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March 9, 2022 ACFAS.org | FootHealthFacts.org | JFAS | FASTRAC | Contact Us

News From ACFAS


It’s Not Too Late to Access ACFAS 2022 On Demand!
If you weren’t able to join us for this year’s meeting in Austin, you’re in luck! You can still take part in the ACFAS 2022 On-Demand Package. Access over 20 hours of learning recorded at this year’s Annual Scientific Conference from your computer wherever you are.

The On-Demand Package includes:
  • 13 recorded ACFAS 2022 Sessions totaling 23 CME hours
  • Ability to view session recordings for up to one year
  • Convenient 24/7 online access
Visit acfas.org/Austin for more information on the ACFAS 2022 On-Demand Package.
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New JFAS Editor Named
The College is pleased to announce Naohiro Shibuya, DPM, MS, FACFAS as the new Editor-in-Chief of the Journal of Foot & Ankle Surgery (JFAS). Dr. Shibuya will step into the editor role officially May 1 and will oversee the editorial content and management of the Journal taking over for the retiring D. Scot Malay, DPM, MSCE, FACFAS.

"I can't think of a better person to follow Dr. Malay than Dr. Shibuya,” said ACFAS President Michael Cornelison, DPM, FACFAS. “Hiro's experience in the realm of scientific investigation within the field of foot and ankle surgery is extensive, but moreover, his enthusiasm for elevating the quality of it is unparalleled. Dr. Shibuya’s track record for innovation through his participation in many aspects of the College, most recently as Chair of our Annual Scientific Committee, leave no doubt in my mind that his stewardship of the Journal of Foot & Ankle Surgery will take it to new levels of excellence,” he adds.

Dr. Shibuya currently serves as the deputy editor of JFAS and has served as section editor and a peer reviewer during his tenure with the Journal. Dr. Shibuya shares, “I am honored to be given the opportunity to greatly influence the future of our profession by leading this important academic branch of ACFAS.” He adds, “I am grateful to the ACFAS Board of Directors and to Dr. Malay who built such a great foundation of excellence for the Journal and the profession over the last 15 years. I plan to build upon that foundation to ensure the quality and standard set before me will continue to make JFAS a journal where quality surgeons and researchers from all over the world submit their best manuscripts to advance the profession of foot and ankle surgery.”
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Applications for New Fellowship Programs Due May 1
If you are a fellowship program director and would like to seek ACFAS status for your program, please submit your application by the May 1, 2022 annual deadline.

The ACFAS Fellowship Committee meets late July in Chicago to review any new applications and will announce new programs in August.

Contact Michelle Kennedy, Director of Member Engagement and Post Graduate Affairs, to request an application or to learn more about the College's Recognized Fellowship Initiative.
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Foot and Ankle Surgery


First Tarsometatarsal Joint Arthrodesis for Hallux Valgus with and Without Intermetatarsal Screw Fixation: A Comparison of Correction and Maintenance of Correction
Researchers assessed the correction via tarsometatarsal joint arthrodesis of hallux valgus deformity and the maintenance of correction with and without the use of a stabilization screw between the first and second metatarsal bases. Sixty-three patients were evaluated, and 27 patients did not have a first to second metatarsal base screw and were placed into the no screw group. Thirty-six patients had a first to second metatarsal base screw and were put in the screw cohort. This study population had an osseous union rate of 95 percent. Clinical and radiographic recurrence transpired in five of 63 patients. At 12-month post-op the measurements showed the screw cohort had an average intermetatarsal angle correction of 11.6 degrees compared to 7.8 degrees for the no screw cohort. At one-year post-op the screw cohort also had more maintenance of the intermetatarsal angle correction with an average change of 0.5 degrees compared to 2.3 degrees in the no screw cohort. This supports the conclusion that adding the stabilization screw improves the first tarsometatarsal joint arthrodesis construct and implements a greater degree of realignment and maintenance of correction.

From the article of the same title
Journal of Foot & Ankle Surgery (02/27/22) Jones, Jacob M.; Schleunes, Scott D.; Vacketta, Vincent G.; et al.
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Outcomes of Surgical Reconstruction Using Custom 3D-Printed Porous Titanium Implants for Critical-Sized Bone Defects of the Foot and Ankle
A study was held to evaluate the outcomes of patients who received custom three-dimensionally (3D)-printed implants made with medical-grade titanium alloy powder to treat critically sized defects (CSDs) of the foot and ankle to help surgeons in selecting suitable surgical candidates. A total of 39 patients received a custom 3D-printed implant with at least one year of follow-up. The mean follow-up time was 27 months, and 13 cases required a secondary surgery and 10 required excision of the implant due to septic nonunion or aseptic nonunion. The average time to secondary surgery was 10 months, while multivariate logistic regression showed patients with neuropathy were more likely to require a secondary surgery with an OR of 5.76. Seventy-four percent of patients who received a custom 3D-printed implant for CSDs did not need subsequent surgery.

From the article of the same title
Foot & Ankle International (02/24/2022) Abar, Bijan; Kwon, Nicholas; Allen, Nicholas B.; et al.
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The Long-Term Clinical Results of Total Talar Replacement at 10 Years or More After Surgery
A study assessed the long-term clinical results of total talar replacement for at least 10 years after the procedure, with nine ankles in 18 patients (one male and 17 female) treated for osteonecrosis of the talus from October 2005 to April 2011. The average follow-up period was 152 months. The median scores for all subscales of the Ankle Osteoarthritis Scale (AOS) significantly improved, while the median Japanese Society for Surgery of the Foot (JSSF) Ankle-Hindfoot Scale score also improved from 58 to 97. In the JSSF subcategories the median pain score improved from 20 to 40 while the median function score improved from 28 to 47. The median postoperative range of motion of the ankle was 45 degrees. Subsidence of the implant was not identified at the final follow-up, and diffusion of osteophytes and degenerative changes in the adjacent joints did not impact the overall results.

From the article of the same title
Journal of Bone and Joint Surgery (02/22) Morita, Shigeki; Taniguchi, Akira; Miyamoto, Takuma; et al.
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Practice Management


Be Flexible When Selling Your Practice
Flexibility is paramount when selling a medical practice, and physicians should enter the process with reasonable expectations. Once a proper valuation has been undertaken, both seller and advisor should concur on the proper approach. The owner must ensure that they are at least somewhat flexible on price. Sellers should be wary of advisors who recommend downgrading the value of the practice in order to sell it quickly and also make sure that the advisor is thorough and fair and will not leave any money on the table because they are eager to close the deal. Not every sale follows an "all cash" model, so owners should be flexible enough to accommodate a combination of arrangements. Physician owners should also be flexible on the buyer, with the ultimate decision based on the numbers as well as who the buyer is. Patience is also a necessity in terms of valuation, finding buyers and finalization.

From the article of the same title
Physicians Practice (02/28/22) Hernandez, Nick
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Many Older Adults Still Have Not Received Care Delayed by COVID-19
The latest University of Michigan National Poll on Healthy Aging found the pandemic disrupted healthcare for some 30 percent of older US adults. Fourteen percent of 1,011 adults age 50 or older said they delayed, rescheduled or canceled a procedure, operation or test in the past year, and another 8 percent said their provider had done so. Fifteen percent of older adults reportedly postponed, rescheduled or canceled a visit to their primary care provider for a COVID-19-related reason in the past year, while 11 percent said their provider had done so. Although most respondents said they had made up the missed test, procedure or operation last year, rescheduling by vaccination status showed stark differences, with 44 percent of unvaccinated older adults rescheduling compared to 81 percent of vaccinated and boosted older adults. "Even as the pandemic continues, it's important for everyone to remember that COVID-19 is not the only risk to health," said poll director Preeti Malani. "It's important to make sure we are taking care of all the health needs of older adults, including care that may have been disrupted."

From the article of the same title
HealthDay News (03/03/22)
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The Tech Savvy Physician: How to Evaluate Technology for Your Practice
Physicians should research technology to see if it is appropriate for their practice, and Massachusetts-based urology practice owner Clifford Gluck advises tapping others' experience with using technology and studying the literature in terms of scientific evidence. "The best method is to evaluate current work flows and then see where the new tech fits in and how it will help the business or improve patient care," says Texas-based general surgery specialist Rafael A. Lugo. The next step is to consider the return on investment. Practices should not make such decisions quickly, as tech can be costly and they could wind up using it for years even if a better solution emerges. Ewa Matuszewski, CEO of MedNetOne Health Solutions in Rochester, Mich., suggests looking at the response time of the customer relations department, as long waits for resolution and a lack of follow-up could make the practice rethink its tech acquisition. Redirect Health President David Berg says when choosing technology, "you don't want to put too much weight on the importance of reviews from other practices unless they are ones you personally know or trust. Building a network that you do trust is an important step for a practice and an effective way to get reliable reviews on new technology you may be considering."

From the article of the same title
Medical Economics (02/28/22) Loria, Keith
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Health Policy and Reimbursement


Employers Are Saving Money by Moving Retirees to Medicare Advantage — but the Switch May Disrupt Care
Many US employers are using the government's Medicare Advantage program as a money-saving substitute for their existing retiree health plan and traditional Medicare coverage. However, retirees' healthcare may be disrupted if the plan no longer covers their doctors and hospitals, or the insurer has new mandates or assesses new fees to access benefits. Employer-sponsored plans receive billions of in federal payments, as well as automatic waivers to some requirements that apply to the policies available to individual beneficiaries. Unlike traditional Medicare, the government pays the insurers that sell Medicare Advantage plans a fixed amount every month for each member they enroll. The Centers for Medicare & Medicaid Services (CMS) reports that the number of beneficiaries in employer-sponsored Medicare Advantage plans has risen from about 1.6 million in 2008 to more than 5 million in 2021. However, CMS is not a party to negotiations among insurers and employers, so it lacks details about how many or which companies are following this strategy or the federal cost for each retiree group.

From the article of the same title
Fortune (03/02/22) Jaffe, Susan
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Medicaid Enrollment Is at an All-Time High. Millions May Soon Get Kicked Off.
Up to 15 million Americans may lose their Medicaid coverage as soon as April as a pandemic rule winds down, even as almost one in four are currently covered. A record 76.7 million people were enrolled in Medicaid as of July 2021, encouraged by a moratorium on eligibility status checks authorized by the Families First Coronavirus Response Act. The end of the pause is worrisome, as some low-income people may lose coverage simply by not knowing that they must provide income verification to continue their coverage under the program. Some healthcare supporters are concerned about the ability of states to manage eligibility checks for a record-high number of enrollees at a time when agency staffing levels may be low. The Urban Institute's Matthew Buettgens says states "are going to have to determine eligibility for a larger population than they have ever had, and potentially very quickly,"

From the article of the same title
CBS News (03/01/22) Picchi, Aimee
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Medicine, Drugs and Devices


A Group of Hospitals Has a Plan to Get Around Congress's Refusal to Lower the Cost of Insulin
A consortium of US hospitals aims to drastically reduce insulin costs for diabetics and circumvent Congress's refusal to do so. The group's nonprofit, Civica Rx, said it intends to fabricate and sell generic versions of insulin at no more than $30 per vial and $55 for five injector-pen cartridges, versus list prices ranging from $125 to more than $500. Civica Rx is about two-thirds of the way through in raising $125 million in capital from its member hospitals, charitable foundations and Blue Cross Blue Shield insurance plans and has partnered with Indian drugmaker Genesys to manufacture insulin drug substance for import to the US A Civica Rx drug plant in Virginia, once completed, will then finish the drugs and fill vials, with a capacity of up to 100 million vials annually. Civica Rx CEO Martin VanTrieste said once production starts, the business will be sustainable without requiring more charitable subsidies.

From the article of the same title
Washington Post (03/03/22) Rowland, Christopher
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Amazon's Voice Assistant Alexa to Start Seeking Doctor Help
Through a partnership between Amazon and telemedicine provider Teladoc Health, owners of Amazon's Echo devices can receive medical help through the Alexa voice assistant. Users need only create an Alexa voice ID and tell the voice assistant that they wish to speak to a doctor. This will connect them to a Teladoc call center, and they will receive a call back from a Teladoc physician on the device. Teladoc's Chris Savarese said Amazon cannot access, record or store the content of the calls. The calls initially will be audio-only, but video is expected to be added soon. Kate McCarthy at research firm Gartner said Amazon's healthcare segment in its cloud computing division is tasked with developing new healthcare services and products, which eventually could involve using Alexa and sensors to monitor patients after a hospital stay.

From the article of the same title
Associated Press (02/28/22) Murphy, Tom; D'Innocenzio, Anne
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The Problem With Wearables Is Bigger Than Just Wearability
A Software Advice poll of more than 450 patients prescribed wearables found technical and design issues are a hindrance, along with little education on using the mHealth devices and how they will enhance care management. Over 85 percent of respondents have had problems using the devices and uploading inaccurate data. Of those who complained of getting inaccurate data, 54 percent said it was unclear how they were supposed to upload data from the devices to their care provider, while 31 percent said the interface was confounding and 15 percent cited malfunctions. Meanwhile, 31 percent said the devices lead to less frequent office visits, which hurt their relationship with their care provider; 8 percent mentioned reduced quality of care and 5 percent said wearables complicate care management. "Prescribers need to be fully aware of their patients' comfort levels with technology in order to offer user training and support that is tailored to individual patients' abilities and knowledge base," the authors contended.

From the article of the same title
HealthLeaders Media (03/03/22) Wicklund, Eric
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This Week @ ACFAS
Content Reviewers

Caroline R. Kiser, DPM, FACFAS

Elynor Giannin Perez DPM, FACFAS

Britton S. Plemmons, DPM, 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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