluations. Six ankles in the unilateral group and six ankles in the bilateral group required revision of the metal component. The mean implant survival time was 10.9 years in the bilateral group and 9.2 years in the unilateral group.

From the article of the same title
Journal of Bone and Joint Surgery (01/17) Vol. 99, No. 2, P. 133-140 Desai, Sagar, J.; Glazebrook, Mark; Penner, Murray, J.; et al.
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Study: Nearly One-Third of Adults with Prediabetes Also Have Arthritis
According to an analysis presented at the American College of Rheumatology Annual Meeting, 30 percent of adults with prediabetes also have arthritis, potentially affecting the physical activity recommended to prevent diabetes. Researchers collected data from the 2009 to 2014 National Health and Nutrition Examination Survey. Prediabetes was defined as a glycated hemoglobin A1c level between 5.7 percent and 6.5 percent. Diabetes was defined as an HbA1c level of at least 6.5 percent. The analysis found that a total of 27.9 million adults with prediabetes also had arthritis. The age-standardized prevalence of arthritis among adults with prediabetes (25.5 percent) was significantly higher than those without prediabetes (21.6 percent) and similar to those with diabetes (28.6 percent).

From the article of the same title
Healio (01/12/2017)
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Practice Management

Ergonomics and Your Practice: Physical Risks of Technology
Prolonged improper use of computers and mobile devices can cause physical harm if ergonomic risks are not addressed within medical practices. New technology is often forced into cramped work spaces, increasing the risk for ergonomic injuries. Discussion and actions to stem ergonomic issues may come too late, after someone comes forward with chronic pain or injury. The U.S. Occupational Safety and Health Administration provides online tools for evaluating and improving computer workstations. First, practices should analyze workflow routines to find any awkwardly placed monitors and keyboards at the front desk, back office and patient care areas. Laptops are sometimes used in crowded areas to save space or are placed on surfaces too low or too high for comfortable use. Minor changes, such as elevating a laptop and using an external keyboard, can improve ergonomics. Consultants may be able to help physicians identify ergonomic issues within their environment and recommend solutions, such as adjustable wall mounts, keyboard floats and rolling laptop tables.

From the article of the same title
Physicians Practice (01/18/17) McCallister, Stephen
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New EHR Meaningful Use Deadline Nears
The U.S. Centers for Medicare and Medicaid Services (CMS) have announced that the registration and attestation system for the Medicare and Medicaid electronic health records (EHR) meaningful use program is open. Participating providers must attest by March 13 to receive meaningful use payments. Failure to attest will result in lower payments in 2018, unless providers are approved for a hardship exemption. CMS also intends to address changes to the electronic Clinical Quality Measures (eCQM) requirements established in the FY 2017 Inpatient Prospective Payment System. Stakeholders have expressed concerns regarding challenges associated with transitioning to new hospital EHR systems, modifying workflows, addressing data element mapping and meeting deadlines to incorporate updates under eCQM specifications in 2017.

From the article of the same title
Health Data Management (01/17/17) Goedert, Joseph
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Use of Mobile EHR Apps Can Boost Productivity
Mobile electronic health record (EHR) applications could help physicians improve their productivity, according to some healthcare information technology experts. Most EHR vendors offer mobile versions of their programs to complement existing desktop applications. Many mobile applications have the same functions and workflow processes as their desktop counterparts, allowing physicians to work on the go via tablets or smartphones. Providers can also opt for mobile apps for specific tasks, such as messaging apps that can be used to respond to patient inquiries and handle prescription refill requests during downtime. Finally, physicians might choose to incorporate mobile video visits into their practices, as video conferences can be significantly shorter than in-person appointments. “Everything is moving to mobile,” says IT consultant Rick Shepardson. “It's just a matter of having the right technology and the right user experience to support it.”

From the article of the same title
Medical Economics (01/12/17) Pratt, Mary K.
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Health Policy and Reimbursement

CBO: The GOP's Obamacare Repeal Could Leave 27 Million People Without Health Insurance and Could Cause Premiums to Skyrocket
A partial repeal of the Affordable Care Act (ACA) proposed by Republicans will lead to a dramatic increase in the number of uninsured Americans and soaring premiums for consumers in the individual insurance market, according to the Congressional Budget Office (CBO). According to the report, the number of uninsured people would increase by 18 million the first year following enactment of a partial repeal. Following the elimination of Medicaid expansion and subsidies, the number would increase to 32 million by 2026. Premiums would be 20 percent to 25 percent more in the next year than they would be if the ACA were kept in place. CBO estimates that premiums would increase by 50 percent if the ACA is repealed fully. The analysis accounts for a repeal that would include rolling back the individual mandate, Medicaid expansion and subsidies for those purchasing insurance in the individual marketplace. The partial repeal could leave some provisions intact, such as children’s ability to stay on their parents’ insurance until age 26 and insurers' inability to deny coverage based on preexisting conditions.

From the article of the same title
Business Insider (01/17/17) Bryan, Bob
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Doctors May Accept Low Fee from Medicare, but Not from All Patients
Medical specialists often charge four to six times more than what they accept from Medicare for the same services, according to a study published in the Journal of the American Medical Association. The researchers analyzed Medicare data on 429,273 physicians in 54 different medical specialties. They also examined excess charges from physicians, and generally half of the physicians charged 2.5 times what Medicare paid for the same services. Half of physicians specializing in general or internal medicine, family practice, psychiatry, dermatology, allergy, immunology and geriatric medicine charged 1.6 to two times more than what Medicare paid. Meanwhile, half of anesthesiologists charged patients about six times more than what they accepted from Medicare, and half of interventional radiologists charged at least 4.5 times more than what they accepted. Emergency medicine physicians charged four times more than what Medicare paid. Excess charges varied by state and region.

From the article of the same title
Reuters (01/17/17) Seaman, Andrew M.
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Republican Senator Would Let States Keep ACA if They Want
Sen. Bill Cassidy (R-La.) plans to introduce a healthcare plan aimed at giving states the option to keep the Affordable Care Act (ACA), eliminate the program or transition to a new system. A key feature of Cassidy’s plan is a provision allowing states to automatically enroll people in health plans unless they opt out. The plan also includes refundable tax credits that would go toward health savings accounts. Medicaid expansion programs would be maintained, but states that did not choose to expand Medicaid would receive new funding based on how many people they insured. As Republicans will need Democratic support to pass a full replacement for the ACA, Cassidy’s approach may be the most likely to appeal to Democrats out of the plans proposed by Republicans so far.

From the article of the same title
Bloomberg (01/17/17) Dennis, Steven T.
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Medicine, Drugs and Devices

New State Rules Are Forcing Opioid Prescribers to Confront ‘Doctor Shopping’
States are moving to force physicians to check on patients’ narcotic purchasing habits, one of the more effective ways of curbing opioid abuse as the deadly drug epidemic continues. Eighteen states have adopted comprehensive mandates in the past four years requiring doctors who prescribe opioids and other controlled substances to check databases that show whether their patients are getting drugs elsewhere. About 13 other states have weaker mandates that cover more limited circumstances, according to a recent review by the Pew Charitable Trusts and Brandeis University.

From the article of the same title
Washington Post (01/14/17) Bernstein, Lenny
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New Study Raises Specter of More Bacteria Resistant to Last-Line Antibiotics
Antibiotic-resistant bacteria are circulating more widely than currently reported among asymptomatic people, according to a new genetic analysis recently published in the Proceedings of the National Academy of Sciences. Researchers sequenced and compared the genomes of bacteria collected from patients whose infections were resistant to carbapenems. There were very few cases of disease in which the bacteria were closely related to each other, suggesting the drug-resistant bacteria were not passed directly from one patient to another, but through asymptomatic carriers. Currently, the U.S. Centers for Disease Control and Prevention collects reports of carbapenem-resistant infections, but hospitals are not required to report them, and few hospitals screen asymptomatic people for antibiotic-resistant bacteria.

From the article of the same title
Wall Street Journal (01/16/17) Kincaid, Ellie
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New Surgical Mask Does Not Just Trap Viruses, It Renders Them Harmless
Research published in Scientific Reports describes a new type of surgical mask that is capable of trapping and killing airborne pathogens. Traditional surgical masks are often worn for protection during outbreaks of influenza or other viruses, but these masks were not designed to prevent the spread of airborne viruses. The masks may trap pathogen-laden aerosol droplets, but viruses on the mask still pose risks for infection and transmission. Researchers developed a salt formulation to improve the mask’s filter and to deactivate influenza viruses. When an aerosol droplet carrying the virus comes in contact with the treated filter, the droplet absorbs the salt. As the droplet evaporates, the virus is destroyed when the salt returns to a crystallized state.

From the article of the same title
ScienceDaily (01/05/17)
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This Week @ ACFAS
Content Reviewers

Mark A. Birmingham, DPM, FACFAS

Daniel C. Jupiter, PhD

Gregory P. Still, DPM, FACFAS

Jakob C. Thorud, DPM, MS, AACFAS

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This Week @ ACFAS is a weekly executive summary of noteworthy articles distributed to ACFAS members. Portions of This Week are derived from a wide variety of news sources. Unless specifically stated otherwise, the content does not necessarily reflect the views of ACFAS and does not imply endorsement of any view, product or service by ACFAS.

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