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AOS/MOS PROGRAM

2018

Alabama Orthopaedic Society&

Mississippi Orthopaedic SocietyAnnual Meeting

May 17-19, 2018Grand Hotel, Marriott

Point Clear, AL

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CONTINUING MEDICAL EDUCATIONACCREDITATION STATEMENT

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American Academy of Orthopaedic Surgeons and the Alabama Orthopaedic Society. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians. The American Academy of Orthopaedic Surgeons designates this live activity for a maximum of 10.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.________________________________________________________________________CME Certificates will be sent to you by e-mail from AAOS.______________________________________________________________________Meeting Evaluation Forms are in your registration envelopes. Please complete these at the conclusion of the meeting on Saturday and return to the registration desk or send to:AOS: email terri@aosdocs.com / FAX 334-460-9925. MOS: email: acunningham@capitolresourcesllc.com /FAX 601-948-1506 This information is helpful in planning future Annual Meetings and in maintaining Category 1 CME accreditation.________________________________________________________________________Participants have disclosed whether they have received something of value from a commercial company or institution. The Alabama and Mississippi Orthopaedic Societies have identified the option to disclose as follows:1. Royalties2. Speakers bureau/paid presentation3. (a)-employee or (b)-paid consultant or (c)-unpaid consultant4. Stock or stock options5. Research or institutional support as a PI6. Other financial or material support7. Royalties, financial or material support from publishersn Nothing to disclose

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ALABAMA ORTHOPAEDIC SOCIETYBOARD OF DIRECTORS

President.....................................................................Howard Miller, M.D. Past-President..................................................................Chris Heck, M.D. Secretary-Treasurer...................................................James G. Davis, M.D. Member-at-Large..................................................James V. Worthen, M.D. Member-at-Large.....................................................Fleming Brooks, M.D. Member-at-Large ................................................ Shawn R. Gilbert, M.D.Member-at-Large ................................................. Eugene Brabston, M.D. Councilor to AAOS...................................................Howard Miller, M.DCouncilor to AAOS...........................................Robert C. Baird, III, M.D. Resident Member-at-Large (UAB) .............................. Erin Ransom, M.D.Resident Member-at-Large (USA) .........................Alex MacDonell, M.D.

2018 Program Planning CommitteeHoward Miller, M.D.

Terri Mendez

Chestley L. Yelton Resident Essay Competition CommitteeRobert Maples, M.D.

Lee Murphy, M.D.Grant Zarzour, M.D.

Executive DirectorTerri Mendez

MISSISSIPPI ORTHOPAEDIC SOCIETYBOARD OF DIRECTORS

President….................................................................. Kurre Luber, M.D.President-Elect….............................................. William McCraney, M.D.Past-President…................................................... Russell C. Linton, M.D.Secretary-Treasurer…...................................... Benjamin Stronach, M.D.Member-at-Large….................................................. Austin Barrett, M.D.Member-at-Large..........................................................… Jim Hurt, M.D.Councilor to AAOS................................................… Jeff Kennedy, M.D.

2018 Program Planning CommitteeJim Hurt, M.D.

Kurre Luber, M.D.Adair Cunningham

Gene Barrett Resident Essay Competition CommitteeAustin Barrett, M.D.

Jim Hurt, M.D.Kurre Luber, M.D.

George Russell, M.D.

Executive DirectorAdair Cunningham

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Disclosures

Participants have disclosed whether they have received something of value from a commercial company or institution. The Alabama and Mississippi Orthopaedic Societies have identified the option to disclose as follows:1. Royalties2. Speakers bureau/paid presentation3. (a)-employee or (b)-paid consultant or (c)-unpaid consultant4. Stock or stock options5. Research or institutional support as a PL6. Other financial or material support7. Royalties, financial or material support from publishersn Nothing to disclose

Eildar Abyar, M.D (n)Jeremy Adams, MD (n)Joseph Anderson (n)Robert Anderson, MD Foot & Ankle International Editorial & Governing Board; 1.

Arthrex, Inc., DJ Orthopaedics, Wright Medical Technologies, Zimmer; 3b. Amniox, Arthrex, DJ Orthopaedics, Wright Medical Technologies, Zimmer; 6. Saunders Mosby-Elsevier; 7. Saunders Mosby-Elsevier;

James R. Andrews, MD. 3b. Bauerfiend, Biomet; 4. Connective Orthopaedics; 5. Fast Health Corporation, Research Support: MiMedx

Patrick Barousse, MD (n)Austin Barrett, MD (n)Mark T. Begonia (n)Blake Bell, JD (n)Hamed A. Benghuzzi, PhD (n)Patrick F. Bergin, MD 2. Acumed, LLC, Synthes; 5. SynthesMajor Extremity

Trauma Research Consortium Joseph A. Bosco III, MD The Orthopedic Learning Center (board member), Bulletin

of The Hospital for Joint Diseases (editorial/governing board), Journal of Bone and Joint Surgergy - American (editorial/governing board); 1. Genovel, Relative Risk Solutions; 2. Medtronic, Pacira; 3a. Labrador Healthcare Consulting; 3b. Genovel, Medtronic, Surgical Direction Consulting; 4. Genovel

Jeffery Brewer, MD (n)Congressman Mo Brooks (n)Matthew Christie, M.D. (n)Kyle Cichos KH, BS (n)MJ Conklin, MD (n)Fred Corley, MD (n)Adair Cunningham (n)Will Cutchen, MD (n)Nic Dahlgren, B.S. (n)Wood W. Dale (n)Casey Davidson, MD (n)Michael Dedwylder, BA (n)Jesse DeLee, MD (n)George El-Bahri D.O, (n)Sean Farrell (n)Jacob Folse, MD (n)Thomas Fowlkes, MD (n)Christopher Fuchs C, MD (n)Shawn Gilbert, MD (n)Jonathan Gillig, MD (n)Matthew L. Graves, MD AAOS (board member), American Orthopaedic Association

(board member), Orthopaedic Trauma Association (board member); 2. Synthes ; 3b. DePuy, A Johnson & Johnson Company

B.G. Griswold, BS, MD (n)Charles E. Hill, MD (n)Park Hudson, MD (n)Allison Hunter, MD (n)Sam Huntley, BS (n)Jim Hurt, MD (n)Josie Hydrick, BS, RN (n)LaRita C. Jones, PhD (n)Steve Jordan, MD 2. Veritas Surgical Solutions; 5 ArthrexJeff Kennedy, MD (n)Daniel Kim, MD (n)Eva Lehtonen, BS (n)Russell Linton, MD (n)Kurre Luber, MD (n)

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LaRita C. Jones, PhD (n)Steve Jordan, MD 2. Veritas Surgical Solutions; 5 ArthrexJeff Kennedy, MD (n)Daniel Kim, MD (n)Eva Lehtonen, BS (n)Russell Linton, MD (n)Kurre Luber, MD (n)Scott Mabry, MD (n)

Alex MacDonnel, MD (n)Allen Maples, MD (n)Richard Marks, MD 2. Acumed; 3b.Stryker, Integra, OsteomedDan Matthews 2, 3b. Results Physical Therapy, HalyardMichelle McClenny, BSN (n)J.L. McFadden, MD, (n)Robert McGuire, MD AO Foundation (board member), Journal of Spinal

Disorders (editorial/governing board) ; 3b. ZavationSiddhant K. Mehta, MD, PhD (n)Terri Mendez (n)Richard Meyer, M.D 3b. Medical Director Nutech BiomedicalHoward Miller, MD (n)Heather Minton, BS (n)David Moore, MD (n)

Lee Murphy, MD2., 3c. Arthrex, Inc., 2. DJO Orthopaedics, 2., 3b. Smith & Nephew

Sameer Naranje, MD (n)Harshadkumar Patel, MD (n)Jeffrey Pearson, MD (n)Jorge Perez, MD (n)Sierra Phillips, MD (n)Martim Pinto, MD (n)Brent Ponce, M.D. 2. Tornier; 3B. Tornier; 5.TornierMark Prevost, MD (n)Kevin Purcell, MD (n)Jonathan Quade, MD (n)Erin Ransom, MD (n)William H. Replogle, PhD 6. wife employed by Allergan

George V. Russell Jr, MDAAOS (board member), Orthopaedic Trauma Association (board member); 2. AONA; 4. SMV, Zimmer

Rajaram Sakthival, M.D. (n)Ashish Shah, M.D. (n)Evan Sheppard, ED, MD (n)Jordan Smith, BS (n)Kenneth Smith, MD (n)Wilburn Smith, MD 3b. NHS Management, LLCClay A. Spitler, MD AAOS (board member), Orthopaedic Trauma Association

(board member), Journal of Bone and Joint Surgery (editorial/governing board); 2. AO Trauma; 5. Synthes

Austin Starnes, MD. (n)Daxton Steele, MD 3b.OrthoCor

Benjamin M. Stronach, MD

Mississippi Orthopaedic Society (board member); 3c. Tighline Development LLC; 4. Joint Development LLC; 5. DePuy, A Johnson & Johnson Company

Michelle Tucci, PhD (n)Marion S. Ward, MD (n)Shawn Watson, PhD (n)Bradley Wills, MD (n)Jack Wilson (n)James Worthen, MD (n)Brad Young, MD (n)Patrick Young, MD (n)Grant Zarzour, MD (n)

Disclosures

Adair Cunningham (n)Jim Hurt, M.D. (n)Kurre Luber, M.D. (n)Terri Mendez (n)Howard Miller, M.D. (n)

Adair Cunningham (n)Terri Mendez (n)

Planning Committee

Association Staff

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Colleagues and Participants--

Welcome to the 2018 combined meeting of the Alabama and Mississippi Orthopaedic Societies. We have assembled a scientific program that includes something of interest to all, no matter your scope of practice, as well as updates on the political scene and issues concerning the practice of orthopaedics. And there is plenty of time available to explore this part of Alabama, so whether you enjoy golfing, fishing, shopping, or relaxing at the spa, this area provides unlimited choices.

We appreciate the exhibitors’ and sponsors’ involvement--spend some time in the exhibit hall and express our appreciation of their participation.

And I hope you plan to stay until the end of the program on Saturday, as there will be some potential rewards for those who do.

Wishing you an enjoyable and rewarding weekend.

Sincerely,

Howard Miller, M.D.President, Alabama Orthopaedic Society

ALABAMA ORTHOPAEDIC SOCIETYPresidential Welcome

AOS PresidentHoward Miller, M.D.

MISSISSIPPI ORTHOPAEDIC SOCIETYPresidential Welcome

MOS PresidentKurre Luber, M.D.

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MISSISSIPPI ORTHOPAEDIC SOCIETYPresidential Welcome

MOS PresidentKurre Luber, M.D.

Dear Colleagues and Guests:

It is my pleasure to welcome you to Point Clear and to the 2018 Joint Annual Meeting of the Alabama and Mississippi Orthopaedic Societies. We are glad you are here and look forward to an exciting weekend of educational and networking opportunities.

We have an interesting scientific program this year including multiple presentations from members in Mississippi and Alabama featuring an array of topics. We are also pleased to have several renowned guest speakers. Dr. Robert Anderson, surgeon to many star athletes, has recently joined the Green Bay Packers’ Medical Team and will be presenting updates on sports related foot and ankle injuries. In addition, Dr. Fred Corley who is currently a Professor with the Department of Orthopaedics at the University of Texas Health Science Center at San Antonio, and has authored numerous scientific publications and presentations will be presenting on hand and systemic disease. Dr. Jesse DeLee will be joining us as well. Dr. DeLee currently serves as clinical professor in the Department of Orthopaedic Surgery at the University of Texas Health Science Center. Dr. DeLee specializes in Sports Medicine and Surgery and Diseases of the Hip and Knee. We will also hear from Dr. Joseph Bosco, AAOS Second President-Elect, Dr. Richard Marks, Professor and Chair of Orthopaedics at the University of South Alabama, and Dr. Thomas Fowlkes, a founding partner of Oxford Treatment Center and former Chief Medical Officer. Representative Mo Brooks (R-AL) will provide legislative updates and discuss key issues in Washington, DC.

We appreciate your support and are glad you could join us. Please be sure to visit the exhibit hall to interact with and experience remarkable technology advances from many exhibiting companies.

We also hope you and your guests will enjoy the many amenities of the area. The Alabama Gulf Coast and the Grand Hotel provide wonderful opportunities to enjoy, sun and sand, and the picturesque town of Fairhope. Our social activities include a golf outing on Friday afternoon at the Marriott Azalea Course or fishing in the Bay. We kick off the Meeting with a Welcome Reception on Cannon Park Lawn at 5:30pm on Thursday. Please also plan to join us Friday evening for the Presidential Reception and Dinner on Julep Point. I hope you enjoy the 2018 Joint Annual Meeting!

Sincerely,

Kurre Luber, MDPresident, Mississippi Orthopaedic Society

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MISSISSIPPI ORTHOPAEDIC SOCIETY PRESIDENT’S

DISTINGUISHED GUEST

Robert Anderson, M.D.

Robert B. Anderson, MD is the founding orthopaedic surgeon of the O.L. Miller Foot and Ankle Institute of OrthoCarolina in Charlotte, North Carolina, practicing there since 1989. Recently joined the Titletown Sports Medicine and Orthopaedic Clinic in Green Bay. Fellowship trained in foot and ankle disorders (Dr John Gould, Milwaukee WI ’88) with a large experience in sport related injuries. Served as a team orthopaedist to the Carolina Panthers from 2000-2017 and now an associate team physician to the Green Bay Packers. Has served as the chairman of the Foot and Ankle Subcommittee for the NFL since 2003. Recently named the co-chair of the NFL’s Musculoskeletal Committee, overseeing all orthopaedic injuries and research in professional football. Is an active consultant to a number of NFL/NBA/NHL/MLB teams and colleges.

Co-founder of the OrthoCarolina Foot and Ankle Fellowship program. Chief of the Foot and Ankle Service at Carolinas Medical Center from 1989-2015, and past Vice-chief of the Department of Orthopaedic Surgery at that institution. He is a Past President of the Medical Staff of Carolinas Medical Center and it’s >1700 physician members. Anderson is also a past-president of the American Orthopaedic Foot and Ankle Society. Co-editor of the 9th edition of Mann’s: Surgery of the Foot and Ankle; former Editor-in-Chief of the journal, Techniques in Foot and Ankle Surgery; associate editor/reviewer for JBJS, JAAOS, FAI, AJSM and numerous other peer-review publications and author/editor of numerous chapters and manuscripts.

Born in Milwaukee, Wisconsin and attended the University of Mississippi where he was inducted into their Hall of Fame. He completed his medical degree at the Medical College of Wisconsin.

He is married to Jean, and has three sons. Hobbies include lawn care, golf and boating/snowshoeing at his lake home in his native state.

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ALABAMA ORTHOPAEDIC SOCIETY PRESIDENT’S DISTINGUISHED GUEST

Fred Corley, M.D.

Dr. Corley is an accomplished hand surgeon with additional expertise in the wrist, and special expertise in the care of elbow fractures. He is a Professor of Orthopaedics at the Health Science Center and a former President of the Texas Orthopaedic Association. He has been on the university faculty and directed the Hand Surgery Service since 1982.

Dr. Corley earned his Doctor of Medicine degree at the University of Mississippi and completed his internship at Parkland Hospital and The University of Texas Southwestern Medical School in Dallas. Following his internship, he served on active duty with the United States Air Force, eluding a tour of duty in Da Nang during the Vietnam War. He completed a residency in Orthopaedic Surgery at The University of Texas Medical School at San Antonio in 1978 and followed that with postgraduate training, including a fellowship in Hand Surgery and Sports Medicine at the University of Virginia School of Medicine; and an Adult Reconstruction and Rheumatoid Surgery fellowship at Princess Margaret Rose Orthopaedic Hospital in Edinburgh, Scotland.

He has been listed in “The Best Doctors in America,” been named “Faculty of the Year” at the Health Science Center and “Alumnus of the Year “at the College of Arts and Sciences, Mississippi State University. He is a member of the Board of Regents at Mississippi State University.He teaches medical students and residents and sees patients at University Hospital and University Health System clinics; the South Texas Veterans Health Care System, Audie Murphy Division; and Wilford Hall Medical Center.He is the author of numerous scientific publications and presentations regarding hand and elbow injuries, microsurgery, pain, carpal tunnel syndrome, and many other topics.

He is a member of ten professional orthopaedic associations and served as President of the Texas Orthopaedic Association from 2001-2002.He is also a consultant in Orthopaedics and Sports Medicine for athletic teams at The University of Texas at Austin, St. Mary’s University in San Antonio and The University of Texas at San Antonio.

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ALABAMA ORTHOPAEDIC SOCIETY PRESIDENT’S DISTINGUISHED GUEST

Jesse DeLee, M.D.

Jesse C. DeLee, MD was raised in Port Arthur, Texas, and graduated from Thomas Jefferson High school in 1964. He attended the University of Texas in Austin and Lamar College. Dr. DeLee graduated from the University of Texas Medical Branch at Galveston in 1970. He was awarded membership in Alpha Omega Alpha National Honor Society (AOA) his junior year. He completed his orthopaedic residency at the University of Texas Health Science Center at San Antonio (UTHSCSA) in 1975 followed by a fellowship in joint reconstruction surgery with Sir John Charnley in Wrightington, England. He was awarded the American-British-Canadian Traveling Fellowship in 1983.

From 1978 to 1983 he served as full time faculty at UTHSCSA, where he still maintains a clinical professorship in orthopaedic surgery and teaches residents. In 1988, he founded the ACGME-accredited sports medicine fellowship at UTHSCSA. In addition to his academic accomplishments at the University, Dr. DeLee founded the Nix Hospital Sports Medicine Clinic in 1983. This clinic provides comprehensive sports medicine care for high school and college athletes in San Antonio and South Texas. With his partner Dr. John Evans, he established the DeLee- Evans Foundation for Sports Medicine, which has awarded over 85 college scholarships to high school students with an interest in athletic training.

Dr. DeLee’s has contributed to the orthopaedic surgery literature through more than 50 peer reviewed articles and 17 textbook chapters. Dr. DeLee is most proud of founding and co-editing with Dr. David Drez the textbook Orthopedic Sports Medicine: Principal and Practice, currently in its 3rd edition

Dr. DeLee has fostered education in Sports Medicine through his Chairmanship of the Annual Sports Medicine Symposium, jointly sponsored by the University of Texas Health Science Center at San Antonio and the Department of Athletics of University of Texas at Austin since 1980. This course is held annually and attracts over 500 attendees including Athletic Trainers, Orthopaedic Sports Medicine Physicians, Physical Therapists, Nurse Practitioners and Physician Assistants.

Dr. DeLee co-edited the first AOSSM Sports Medicine Fellowship examination. He continues to serve as Co-Chairman of the AOSSM Sports Medicine Examination Committee. Additional leadership positions held by Dr. DeLee include:

• Reviewer, The Journal of Bone and Joint Surgery, The American Journal of • Sports Medicine, and Arthroscopy• Co-editor, Operative Techniques in Sports Medicine(1992 – 2012)• Member, Board of Trustees of The Journal of Bone and Joint Surgery (1999 – 2006)• Member / Committee Member: American Academy of Orthopaedic Surgeons, the

American Orthopaedic Association, AOSSM, The Knee Society, American Orthopaedic Foot and Ankle Society, Herodicus Society

• Founding member, Arthroscopy Association of North America• Chair, UTHSCSA Annual Symposium on Sports Medicine• Chair, University Interscholastic League (UIL) Medical Advisory Committee, responsible

for oversight of all medical aspects of high school athletics in Texas

Dr. DeLee was inducted into the American Orthopaedic Society of Sports Medicine Hall of Fame on July 21, 207, joining the founders of this specialty

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Dr. Marks is Professor and Chair of Orthopaedics at the University of South Alabama. Formerly the director of the Foot and Ankle Fellowship at the Medical College of Wisconsin, he joined USA in 2017.

Dr. Marks completed medical school at Sidney Kimmel Medical College and residency at Thomas Jefferson University. He completed a Foot and Ankle fellowship in Baltimore, Maryland at Union Memorial Hospital. Dr. Marks serves as a reviewer of Techniques in Foot and Ankle Surgery Journal and Journal of the American Academy of Orthopaedic Surgeons, as well as an associate editor of Clinical Orthopaedics and Related Research.

Dr. Marks is a diplomat of the American Board of Orthopaedic Surgery and a member of the American Academy of Orthopaedic Surgeons, American Orthopaedic Foot and Ankle Society, American College of Surgeons and American Orthopaedic Association.

Clinical InterestsTreatment of sports injuries of the foot and ankle; Ankle replacement surgery; Achilles’ tendon disorders; Reconstructive surgery for flatfoot deformity; Neuropathic disorders; Forefoot surgery including bunion and hammertoe correction

Research InterestsOutcomes analysis of total ankle replacement and ankle fusion; Gait lab analysis of ankle arthritis, posterior tibial tendon dysfunction and rheumatoid arthritis disorders

SOUTHEAST ORTHOPAEDIC FOOT CLUB GUEST SPEAKER

Richard Marks, M.D.

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AAOS SECOND VICE-PRESIDENT

Joseph Bosco III, M.D.

Joseph A. Bosco, III, MD is Vice Chairman for Clinical Affairs of the NYU Langone Department of Orthopedic Surgery, and Professor of Orthopedic Surgery at New York University School of Medicine. Dr. Bosco has served as team physician for the Durham Bulls and Brooklyn Cyclones minor league baseball teams. From 2002 until 2004, he was a team physician for the New York Mets professional baseball team. He is a member of and held leadership positions in numerous professional societies, including The American Orthopedic Society for Sports Medicine (former member Board of Councilors), The American Orthopedic Association, The American Academy of Orthopedic Surgery (Former BOD member and presently Chair of the Annual Meeting Committee), The New York Academy of Medicine, The Eastern Orthopedic Association and the New York State Society of Orthopedic Surgeons (currently Vice President). He is the immediate past president of the BOD of The Orthopaedic Learning Center and served on the BOD of The Association of Professionals in Infection Control. He was chosen to, and completed, the prestigious American Academy of Orthopedic Surgeons Leadership Fellows Program.

Dr. Bosco has published and lectured, both nationally and internationally, on Alternative Payment Models and healthcare policy.

Thomas Fowlkes, M.D.

Thomas Fowlkes, MD is co-founder of the Oxford Treat-ment Center and is a Board Certified Addiction Medi-cine Specialist as well as Board Certified in Emergency Medicine. Dr. Fowlkes has over 18 years of senior health care experience as the Medical Director of both inpatient and outpatient behavioral healthcare service providers. Dr. Fowlkes’ vast knowledge and experience treating chemical dependent patients and families leads the Ox-

ford Treatment Center’s commitment to clinical excellence and quality patient outcomes. Dr. Fowlkes has practiced medicine in the Oxford / Lafayette County area for over 20 years and is well respected and integrated into the medical community.

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Congressman Mo Brooks (R-AL) is the Representative for Alabama’s 5th Congressional District. He proudly represents the people of North Alabama and serves on three important committees: Armed Services, Science, Space, and Technology, and Foreign Affairs. Brooks supports America’s missile defense technologies; he introduced successful legislation in 2011, 2012, and 2013 that blocked the White House from sharing classified missile technologies with Russia, and was adapted into the National Defense Authorization Act in FY2012.

Rep. Brooks is also a vocal opponent of sequestration, voting against the Budget Control Act and called upon Administration officials to account for the consequences of sequestration in a HASC Strategic Forces Subcommittee hearing on April 18, 2012.

During his first year on the Hill, Brooks founded and became co-chairman of the Army Aviation Caucus, a forum in which Members of Congress, staff, and Army leadership raise awareness for Army Aviation and seek to affect legislative priorities. The Caucus now includes more than 40 members and is one of the most active caucuses on Capitol Hill.

Rep. Brooks graduated from Duke University with a double major in political science and economics, with highest honors in economics. In 1978, he graduated from the University of Alabama Law School. After graduation, Rep. Brooks worked as a prosecutor in the Tuscaloosa District Attorney’s office, where he built a solid “tough-on-crime” reputation. While there, he obtained guilty verdicts in every one of the 20-plus jury trials he prosecuted. He also organized and managed the grand jury.

In 1982, Brooks was elected to the Alabama House of Representatives and was reelected to the Alabama House in 1983, 1986, and 1990.

Mo Brooks is married Martha Jenkins of Toledo. Mo and Martha are the proud parents of four children and grandparents of eight grandchildren.

CONGRESSMAN

Mo Brooks(R- Huntsville, AL)

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GOALS AND OBJECTIVES OF THEAOS/MOS JOINT 2018 ANNUAL MEETING

Program Overview:

The Alabama Orthopaedic Society (AOS) & The Mississippi Orthopaedic Society (MOS), in collaboration with the American Academy of Orthopaedic Surgeons (AAOS), recognize that advances in orthopaedic surgery and medicine occur at a rapid pace. The 2018 AOS/MOS Joint Meeting is a live opportunity to update practicing orthopaedists with educational programs from nationally known orthopaedic experts in numerous sub-specialty areas. This 2-day live conference provides a comprehensive overview of the newest therapies and procedures through advanced educational sessions.

Goals:1. Update members on new developments in orthopaedic surgery.2. Discuss recent economic and political changes that effect our specialty.3. Offer continuing medical education opportunities to our members.4. Notify members of recent developments in Washington DC that affect our specialty.5. Bringing together Orthopaedic surgeons from diverse practice backgrounds to collaborate and develop professional networking.

Objectives:1. Update members on the evolution of current treatment of orthopaedic diagnoses.2. To present recent research in multiple orthopaedic sub-specialties.3. Discuss the current political platform and situations that affects orthopaedic surgeons.4. Evaluate established and new technology in orthopaedic surgery exhibited by the medical industry via exhibits.

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Alabama Orthopaedic SocietyMississippi Orthopaedic Society

2018 Joint Meeting Program

THURSDAY, MAY 17, 2018

2:00-5:00 p.m. Attendee Registration Grand Ballroom Foyer Exhibitor Set-Up Grand Ballroom North

3:00-5:00 p.m. AOS Board of Directors Meeting Magnolia 2 5:30-7:00 p.m. Welcome Reception Cannon Park Lawn

7:30 p.m. Board of Directors Dinner Grand Ballroom Patio Outside of Conference Center (invitation only)

FRIDAY, MAY 18, 2018

6:30-7:30 a.m. Registration Grand Ballroom Foyer American Breakfast Grand Ballroom North Exhibits Open Grand Ballroom North

FIRST SCIENTIFIC SESSIONGrand Ballroom South

7:30-7:35 a.m. Welcome and Opening Remarks Howard Miller, M.D., President, AOS Kurre Luber, M.D., President, MOS 7:35-7:40 a.m. (1) Surgical Decompression for Thoracic Outlet Syndrome in Adolescent Patients Erin Ransom, M.D. (UAB) 7:40-7:45 a.m. (2) Custom Triflange Acetabular Components for Large Acetabular Defects: 10 year minimum Follow-up Bradley Wills, M.D. (UAB)

7:45-7:55 a.m. Questions & Discussions

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Southeastern Orthopaedic Foot Club Guest Speaker

7:55-8:20 a.m. Mid-term Pospective Clinical and Radiographic Outcomes of a Modern Fixed-bearing Total Ankle Arthroplasty Richard Marks, M.D.

8:20-8:30 a.m. Questions and Discussion

8:30-8:35 a.m. (3) The Effect of a Dynamic Fixation Construct on Syndesmosis Reduction: A Cadaveric Study Matthew Christie, M.D. (UAB)

8:35-8:40 a.m. (4) Staple Versus Suture Closure for Ankle Fracture Fixation: Retrospective Chart Review for Safety and Outcomes Kenneth Smith, M.D. (UAB) 8:40-8:45 a.m. (5) Tibial Shaft and Pilon Fractures with Associated Syndesmotic Injury: Complex Injury Pattern Fraught with Complications Kevin Purcell, M.D. (UMMC)

8:45-8:55 a.m. Questions and Discussion

Mississippi Presidential Guest Speaker

8:55-9:00 a.m. Introduction Presidential Guest Speaker Robert Anderson, M.D.

9:00-9:40 a.m. Updates on Sports Related Foot & Ankle Injuries Robert Anderson, M.D.

9:40 - 9:50 a.m. Questions and Discussion

9:50-10:20 a.m Break in Exhibit Hall - Grand Ballroom North

Alabama Presidential Guest Speaker

10:20-10:25 a.m. Introduction Presidential Guest Speaker Jesse DeLee, M.D.

10:25-10:50 a.m. Gravity Assisted Passive Flexion (Gap Flex) to improve Total Knee Replacement Results Jesse DeLee, M.D.

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10:50 - 11:00 a.m. Questions and Discussion

11:00 - 11:25 a.m. AAOS Update Joseph Bosco, M.D.

11:25-11:35 a.m. Questions & Discussions

11:35 - 12:35 p.m. Treating The Drug Addicted Patient Thomas Fowlkes, M.D. 12:35 - 12:45 p.m. Questions & Discussions 12:45 - 2:15 p.m. The Hazards of Drug Diversion Video

2:15 p.m. Adjourn

1:00-6:00 p.m. Activities On Your Own

1:30 p.m. Golf Event Azalea Golf Course (pre-register) Box Lunch & Soft Drinks Provided - Clubhouse

1:30 p.m. Fishing Event - Fuel Dock Grand Hotel Marina (pre-register) Box Lunch & Soft Drinks Provided

6:00-9:00 p.m. AOS/MOS Presidential Reception & Dinner Hosted by Gulf South Ortho, NHS, Prime Surgical, Alon Medical,Gentleman Orthopaedic Julep Point

SATURDAY, MAY 19, 2018

6:30-7:30 a.m. Registration Grand Ballroom Foyer American Breakfast Grand Ballroom North Exhibits Open Grand Ballroom North

SECOND SCIENTIFIC SESSIONGrand Ballroom South

7:30-7:35 a.m Welcome and Opening Remarks James Worthen M.D., AOS Jim Hurt, M.D., MOS Program Chair 7:35-7:40 a.m. (6) Effects of Fluoxetine on Fracture Healing in Rats Siddhant K. Mehta, MD (UMMC)

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7:40-7:45 a.m. (7) Risk Factors for Kidney Dysfunction with the Use of Gentamicin in Open Fracture Antibiotic Prophylaxis Jacob Folse, MD (UMMC) 7:45-7:50 a.m. (8) Civilian Ballistic Forearm Fractures: A Retrospective Review Siddhant K. Mehta, MD (UMMC)

7:50-8:00 a.m. Questions and Discussion

8:00-8:05 a.m. Introduction Congressman Mo Brooks

8:05-8:35 a.m. Washington Update Congressman Mo Brooks

8:35 - 8:45 a.m. Questions & Discussions

8:45-9:10 a.m Legislative Updates Howard Miller, M.D. and Blake Bell, JD

9:10-9:20 a.m. Questions & Discussions

Alabama Presidential Guest Speaker

9:20-9:25 a.m. Introduction Presidential Guest Speaker Fred Corley, M.D.

9:25-9:55 a.m. The Hand and Systemic Disease Fred Corley, M.D.

9:55-10:05 a.m. Questions & Discussions

10:05-10:35 a.m. Lefties Fred Corley, M.D.

10:35-10:45 a.m. Questions & Discussions

10:45-11:15 a.m. Break in Exhibit Hall

11:15-11:20 a.m. (9) Spinopelvic Dissociation: Comparison of Outcomes of Percutaneous versus Open Fixation Strategies Jeffrey Pearson, M.D. (UAB)

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11:20-11:25 a.m. (10) Viability of pedicle screw fixation of the second cervical spine CT scans Casey Davidson, M.D. (UMMC)

11:25-11:40 a.m. (11) Comparison of NPY Y1 receptors in the Spines of Ovariectomized and Ovary Intact Rats. Robert McGuire, M.D.

11:40-11:50 a.m. Questions and Discussion

11:50-11:55 a.m (12) Accurate Prediction of Antegrade or Retrograde Fermoral Intramedullary Implant Length from Patient Height: A Review of 608 Cases Matthew Christie, M.D. (UAB)

11:55-12:00 p.m. (13) Infection Rate in Open Tibia Fractures with use of Intraoperative Antibiotic Powder Mark Prevost, M.D. (USA)

12:00 - 12:05 p.m. (14) Humeral Head Cysts in Young Athletes: Their Relationship with Shoulder Pathology Daniel Kim, M.D. (USA)

12:05-12:15 p.m. Questions & Discussions

12:15 - 12:30 p.m. (15) Prospective Analysis of Surgeon Placed Saphenous Nerve Block and Continuous Indwelling Catheter in the Adductor Canal in TKA Daniel Matthews, M.D.

12:30-12:35 p.m (16) Is Choice of Approach Associated with Risk of Avascular Necrosis in Pediatric Septic Hip Scott Mabry, M.D. (UAB)

12:35-12:40 p.m. (17) The Effect of Sacrificing the Posterior Cruciate Ligament in Total Knee Arthroplasties that Use a Highly Congruent Polyethylene Component Jeremy C. Adams, M.D. (UMMC)) 12:40-12:45 p.m. (18) Patient Satisfaction Following Kinematic Alignment Technique of Total Knee Arthroplasty Jonathan Gillig, M.D. (USA)

12:45-12:55 p.m. Questions & Discussions

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12:55-1:00 p.m. (19) Trends and Risk Factors in Orthopaedic Lawsuits: Analysis of a National Legal Database Evan Sheppard, M.D. (AL)

1:00-1:05 p.m. (20) Outcomes with Overlapping-Surgery at Large Academic Medical Center Bradley Wills, M.D. (UAB)

1:05-1:15 p.m. Questions and Discussion

1:15-1:30 p.m. (21) Taming the Pre-Authorization Tiger Wilburn Smith, M.D. (AL)

1:30 - 1:40 p.m. Questions and Discussion

1:40 - 1:50 p.m. Announcement of Winners of Resident Essay Contests Yelton Essay Award (AL) Barrett Essay Award (MS) 1:50 - 2:00 p.m. Closing Remarks

2:00-2:30 p.m. AOS Business Meeting

2:30 p.m. Meeting Adjourns

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Surgical Decompression for Thoracic Outlet Syndrome in Adolescent Patients

Erin Ransom, MD1, Heather Minton, BS1, Brad Young, MD2, Brent Ponce, MD1, Richard Meyer, MD1

University of of Alabama School of Medicine

Introduction. Thoracic Outlet Syndrome (TOS) refers to compression of the neurovascular structures in the thoracic outlet region or subcoracoid space. The purpose of this study is to characterize surgical outcomes following nTOS decompression at a large referral center in adolescent patients and identify relationships between perioperative factors and these outcomes.

Methods. A retrospective chart review of adolescent patients aged 13-21treated surgically by a single surgeon for nTOS from 2000 and 2015, was conducted. The preoperative characteristics as well as intraoperative findings are described for these patients. In addition, patients with at least 24 months follow up were included in long-term follow up analysis. In these patients, clinical outcomes included the Quick Disabilities of the Arm, Shoulder and Hand Survey (quickDASH), the Cervical-Brachial Symptom Questionnaire (CBSQ), the 10-point visual analog scale (VAS) for pain, the Single Assessment Numeric Evaluation (SANE), and the neurogenic TOS index (nTOS index). Analysis of variance (ANOVA) was used to compare outcomes between patients with different mechanisms of injury including: idiopathic, trauma, and overuse from sports or occupation. In addition, patients with rib resection versus those without rib resection were compared.

Results. The study population consisted of 54 adolescents (61 arms) with a median age of 16.8 years. Mechanisms of injury primarily involved overuse in 31 patients (50.8%) or trauma in 13 patients (21.3%). Initial symptoms most frequently consisted of pain and numbness of the shoulder, arm, and/or hand. Preoperative physical exam included the Roos Test, Tinel’s Sign of the Neck, Upper Limb Tension test, Adson test, and Compression test. Forty-five patients (83.3%) had positive findings on TOS exam. Surgical procedures included neurolysis of the brachial plexus (60 extremities; 98.4%), anterior scalenectomy (59 extremities; 96.7%), middle scalenectomy (54 extremities; 88.5%), excision of the first rib (28 extremities; 45.9%), excision of cervical rib (5 extremities; 8.2%), excision of coracocostal ligaments (26 extremities, 42.6 %), pectoralis minor tenotomy (9 extremities, 14.8%), and subclavian artery manipulation (50 extremities, 81.9%). A second incision in the subcoracoid space was utilized in 28 (45.9%) extremities for exploration of the infraclavicular brachial plexus. Long-term follow-up including patient reported outcomes was collected for 24 patients. In this patient subset the average follow-up was 69.50 months and ranged from 24 months to 180 months. There was improvement in the VAS of 6.18 points from a preoperative average score of 8.18 and postoperative average score of 2.00. The average postoperative quickDASH and CBSQ scores were 11.36 with a range from 0 to 54.55 on a 100-point scale and 27.38 with a range from 0 to 92 on a 120-point scale, respectively. The average NTOS Index was 17.19. The average SANE score before surgery as 28.96 and after was 85.42, representing a patient reported improvement in functionality of 194.95%.

Conclusion. We present the largest series to date of adolescent patients undergoing thoracic outlet decompression. In addition, we show excellent results and improvement in clinical outcome scores of these patients after surgical decompression in the longest follow-up study of these patients to date in the literature.

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Custom Triflange Acetabular Components for Large Acetabular Defects: 10 year minimum follow-up

Bradley Wills, M.D., K. David Moore, M.D., Michelle McClenny, BSN

University of of Alabama School of Medicine

Abstract

Background: Compromise of bony support presents a difficult problem in acetabular revision surgery. Various methods have been proposed to cope with this issue with variable results and little long-term follow-up.

Methods: We reviewed the results of patients undergoing custom tri-flange revision surgery from the senior author’s practice between September 2001 and December 2005. 37 patients were identified. Two patients were lost to follow-up after less than 10 year follow-up leaving 35 patients with minimum 10 year clinical and radiographic follow-up.

Results: 32 of 35 (91%) components were unrevised and functioning well at minimum 10 year follow-up. One component placed for pelvic discontinuity loosened at 12 years from surgery but was converted to a conventional total hip. One component demonstrated failure of 3 ischial screws at 6 months but at 11 years, the patient shows no additional evidence of loosening either clinically or radiographically. Two components (6%) had been removed for infection. There were no dislocations. The average Harris Hip Score was 28 preoperatively and 90 postoperatively.

Conclusion: Revision of large acetabular defects with a custom tri-flange component resulted in reliably good to excellent results at minimum 10 year follow-up.

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Syndesmotic fixation with suture button. Neurovascular structures at risk. A

Cadaver Study.

Matthew Christie,M.D., Eva Lehtonen, B.S., Martim Pinto, M.D., Harshad Patel, M.D.,

Nic Dahlgren, B.S., Eildar Abyar, M.D., Ashish Shah, M.D.

Corresponding Author: Ashish Shah, M.D.

Background: Damage to distal tibiofibular syndesmosis occurs in 25% of operative ankle fractures.

Syndesmotic stabilization is crucial to prevent significant pain, instability and degeneration of the joint.

Suture button fixation is one common method of fixation, and though effective, this method can result in

entrapment and damage of the saphenous neurovasculature. The purpose of this study was to describe the

anatomic variations in the saphenous nerve and risk of direct injury to the saphenous nerve and greater

saphenous vein during syndesmotic suture button fixation.

Methods: Under fluoroscopic guidance, syndesmotic suture buttons were placed from lateral to medial at

1cm, 2cm, and 3cm above the tibial plafond on ten below knee cadaver leg specimens. The distance and

position of each button from the greater saphenous vein and saphenous nerve were evaluated.

Results: The mean distance of the saphenous nerve to the suture buttons at 1cm, 2cm, and 3cm were 7.1 ±

5.6mm, 6.5 ± 4.6mm, and 6.1 ± 4.2mm, respectively. Respective rate of nerve compression was as follows,

20% at 1cm, 20% at 2cm, 10% at 3cm. Mean distance of the greater saphenous vein from the suture buttons

at 1cm, 2cm, and 3cm was 8.6 ± 7.1mm, 9.1 ± 5.3mm, and 7.9 ± 4.9mm, respectively. Respective rate of

vein compression was 20%, 10%, and 10%. A single nerve branch was identified in seven specimens, and

two branches were identified in three specimens.

Conclusion: There was at least one case of injury to the saphenous vein and nerve at every level of button

insertion at a rate of 10-20%. Neurovascular injury during syndesmotic suture button fixation may be a

common occurrence despite vigilant use of fluoroscopy and adequate surgical technique.

Clinical Relevance: Further investigation into the use of direct medial visualization of these high-risk

structures should be done to minimize the risk.

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4

Staple Versus Suture Closure for Ankle Fracture Fixation: Retrospective Chart Review for Safety and Outcomes

Kenneth Smith, Ashish Shah, Eva Lehtonen, Harshadkumar Patel, Sierra Phillips, Martim Pinto, Sameer Naranje

University of of Alabama School of Medicine

Introduction: Ankle fractures are commonly treated fractures by orthopaedic surgeons with unique challenges to skin closure due to the lack of subcutane-ous support. This study aimed to evaluate the safety of staple closure for open reduction and internal fixation of acute traumatic ankle fractures. Methods: The medical records of 94 patients treated at our institution with open fixation of an acute traumatic ankle fracture by a single surgeon between January 2011 and June 2017 were retrospectively reviewed. Demographics, preoperative characteristics, operative characteristics, and postoperative out-comes were compared between patients who received superficial skin closure using staples versus suture techniques. Statistical analysis was performed using chi-squared test and Fisher’s exact test, with P=.05 used to denote statis-tical significance.

Results: The staple and suture group patients were demographically similar at baseline. Of the 94 patients included in this study, 10 patients developed local wound related complications postoperatively, including 5 with wound dehis-cence (2 staple, 3 suture), 4 with superficial wound infections (suture group), and 1 deep infection (staple group). Eight patients (2 staple, 6 suture) required revision surgery due to infection or wound dehiscence. With the numbers available, no significant differences could be detected in the incidence of sur-gical site infections (P =.361), local wound related complications (P = .316), or revision surgeries (P= .267) between wound closure technique. Discussion: Our data suggests that staple closure may be a safe alternative to sutures for superficial skin closure in healthy patients following open fixa-tion of acute traumatic ankle fractures. The potential benefits of staple closure include reduced closure time, faster and less painful removal, and improved cosmetic appearance.

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Effects of Fluoxetine on Fracture Healing in Rats

Siddhant K. Mehta, MD, Mark T. Begonia, PhD, Michelle A. Tucci, PhD, Hamed A. Benghuzzi, PhD, Patrick F. Bergin, MD, George V. Russell, MD

University of Mississippi Medical Center, Jackson, MS

Background: SSRIs are among the most commonly prescribed pharmacologic agents for treatment of anxiety & mood disorders. Interestingly, SSRIs have recently been associated with a reduction in bone mineral density, increased risk of fragility fractures, and attenuation of the inflammatory response. As such, SSRIs may delay osseous healing in the setting of orthopaedic trauma. In this series, we evaluate the in vivo effects of the selective serotonin reuptake inhibitor (SSRI) fluoxetine upon fracture healing.

Methods: A rat femoral fracture model was employed to study effects of systemic fluoxetine treatment on fracture healing. Structural and functional properties of the fracture callus were characterized. Quantitative differences between control and fluoxetine treatment groups were analyzed using one-way analysis of variance (ANOVA).

Results: No significant difference between control, low-, or high-dose fluoxetine groups was noted with respect to the structural properties of the fracture callus as assessed using early radiographic parameters and semi-quantitative histologic scoring. These findings correlated with micro-CT three-dimensional morphometric analysis demonstrating equivocal findings for total callus volume, mineralized callus volume, and mineralized volume fraction. The functional properties of the fracture callus as studied by biomechanical testing remained unaffected by fluoxetine exposure.

ConclusionFluoxetine treatment does not exert a negative effect on bone regeneration.

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8

Civilian Ballistic Forearm Fractures: A Retrospective Review

Siddhant K. Mehta, MD, Wood W. Dale, Michael D. Dedwylder, Patrick F. Bergin, MD, Clay A. Spitler, MD

University of Mississippi Medical Center, Jackson, MS

Purpose: Ballistic fractures of the radius and ulna occur relatively infrequently and thus are not well described in the literature. This series evaluates the incidence of neurovascular injuries and the injury factors predictive of neurovascular injury following ballistic fractures of the radius and ulna.

Methods: A retrospective review was performed to identify all ballistic open fractures of the radius and ulna in skeletally mature patients over a 5-year period at a single level-1 trauma center. Chart and radiographic review was performed to identify patient and injury demographics, associated neurologic or vascular injuries, and fracture characteristics. Fracture location was measured on computerized imaging software and fractures were grouped into bone(s) segments involved. Proximal, mid-diaphyseal, and distal locations were used for statistical analysis. Statistical analysis included descriptive statistics, Chi-squared test, and Fisher’s exact test.

Results: Fifty-six extremities in fifty-five patients were identified, with a mean age of 32 years and male to female ratio of 9:1. Overall incidence of neurologic injury was 50%, arterial injury 32%, and compartment syndrome 7.1%. There was no association between fracture location and incidence of arterial injury or compartment syndrome. However, the presence of a proximal third forearm fracture was associated with an increased risk for neurologic injury (p<0.01), with an odds ratio of 5.7 (95% confidence interval, 1.7 to 18.4). Furthermore, high velocity ballistic injuries had a significantly higher incidence of neurologic injury (p=0.02), occurring in 6 of 6 cases.

Conclusion: Ballistic forearm fractures can result in high rates of neurovascular injury. Fractures caused by high velocity firearms have extremely high rates of neurovascular injury when compared with low velocity ballistic injuries. Ballistic fractures involving the proximal third of the radius or ulna are five times more likely to be associated with neurologic injury after a ballistic injury and should be assessed carefully on initial evaluation.

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9

Spinopelvic Dissociation: Comparison of Outcomes of Percutaneous versus Open Fixation Strategies

Jeffrey Pearson, M.D. Rajaram Sakthival, M.D.

Introduction: Spinopelvic dissociation injuries are historically treated with open reduction with or without decompressive laminectomy. Recent technological advances has allowed for percutaneous fixation with indirect reduction. Herein, we evaluate outcomes and complications between patients treated with open reduction versus percutaneous spinopelvic fixation. Methods: Retrospective review of patients undergoing spinopelvic fixation from a single, level-one trauma center from 2012-2017. Patient information regarding demographics, associated injuries, and treatment outcome measures were recorded and analyzed. All fractures were classified via AO Spine classification system. Results: Thirty-one spinopelvic dissociations were identified 15 treated with open and 16 with percutaneous techniques. The two treatment groups had similar preoperative characteristics including spinopelvic parameters (pelvic incidence and lumbar lordosis). Compared to open reduction internal fixation, percutaneous fixation of spinopelvic dissociation resulted in statistically significantly lower blood loss (171cc vs. 538cc; p=0.0013). There were no significant differences in surgical site infections (p=0.48) or operating room time (p=0.66). Conclusion: Percutaneous fixation of spinopelvic dissociation is associated with significantly less blood loss. Treatment outcomes in terms of infection, length of stay, operative cost and final alignment between the open and percutaneous group were similar.

University of of Alabama School of Medicine

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Viability of Pedicle Screw Fixation of the Second Cervical Vertebra Using Multiplanar Reformatting Technology of Cervical Spine CT Scans

Casey Davidson, MD, Patrick F. Bergin, MDThe University of Mississippi Medical Center

Background. Variations in the anatomy of the vertebral artery at the C2 level can preclude pedicle screw placement in some patients. While careful preopera-tive planning with fine-cut computed tomography (CT) is imperative for pedicle instrumentation at C-2, literature suggest safe screw placement is impossible in some anatomy. Other sites have suggested near universal ability to place pedicle screws using OsiriX (Pixmeo) software to reformat the scans in the plane of the screw trajectory.

Methods. The authors conducted a retrospective review of CT scans of the cervi-cal spine in 150 randomly selected patients from the University of Mississippi Medical Center who received a standardized thin cut cervical spine CT scan. For each patient, multi-planar reformatting in the plane of the pedicle was performed using the Osirix program. OsiriX is a DICOM viewer that enables navigation and visualization in multidimensional imaging. Vertebral anatomy was assessed using a circle propagated through the para-coronal refomatted images to mimic an actual screw to determine whether aberrant anatomy would preclude pedicle fixation. The percentage of cases in which a safe screw trajectory could be found was compared with historical literature.

Results. Of the 150 patients, we found that using a traditional starting point, nearly a third of patients had anatomy that precluded screw placement. When 3D navigation was used to find a trajectory optimizing the narrowest portion of the pedicle, 86% of patients had a safe corridor for pedicle screw placement with an average screw length of 27.3mm.

Conclusion. Multiplanar reformatting of cervical spine CT scans that optimizes the trajectory through the narrowest portion of the pedicle and allows for a vari-able starting point improved the ability to place C-2 pedicle screws.

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Accurate Prediction of Antegrade or Retrograde Femoral Intramedullary Implant Length from Patient Height: A Review of 608 Cases

Jeffrey Pearson, M.D., Jonathan Quade, M.D.

Purpose: The aim of this study was to determine if patient height correlates with implant length selection of antegrade or retrograde femoral intramedullary implants. Methods: IRB approved retrospective chart review of 608 operatively treated femoral shaft fractures at a level I trauma center from 2011-2017. Patient Height (PH) was recorded in cm as well as femoral intramedullary implant length. Implant length, patient height and technique (antegrade or retrograde) were recorded. Spearman and Pearson Correlation Coefficients were utilized for statistical analysis of implant length and patient height. A p value of <0.05 was considered significant. Results: 608 operatively treated fractures were reviewed, 350 antegrade, 258 retrograde. Pearson Correlation Coefficients for antegrade implants 0.676 with p<0.01, retrograde implants 0.628 with p<0.01. Two separate equations were determined to accurately predict p<0.01femur nail implant length based on patient height. Antegrade Equation: =97.14033 +(1.76*(PHcm)). Retrograde Equation: =58.74479+(1.89317*(PHcm)). Conclusion: Femur nail implant length can be accurately predicted based on patient height and technique utilizing the above equations. This is the first study utilizing a large number of femora to establish simple equations to aide with several issues. These equations serve as a simple templating tool. There is nothing in the literature that describes an accurate prediction model. Templating allows a check for the intraoperative measuring which would prevent an implant of incorrect length being implanted and discarded. This also allows for immediate implant availability as the implant representative can have a small selection nails in the operating room, decreasing time spent waiting on implant retrieval. Another application is in the case of bilateral comminuted femur fractures to accurately estimate limb length. A fourth application is in remote environments where surgical planning is critical for determining implant needs.

Presented by Matthew Christie, M.D.

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InfectionRatesinOpenTibiaFractureswiththeuseofIntraoperativeTopicalVancomycin/TobramycinPowder

MarkPrevostMD,WillCutchenMD,PatrickBarousseMD,PatrickYoungBS,

JeffreyBrewerMD

Background:Postoperativeinfectionshavethepotentialtobeadevastatingconsequencefollowingopenfractures.Timetointravenousantibiotics,timingandqualityofinitialdebridement,andtheseverityofthesofttissueinjuryhavebeenshowntosignificantlyimpactinfectionrates.Administrationoflocalantibiotics,withtopicallyappliedvancomycinandtobramycinpowder,hasbeeneffectiveinspineandpelvic/acetabulumsurgerywithreducedratesofsurgicalsiteinfections(SSI).However,thereisapaucityofdatarelatedtotopicallyappliedantibioticsandopenfractures.Objective:Tocomparepostoperativeinfectionratesinopentibiafracturesinpatientsreceivingtopicallyappliedvancomycinandtobramycinpowderintraoperatively(treatmentgroup)andthosenotreceivingtopicallyappliedantibiotics(controlgroup).Methods:Duringa21-monthperiod53patientswithopentibiafracturesweretreatedatalevel1traumacenter.Thirtypatientsweretreatedwithtopicallyappliedantibioticsattheopenfracturesiteduringinitialdebridements,while23patientsdidnotreceivelocalizedantibiotictherapy.Fractureswereclassifiedaccordingtotheareaofthetibiafracture(plateau,shaft,pilon)andthetypeofopenfractureaccordingtotheGustilo-Andersonclassification.Theoutcomemeasurereviewedwasdeepinfectionrequiringaformalirrigationanddebridementintheoperativetheatre.Results:Theoverallrateofinfectioninopentibiafractureswasfoundtobe26.4%.AmajorityoftheinfectionsoccurredinGustilo-AndersontypeIIIopenfracturesyieldinganinfectionrateof32.5%.IntypeIIIfractures,thecontrolgroup(n=14)hadaninfectionrateof42.9%comparedtothetreatmentgroup’s(n=26)infectionrateof26.9%(OR=0.49,CI:0.12-1.93,p=0.31).Conclusion:DecreasedratesofinfectionwereobservedinGustilo-AndersontypeIIIopentibiafracturestreatedwithtopicalantibioticpowderatthefracturesitewithoutstatisticalsignificance.

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14

Humeral Head Cysts in Young Athletes: Their Relationship with Shoulder Pathology

Daniel Kim M.D. M.S., George El-Bahri D.O, James R. Andrews M.D., Steve Jordan M.D.

Purpose: To investigate the incidence, etiology and significance of humeral head cysts seen in young athletes.

Background: The incidence and implications of humeral head cysts in young athletes has not been discussed or reported. The earliest description of humeral head cysts in adults was by EA Codman in 1934, who noted an association with cystic changes of the greater tuberosity and rotator cuff tears seen at autopsy. Several authors have written about the overall significance and etiology of these radiologic findings in all age groups, but, to date, no one has examined the incidence and importance of humeral head cysts seen in young athletes. Two distinct types of humeral head cysts have been described based on their location in the greater tuberosity, anterior or posterior. Posterior cysts are more common than anterior cysts and did not appear to be related to rotator cuff diagnoses. Anterior cysts have been linked to rotator cuff disease but are not statistically related to age, while some authors conclude that posterior cysts are. While humeral head cysts in young athletes would not appear to be related to the aging process, there has been little discussion as to their etiology or significance in this age group. One theory suggested these changes could be related to internal impingement and stress from repetitive overhead activities. Humeral head cysts are not uncommonly seen in MRIs performed on shoulders of young athletes, and there exists no prior research on the incidence and etiology of these findings specifically in young patients who are involved in sports or repetitive overhead activities. The purpose of this study was to determine the incidence, characteristics, and relationship to shoulder pathology of humeral cysts in young patients presenting for treatment of shoulder pain at our institution, and to use this information along with clinical correlation to help clinicians in advising patients with regards to prognosis and treatment. Hypothesis: The incidence of humeral head cysts is increased in young athletes with shoulder pathology due to repetitive overhead activity and may indicate enthiosopathic stress related to internal impingement. Study Design: Observational level III Methods: 524 shoulder MRIs performed on patients from age 8-24 over a 3-year period at our facility were retrospectively reviewed assessed for presence of humeral head cysts. 150 shoulders with cystic changes were identified. The size, location, number, and quality of the cysts were recorded. Associated labral and rotator cuff pathology were noted. An independent t-test was performed to determine if humeral cysts size was different for patients with rotator cuff pathology and labral pathology. A chi-square test was used to determine if cyst location (anterior/posterior) was different between patients with rotator cuff pathology and labral pathology. Results: The incidence of humeral head cysts in our study was 28.6%. Average age of patients was 17 years old with a range of 13-24. There were 12(8%) anterior and 130 (89%) posterior cysts, with an average number of 2.6 ± 1.9 cysts per humeral head and average size 31mm2. 30% of all cysts were associated with rotator cuff pathology and 33% with labral pathology. No statistically significant difference was found between cysts in size, location, number, and association with rotator cuff or labral pathology. Clinical Relevance: This is the first study that has assessed the incidence, size, and location of cystic changes in young athletes. Humeral head cysts are commonly seen in shoulder MRIs in adults and the results of this study indicate that humeral cysts are also present in young overhead athletes. It is unclear when these cysts develop and how they are related to pathology, although in adults they are believed to be related to rotator cuff enthesiopathy or degenerative changes. Current analysis of clinical correlation of patient symptoms, mechanism, and other factors will further elucidate the nature of humeral head cysts.

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15

Prospective Analysis of Surgeon Placed Saphenous Nerve Block and Continuous Indwelling Catheter in the Adductor Canal in TKA

Daniel E. Matthews MD, Jordan Smith BS Investigation and all Surgeries were performed by the senior author at Thomas Hospital and in association with the University of South Alabama Department of Orthopaedic Surgery Background: Total Knee Arthroplasty (TKA) can be a very painful surgery and traditionally requires parental opioid analgesics in a inpatient setting for 2-3 days. Significant improvements have been made in pain management over the past decade and most significantly with the use of regional block anesthesia. Traditionally these regional nerve blocks are placed by Anesthesia services using a nerve stimulator or more recently under ultrasonic guidance. These anesthesia services are not always available and when available requires a significant learning curve to become efficient and efficacious. The purpose of this study was to investigate the safely, efficacy, efficiency and cost effectiveness of a new novel surgeon placed single injection saphenous nerve block and placement of a catheter for a continuous adductor canal block. Methods: Fifty-six (56) patients were entered into the study cohort in a prospective manner. Each patient underwent TKA by a single surgeon utilizing a surgeon placed single shot saphenous nerve block and indwelling catheter placed under direct visualization of the neurovascular bundle in the adductor canal. These blocks were placed by the primary Surgeon during TKA, while the cement was curing, adding no time to the operative procedure while eliminating the need for an additional anesthesia procedure. Patients were collected in a prospective manner, entered into an outcomes data base (ON-Q TRAC TM ) and then compared to an aggregate of over 3500 comparative TKA patients in the data base who did not receive blocks as described in this study. Analysis was preformed evaluating, perioperative pain using a Visual Analog Scale (VAS), perioperative opioid usage, patient’s expectations of pain control, incidence of common side effects and average hospital length of stay. Results: Fifty-six (56) patients, utilizing this surgeon placed single shot saphenous nerve block and placement of the continuous indwelling catheter during TKA, were entered into the ON-Q* TRACtm database to compare against over thirty five hundred (3500) TKA patients in the data base. The data base cohort is made up of patients from various sites throughout the United States who underwent TKA and did not receive the single nerve block and the indwelling catheter as described in this study. The patients in this study had a 24% reduction in total opioid pills used, (POD 1-7), 25% reduction in pain on VAS (3.9 to 2.9), 50% reduction in Dizziness,19% reduction in Drowsiness,88% reduction in Vomiting, 62% reduction in Nausea. These patients also had decreased pain compared to pre-operative expectations with 40% more patients reporting “Much less pain than expected” and a reduction in LOS (length of stay) from 2-3 days to 1 day. The primary surgeon also received an HCAHPS score of 97.2% (with a 2.8% adjustment mode) during the collection period. Conclusions: Using the placement technique described in this study surgeons can reproducibly place a single injection and a indwelling catheter for a continuous nerve block in the adductor canal under direct visualization. This technique and placement has potential advantages over other placement techniques with regards to efficacy, efficiency and safety. When using this technique described in combination of a comprehensive pain management protocol patients may experience significantly less pain, use less opioids, have shorter hospital Length of stay (LOS) and have less side effects without jeopardizing quality scores and patient satisfaction. There is also the potential for significant cost reduction in a bundle payment scenario with elimination of additional anesthesia procedures.

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Is Choice of Approach Associated with Risk of Avascular Necrosis in Pediatric Septic Hip SE Mabry, MD*, BG Griswold, BS*, JL McFadden, MD, S Gilbert, MD, MJ Conklin, MD

Abstract Introduction: Septic arthritis of the hip is a common, potentially devastating, condition in pediatric patients. Prompt diagnosis and emergent interventions are necessary to increase chances for favorable outcomes. Historically, pediatric hips have been accessed via an anterior approach as to avoid the femoral head blood supply, thus reducing risk for development of avascular necrosis(AVN). There have been many studies focusing on sequelae of anterior and medial approaches to the pediatric hip for reduction of congenital hip dislocations, but very few have investigated the comparison of these approaches to the pediatric septic hip. We hypothesize that there will be no significant difference in incidence of hip AVN between the medial and anterior approaches to the pediatric septic hip. Methods: The present study is a retrospective review of pediatric septic hips treated at one single institution using either the medial or anterior approach. We reviewed all cases of pediatric septic hips between 2004 and 2014 performed by 4 pediatric fellowship trained orthopaedic surgeons. Our primary outcome measure was development of AVN. Results: When comparing the medial and anterior approach, the cohorts were similar regarding age at time of surgery, gender, time to surgery and length of stay. At an average follow up of 480 days, 4/71 (5.6%) total patients developed AVN. 2/48 (4.2%) of anterior approaches developed AVN while 2/23 via medial approach developed AVN (8.7%). The average age at the time of surgery was 10.9 years old for patients with AVN and 7.17 years old for patients without AVN (p=0.06). The average duration of symptoms for patients with AVN was 7.8 days and was 4.3 days for patients without AVN (p=0.072). The average time to surgery after presentation was 1.5 days for patients developing AVN and 1.2 days for patients who did not develop AVN (p=0.32). Conclusion: In this study comparing the medial and anterior approach to the pediatric septic hip, we found that the medial approach has a similar rate of development of AVN as the anterior approach. Additionally, we found that older age and average duration of symptoms prior to intervention approached, but did not achieve statistical significance. Significance: This is the first study comparing these two surgical techniques in the study of pediatric septic hip. It echoes prior studies that state medial approach is a safe option for surgical approach to the pediatric hip Level of Evidence: Level III—retrospective comparative study Key Words: septic hip, avascular necrosis, surgical approach

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Patient Satisfaction Following Kinematic Alignment Technique of Total Knee ArthroplastyJonathan Gillig, M.D., Joseph Anderson, MS3, G. Daxton Steele, MD

Introduction: Total knee arthroplasty (TKA) remains one of the most successful procedures that has a significant impact on improving patient’s quality of life and reducing pain. Despite its success however, a subset of patients remain dissatisfied with their arthroplasty and furthermore 33-54% of patients report residual symptoms and functional problems after TKA. This subset of individuals who remain dissatisfied is the focus of significant attention in helping to pre-operatively identify those individuals and to also improve operative techniques that will result in improved outcomes. Kinematic alignment of total knee arthroplasty is an innovative surgical technique that approaches knee replacements from a different angle than the traditional measured resection and gap balancing mantras. Restoration of native knee function is the primary goal with care taken to restore native joint lines and ligamentous tensions without pursing large soft tissue releases or boney cuts.

Hypothesis: Initial studies following patients after kinematically aligned total knee arthroplasties have shown promise in reducing the subset of patients who are dissatisfied with their procedures. Our study is a cohort study comparing patients who underwent knee replacement using the standard gap balancing technique versus those who underwent knee replacement using the kinematic alignment technique. Patients in both groups were followed a minimum of a year post operatively to determine longer term satisfaction and all procedures were performed by one surgeon. Our hypothesis is that kinematically aligned total knees have at least the same patient satisfaction compared to gap balancing techniques at one year.

Methods: This prospective cohort study seeks to both objectively and subjectively measure patient outcomes following kinematically aligned total knee arthroplasties versus knees performed using gap balancing by the same surgeon. The first cohort in this study was collected during a period when the attending surgeon only performed gap balanced total knees and the second cohort was performed immediately following using kinematic alignment. Preoperative knee range of motion (ROM), knee injury and osteoarthritis outcome scores (KOOS), and PROMIS 10 scores were obtained from each patient. Furthermore, other patient data such as BMI, knee alignment, surgical time, length of hospital stay, and disposition were also recorded. Following this knee range of motion was measured at 2 weeks, 6 weeks, 3 months and 1 year post-operatively. Patient subjective outcome measures were also taken at 3 months, 1 year and 2+ years postoperatively. Following data collection the measures were compared across cohorts.

Results: This study compared fifty-onee consecutive patients who underwent total knee replacement using a gap balancing technique and a subsequent fifty one patients who underwent total knee replacement using a kinematic alignment technique. Preoperative KOOS Jr, PROMIS Physical, and PROMIS Mental Scores were not statistically different when comparing the two cohort groups with kinematic scores of 44.7/37.8/46.7 respectively and gap balancing of 44.2/39/46. At one year the final KOOS Jr, PROMIS Physical, and PROMIS Mental also had similar results with no statistically significant difference of 81.8/42.2/51 in gap balancing and 84/48.1/46.7 in kinematic alignment.

Conclusions: This cohort study demonstrates that patients undergoing kinematically aligned total knee arthroplasties have equivalent patient satisfaction compared to those who have their knees replaced using the gap balancing technique.

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19

Trends and Risk Factors in Orthopaedic Lawsuits:

Analysis of a National Legal Database

Cichos KH, BS1, Sheppard ED, MD1, Fuchs C, MD1, Ponce BA, MD1, Institutional Affiliation:

1University of Alabama at Birmingham, Department of Orthopaedic Surgery

Background: Medical malpractice claims are frequently encountered by orthopaedic surgeons. The purpose of this

study was to assess trends and risk factors of lawsuits with verdicts for or against orthopedic surgeons using a

national legal database.

Methods: Westlaw, a legal research service, was used to search publicly available settlement and verdict reports

between 1988 and 2014. The search terms “orthopaedic or orthopedic” and “malpractice” were used to identify

cases. Temporal trends were evaluated and logistic regression was used to identify independent risk factors for case

outcomes.

Results: 1,562 publicly reported malpractice cases brought against orthopaedic surgeons, proceeding to trial over a

27 year period, were analyzed. The plaintiffs won 462 (30%) of cases with an average award of $1.4 million. The

frequency of litigation and payouts for plaintiffs increased 215% and 280% between the first and last five year

periods. The average payout for plaintiff-favorable verdicts was highest at $2.6 million in pediatrics, followed by

$1.7 million in spine and $1.6 million in oncology. Fracture fixation (363 cases), arthroplasty (290 cases), and spine

(231 cases) were the most commonly litigated procedures while plaintiffs were most successful winning verdicts for

fasciotomy (48%), infection-treating procedures (43%), and carpal tunnel release (37%). When analyzing data by

state/region, adjusted for population, northeastern states had a higher frequency of lawsuits.

Conclusion: Malpractice liability has increased over the past three decades while orthopaedic surgeons continue to

win the majority of cases that make it to court. As patients continue to shop around for medical care via publicly

available information, it is important for orthopaedic surgeons to understand what aspects of their own practice carry

different risks of litigation.

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Outcomes with Overlapping Surgery at a Large Academic Medical Center

Bradley Wills, M.D., Brent Ponce, M.D, Park Hudson, M.D, Austin Starnes, M.D, Shawn Watson,PhD, M.D, Jorge Perez, M.D, Gerald McGwin, PhD, MS, Sam Huntley, BS

Objective: To evaluate the efficiency and safety of Overlapping Surgery (OS) at a training institution by comparing

it to non-overlapping surgery (NO) with respect to operative time, mortality, readmissions, and complications.

Background: Overlapping surgery is the practice of an attending physician providing supervision to two surgeries

that are scheduled at overlapping times. Recent media and government attention has raised concerns about this

practice and the need for informed patient consent.

Methods: A population-based, retrospective, cohort study was conducted using data on operative procedures from

January 1, 2014 to December 31, 2015 at a large tertiary academic center. Patients who had undergone surgery by

attending surgeons who performed 10% or more of their cases overlapping were selected. 30-day mortality,

readmission within 30 days, and seven patient safety indicators (PSIs) were recorded.

Results: A total of 26,260 cases met our criteria for analysis for surgical time and 15,106 cases for outcomes. OS

patients had an average case length of 2.18 hours compared to 1.64 hours among NO patients, (p<0.0001), a

decreased risk of mortality (relative risk [RR] 0.42, 95% confidence interval [CI] 0.34-0.52, p<0.0001), a decreased

risk of readmission (RR 0.92, 95% CI 0.86-0.98, p=0.0148), and a decreased risk of experiencing any PSI (RR 0.67,

95% CI 0.55-0.83, p=0.0002).

Conclusion: The present study confirms prior reports and addresses gaps in the literature regarding OS, such as the

effect of resident involvement and the individual effect of OS in 13 different surgical specialties. The findings

highlight the need for additional investigation and suggest that the practice of overlapping surgery does not expose

patients to increased risk of negative outcomes.

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21

Taming the Preauthorization Tiger

Wilburn Smith, M.D.

For the foreseeable future, all payers are going to use preauthorization to lower their expenditures for imaging, special testing, specialty medications, and with more strenuous review of procedures in cardiology, surgery, and pain management in the offing. The flip side at least in radiology benefit reviews, ~75% of requests are approved without any detailed review. Of the remaining 25%, half are approved on MD review and a further half on peer-to-peer conversations.

There are things that both your office and you can do to lower your initial denial rate and minimize p2p call interruptions with those that do occur having successful outcomes.

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1952-1953 Paul W. Shannon, M.D.*1953-1954 W.C. Hannon, M.D.*1954-1955 David G. Vesely, M.D.*1955-1956 Robert O. Denton, M.D.*1956-1957 T.J. Bender, Jr., M.D.* 1957-1958 Elias N. Kaiser, M.D.*1958-1959 John Fletcher Comer, M.D.*1959-1960 Alfred R. Earl, M.D.*1960-1961 John E. Hanby, M.D.*1961-1962 Charles H. Wilson, M.D.*1962-1963 William Joseph Neely, M.D.*1963-1964 Paul D. Everest, M.D.*1964-1965 Ralph Terhune M.D.*1965-1966 Guy L. Rutledge, Jr., M.D.*1966-1967 Mervel V. Parker, M.D.1967-1968 Chestley L. Yelton, M.D.*1968-1969 Robert O. Denton, M.D.*1969-1970 Crampton Harris, Jr., M.D.* 1970-1971 Fay M. Randall, Jr., M.D.1971-1972 L.R. Lonnergan, Jr., M.D.*1972-1973 Kenneth M. Hannon, M.D.*1973-1974 John D. Sherrill, M.D.*1974-1975 E.C. Brock, M.D.1975-1976 Frederick H. DeVane, M.D.*1976-1977 William A. Sims, M.D.,1977-1978 Kurt M.W. Niemann, M.D.1978-1979 William B. Hanson, M.D.1979-1980 Chauncey B. Thuss, M.D.*1980-1981 Jack E. Reagan, M.D. 1981-1982 R. Joe Burleson, M.D.*1982-1983 Joseph E. Nelms, M.D.*1983-1984 Phillip L. Williams, M.D.1985-1985 Ralph J.W. Hobbs, M.D.*1985-1986 M. Preston Daughtery, Jr., M.D.1986-1987 Lewis D. Anderson, M.D.*1987-1988 H. Chester Boston, M.D. 1988-1989 Glenn D. Barnes, M.D.*

ALABAMA ORTHOPAEDIC SOCIETYPAST PRESIDENTS

1989-1990 Robert B. Mitchell, M.D. 1990-1991 James G. Davis, M.D. 1991-1992 S. Rushing Smith, M.D.1992-1993 John E. Semon, M.D. 1993-1994 Donald A. Deinlein, M.D.1994-1995 James H. Armstrong, M.D.1995-1996 Louis G. Horn, M.D.1996-1997 John R. Payne, M.D.1997-1998 Joseph M. Sherrill, M.D.1998-1999 Guy L. Rutledge, III, M.D.1999-2000 Ray A. Fambrough, M.D.2000-2001 Stephen T. Ikard, M.D.2001-2002 Wilburn A. Smith, Jr., M.D.2002-2003 Kenneth Vandervoort, M.D.2003-2004 John M. Cuckler, M.D.2004-2005 Prasit Nimityongskul, M.D.2005-2006 Mark A. Leberte, M.D.2006-2007 Joseph F. Curtis, M.D.2007-2008 Joseph W. Clark, M.D.2008-2009 Albert W. Pearsall, IV, M.D.2009-2010 John T. Killian, M.D.2010-2011 John S. Gould, M.D.*2011-2012 Russell A. Hudgens, M.D.2012-2013 Frederick N. Meyer, M.D.*2013-2014 Steven M. Theiss, M.D.2014-2015 Brent A. Ponce, M.D.2015-2016 Ginger Bryant, M.D2016-2017 Christopher Heck, M.D.2017-2018 Howard Miller, M.D.

* deceased

MISSISSIPPI ORTHOPAEDIC SOCIETYPAST PRESIDENTS

1958 - T.H. Blake, M.D.1959 – George Purvis, M.D.1960 – Don Imrie, M.D.1961 – Thomas Turner, M.D.1962 – Griffin Bland, M.D.1963 – T. S. Eddleman, M.D.1964 – E. A. Attix, M.D.1965 - W. C. Warner, M.D.1966 – Houston Frank, M.D.1967 – John Caden, M.D.1968 – Paul Derian, M.D.1969 – William Thompson, M.D.1970 – Daniel Enger, M.D.1971 – Louis Farber, M.D.1972 – Magruder Corban, M.D.1973 – William Sanders, M.D.1974 – James Manning, M.D.1975 – Sidney Berry, M.D.1976 – Cleve Johnson, M.D.1977 – Elmer Nix, M.D.1978 – Houston Frank, M.D.1979 – J. Stewart Williford, M.D.1980 – James L. Hughes, M.D.1981 – George W. Truett, M.D.1982 – Wayne T. Lamar, M.D.1983 – Thomas H. Blake, M.D.1984 – Wiley C. Hutchins, M.D.1985 – Alan E. Freeland, M.D.1986 – McWillie M. Robinson, M.D.1987 – Thomas D. Little, M.D.1988 – Gene Taylor, M.D.1989 - Gene Barrett, M.D.1990 – John Purvis, M.D.1991 – Doug Rouse, M.D.1992 – Walter Shelton, M.D.1993 – Charles Rhea, M.D.1994 – James Green, M.D.1995 – Robert McGuire, M.D.

1996 – Earl Whitwell, M.D.1997 - John Drake, M.D.1998 – David Bomboy, M.D.1999 – Audrey D. Tsao, M.D.2000 – John J. McGraw, M.D.2001 – Edward T. James, M.D.2002 – William Rice, M.D.2003 – Thom Tarquinio, M.D.2004 - Alex Blevens, M.D.2005 – J. Patrick Barrett, M.D.2006 – George V. Russell, M.D.2007 – Keith P. Melancon, M.D.2008 – Larry Field, M.D.2009 – Jeffrey D. Noblin, M.D.2010 – B. Thomas Jeffcoat, M.D.2011 - E. Jeff Kennedy, M.D.2012 – James W. O’Mara, M.D.2013 – Robert “Kerk” Mehrle, M.D.2014 – Donnis K. Harrison, M.D.2015 – Lance Line, M.D.2016 - Russell Linton, M.D.2017 - Kurre Luber, M.D.

Presidential Reception & DinnerFriday, May 186:00 - 9:00 p.m.

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Program at a Glance2018 Meeting Schedule

Thursday, May 17, 20182:00 p.m. - 5:00 p.m. Registration Grand Ballroom Foyer3:00 p.m.-5:00 p.m. AOS Board of Directors Meeting Magnolia 25:30 p.m. - 7:00 p.m. Welcome Reception Cannon Park Lawn7:30 p.m. - 9:30 p.m. Board of Directors Dinner Grand Ballroom Patio - By Invitation Only

Friday, May 18, 20186:30 a.m. - 7:30 a.m. Registration Breakfast - Exhibit Hall Grand Ballroom South6:30 a.m. - 7:30 a.m. MOS Board of Directors Meeting7:30 a.m. - 1:00 p.m. Scientific Program Grand Ballroom North9:50 a.m. - 10:20 a.m. Break Exhibit Hall-Grand Ballroom South1:30 p.m. - 5:30 p.m. Golf Tournament Azalea Golf Course

Fishing Outing Grand Hotel Marina - Fuel Dock6:00 p.m. - 9:00 p.m. Presidential Reception & Dinner Julep Point

Saturday, May 19, 20186:30 a.m. - 7:30 a.m. Breakfast Exhibit Hall Grand Ballroom South7:30 a.m. - 1:00 p.m. Scientific Program Grand Ballroom North Grand Ballroom North10:10 a.m. - 10:40 a.m. Break Exhibit Hall Grand Ballroom South2:00 p.m. AOS Business Meeting Grand Ballroom North2:30 p.m. Adjourn