News From ACFAS

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Looking for new creative ways to market your practice? Need a new way to explain important health information to your patients? Check out the newest editions to the ACFAS Animation Video Library, the Proper Foot Stretching Techniques and Using a Knee Walker/Roll About videos.

These videos are designed to give patients proper stretching techniques when battling different conditions, including plantar fasciitis and Achilles tendonitis as well as instructions on how to use a knee walker/roll about after surgery. The animation in the videos make it easy to see how to properly stretch out different parts of the leg and foot and how to properly and safely get around on the knee walker/roll about when recovering from an injury.

These colorful, easy-to-follow animated patient education videos are now available for you to share with your patients during their visit, on your website or on your social media sites to explain some of the most common instructions you give in each visit.

Visit the ACFAS Marketing Toolbox at acfas.org/Marketing to download the new videos now and be sure to check out the other valuable tools available to help you market your practice. ACFAS’ Arthroscopy of the Foot and Ankle Surgical Skills Course is back in-person with dates for 2021! Join us for one of these upcoming dates to get the latest techniques, didactic lectures and surgical demonstrations at the Orthpaedic Learning Center (OLC) in Rosemont, Illinois.

March 20-21, 2021
April 17-18, 2021
August 14-15, 2021
October 2-3, 2021
December 11-12, 2021

Visit acfas.org/skills for more information and to secure your spot at one of these popular, highly interactive course’s upcoming dates.

Foot and Ankle Surgery

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As sutures have progressed in strength, increasing evidence supports the suture tendon interface as the site where most tendon repairs fail. Researchers investigated whether suture tape would have a higher load to failure versus polyblend suture due to its larger surface area. Eleven matched pairs of cadaveric Achilles tendons were sutured with two millimeter wide braided ultrahigh molecular weight polyethylene tape (Tape) or two millimeter wide braided ultrahigh molecular weight polyethylene suture (Suture) using a Krackow repair method. All Achilles repair constructs were cyclically loaded, after which they were loaded to failure. Clinical loads to failure for Tape and Suture were 290.4 and 231.7 Newtons, respectively. Ultimate loads to failure for Tape and Suture were 352.9 and 289.8 Newtons, respectively. Cyclic testing resulted in significant changes in footprint height for both Tape and Suture, but the two sutures did not differ in terms of the magnitude of change in footprint height. The suture tendon interface was the most common site of failure for both Tape and Suture.


The study aimed to observe the variations in the origin, course and branching pattern of the dorsalis pedis artery. Normal anatomic description was found in 27 limbs. In 13 specimens researchers noted variations, including bilateral anomalous origin of dorsalis pedis artery, bilateral lateral deviation of dorsalis pedis artery, double dorsalis pedis artery, trifurcation of dorsalis pedis artery and absence of arcuate artery.


The study investigated the influence of angioplasty on free flap survival in diabetic foot ulcer reconstruction in 46 diabetic patients. All patients involved underwent free flap reconstruction because of their non-healing wound with tendon or bone exposure. Sever infrapopliteal arterial stenosis occurred in 23 of the patients, all of whom underwent endovascular intervention. Their final results of the pedal arch were type one in 13 patients, type 2A in seven patients, type 2B in two patients and type three in one patient. Total flap necrosis was found in five cases, marginal necrosis in four cases and wound dehiscence in four cases. There was no significant difference in flap loss between severe and non-severe arterial stenosis patients. In the severe arterial stenosis group, after endovascular intervention, patients with type one of pedal arch had a significantly lower rate of total flap necrosis than others. There was no association between the use of revascularized recipient artery and flap survival.

Practice Management

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Medical professionals can take several actions to start 2021 in better financial health. The first step is to "trim the fat" in one's financial life, cutting out unnecessary bills, debts or habits. It is also a good time to organize one's financial documents and keep them organized. Beneficiary designations on insurance policies, retirement accounts, bank account, and brokerage accounts should be reviewed annually. It is worth noting that contributions for most kinds of retirement accounts will remain the same for 2021. The best way to invest is to do so early, often and on a consistent basis. Keeping your long-term picture in mind is ideal when it comes to your investment portfolio. However, sometimes shifts in personal circumstances or the market conditions themselves make it necessary for us to adjust portfolio allocations.


In this interview, Pete Reilly and Glenn Day of HUB International discuss the matter of liability in the age of COVID. Reilly emphasizes the importance of practice insurance and recommends against forgoing coverage to cut costs. He also warns that malpractice risks are just as present with telehealth as with in-person visits. Day and Reilly also discuss worker's compensation costs, which have been unusually high during the pandemic due to the expense of treating COVID-19 cases contracted on the job. It is also generally assumed that if an essential worker or healthcare professional contracts COVID-19, they did so on the job and the employer may have liability. Practices can reduce worker's compensation risks by providing adequate personal protective equipment and making sure their procedures and policies are updated frequently according to the latest recommendations.

Health Policy and Reimbursement

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The US Centers for Medicare and Medicaid Services (CMS) has issued a final rule designed to reduce cost sharing for enrollees in Medicare Advantage and Part D prescription drug programs. The changes will result in an estimated $75.4 million in savings to the federal government over the course of a decade. The final rule will require Part D plans to implement a real-time benefit comparison tool starting January 1, 2023, so enrollees can obtain information about lower-cost alternative therapies under their prescription drug benefit plan. Enrollees would have a better idea of what they will need to pay before they arrive at the pharmacy counter. A similar CMS requirement for Medicare Part D plans that took effect on January 1, 2021, allows users to access a real-time drug benefit tool.


The US Federal Trade Commission (FTC) has issued orders to six health insurance companies to provide information that will allow the agency to study the effects of physician group and healthcare facility consolidation that occurred from 2015 through 2020. This study is part of a broader initiative recently announced by the FTC's Bureau of Economics to revamp its merger retrospective program.

Medicine, Drugs and Devices

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The US Department of Health and Human Services Office of the National Coordinator for Health Information Technology has announced the launch of the Synthetic Health Data Challenge. The program invites participants to create and test innovative and novel solutions that will further cultivate the capabilities of Synthea, an open-source synthetic patient generator that models the medical histories of synthetic patients. The Synthetic Health Data Challenge encourages researchers and developers to validate the realism of synthetic health records generated by Synthea, develop or improve the disease-progression and treatment modules used to create synthetic records and spur novel uses of synthetic health data.


Janet Woodcock, MD, the longtime director of the US Food and Drug Administration (FDA) Center for Drug Evaluation and Research, is set to serve as interim FDA commissioner after current Commissioner Stephen Hahn, MD, departs Wednesday. The incoming Biden administration has not yet nominated an FDA commissioner to permanently replace him. Woodcock, who joined FDA in 1986, has been involved with Operation Warp Speed, the multi-agency task force aimed at accelerating the development of COVID-19-related drugs and other medical products.