2020 TOA/TOF/TSSM Annual Conference

10Days 08Hours 00Minutes 59Seconds



Program Chair:
Vinod K. Panchbhavi, MD

TOA President:
Adam J. Bruggeman , MD

TOA 1st President Elect:
Kenneth J. Kaminski, MD

TOA 2nd President Elect
TOPAC Chair:
Luis H. Urrea, II MD

TSSM President:
B. Christian Balldin, MD


February 7, 2020 7:20 a.m. – February 8, 2020 2:45 p.m.

February 6, 2020 – 2:00 pm to 4:00 pm

Visit to the Center for the Intrepid
3851 Roger Brooke Dr
San Antonio, TX 78234

TOA will lead a visit to the Center for the Intrepid at the San Antonio Military Medical Center on the afternoon of Thursday, February 6 from 2:00 pm to 4:00 pm to learn about the military’s cutting-edge techniques for dealing with the most complicated trauma cases.  Transportation from the Westin Riverwalk will depart at 1:15 pm.

CME will be offered.  For security purposes, you must register by January 10, 2020 to participate in this event.

February 7, 2020

7:15 AM 8:00 AM Registration, Breakfast & Exhibitor Visitation
7:20 AM 7:55 AM Paper Presentations
Click here for Papers/Presenters
7:55 AM 8:00 AM Opening Remarks
Vinod K. Panchbhavi, MD
8:00 AM 8:55 AM My Worst Complication: What I Learned From It
Vinod K. Panchbhavi, MD – Moderator
Operating on Other Physicians … What Could Go Wrong?
Frank A. Buttacavoli, MD
Volar Plates for Everyone?
Scott E. Hecox, MD
When Everything That Can Go Wrong with a Knee Dislocation Does … and More
William M. Weiss, MD
Active Shooter: El Paso – When Lessons Are Dictated by the Circumstances
William M. Weiss, MD
8:55 AM 9:00 AM Low Vitamin D Levels in the Outpatient Orthopaedic Clinic Population
Edward P. Southern, MD
9:00 AM 10:00 AM Complications in Trauma Cases
Patrick M. Osborn, MD – Moderator
Postoperative Infection
Eric G. Verwiebe, MD
Failure of Fixation
Ravi A. Karia, MD
John C. Hagedorn II, MD
10:00 AM 10:30 AM Break with Exhibitors
10:30 AM 11:30 AM Sports Medicine: What We Can Learn from Complications
B. Christian Balldin, MD – Moderator
Complications of Hip Arthroscopy Labral Repair/Reconstruction
Complications of Biologics in Orthopedics

Paul C. Chin, MD, PhD
Complications of Arthroscopic Superior Capsular Reconstruction
Robert U. Hartzler, MD
Complications of Arthroscopic All Inside ACL Reconstructions
Clayton W. Nuelle, MD
Complications of Adolescent Patellofemoral  Surgery
Henry B. Ellis, Jr., MD
11:30 AM 11:45 AM ABOS Update 2020
Gregory A. Mencio, MD
11:45 AM 12:45 PM Lunch Presentations: General Orthopaedic Issues
Biofilms: Diagnosis & Treatment
Gerhard E. Maale, MD
Should Orthopaedic Oncologists Manage All Metastatic Disease?
Rajiv Rajani, MD
Developing a Secondary Fracture Prevention Program
Kevin L. Kirk, DO
12:45 PM 1:00 PM Paper Presentations
Click here for Papers/Presenters
General Session
1:00 PM 2:00 PM Hip Preservation: What Can Go Wrong
Wrong Patient Selection
Technical Mistakes In the Surgery
Post-Operative Complications

Matthew R. Schmitz, MD – Moderator, John J. Christoforetti, II, MD, Henry B, Ellis, Jr., MD & Casey D. Taber, MD
Breakout Session in Villa Room
1:00 PM
2:00 PM Latest Legal Issues for Orthopaedic Practices (more info here)
Christopher B. Reed, JD
of Weaver Johnston & Nelson PLLC


February 7, 2020

2:00 PM
2:05 AM TOA Policy Update: Commercial Insurance & Workers’ Comp
Bobby Hillert (Texas Orthopaedic Association)
2:05 PM 2:45 PM Patient-Centered Care: Is It Just Talk?
Mike McCaslin, CPA (Somerset CPAs and Advisors | OrthoForum)
2:45 PM 3:15 PM Break with Exhibitors
3:15 PM
4:00 PM Changing Your Income Distribution Plan: Does It Have to Be a Zero Sum Gain?
Mike McCaslin, CPA (Somerset CPAs and Advisors | OrthoForum)
4:00 PM 5:00 PM The Rothman Institute’s Journey to the Bundle
Alexander R. Vaccaro, MD, PhD
5:00 PM 5:15 PM Paper Presentations
Click here for Papers/Presenters
5:15 PM 5:20 PM TOA Policy Update: Opioids
Bobby Hillert (Texas Orthopaedic Association)
6:30 PM 9:30 PM Pearl Brewery Stable Party
Dinner: 6:30 p.m. to 8:30 p.m. | Drinks: 6:30 p.m. to 9:30 p.m.

February 8, 2020

7:15 AM 8:00 AM Registration, Breakfast & Exhibitor Visitation
7:30 AM 7:55 AM Paper Presentations
Click here for Papers/Presenters
7:55 AM
8:00 AM TOA Policy Update: Scope of Practice
Bobby Hillert (Texas Orthopaedic Association)
8:00 AM 8:00 AM Opening Remarks
Vinod K. Panchbhavi, MD
8:00 AM 8:45 AM Innovations in My Field
What’s New in Shoulder and Elbow Surgery
Jeremy S. Somerson, MD – Moderator
What’s New in Hip and Knee Arthroplasty
Frank A. Buttacavoli, MD
What’s New in Hand Surgery
Scott E. Hecox, MD
What’s New in Femoral Neck Fixation, Clavicle Fixation and Fenestrated Implants
John C. Hagedorn, II, MD
What’s New in Foot and Ankle Surgery
Eugene F. Stautberg, MD

8:45 AM 9:30 AM Case Studies by Specialty: Breakouts
Upper Extremity/Hand – (Zapata)
Scott E. Hecox, MD – Moderator
Hips/Knees – (Navarro A)
Benjamin A. McArthur, MD – Moderator
David P. Brigati, MD – Moderator
Sports Medicine – (Villa)
B. Christian Balldin, MD – Moderator
Trauma – (Navarro A)
John C. Hagedorn, II, MD – Moderator
9:30 AM 10:00 AM Break with Exhibitors
10:00 AM 11:00 AM Foot & Ankle: Cases That Didn’t Go as Expected
1MTP Joint Arthrodesis in the Setting of Failed Arthroplasty
Failed Total Ankle Arthoplasty
5th Metatarsal Fracture Surgical Treatment
Failed Ankle Fracture Nonunion
Failed Ankle Fusion

Thomas C. Dowd, MD – Moderator, Kevin L. Kirk, DO, John S. Early, MD,  Uma Erard, DO & Kevin E. Varner, MD
11:00 AM 12:00 PM THA/TKA: Learning From Complications
Hip Instability/Dislocation 
Benjamin A. McArthur, MD – Co Moderator
Acute Prosthetic Infection 
David P. Brigati, MD – Co Moderator
Periprosthetic Proximal Femur Fractures 
Hugo B. Sanchez, MD
Nerve Injury After TKA 
Kenneth B. Mathis, MD
Extensor Mechanism Failure 
Frank A. Buttacavoli, MD
12:00 PM
12:05 PM TOA Policy Update: Medicare
Bobby Hillert (Texas Orthopaedic Association)
12:05 P 12:45 PM Lunch Presentation & TOA Business Meeting
Adam J. Bruggeman, MD
Kenneth J. Kaminski, MD
12:45 PM 1:15 PM Paper Presentations
Click here for Papers/Presenters
1:15 PM 1:45 PM Lessons Learned From a Lifetime of Service
John W. Hinchey, MD – Moderator, Fred G. Corley, MD, Bernard F. Morrey, MD & Jesse C. DeLee, MD
1:45 PM 2:45 PM 18th Annual Resident Quiz Bowl
Kyle F. Dickson, MD – Emcee


TOA’s special rate at the San Antonio Westin Riverwalk has sold out. However, a number of hotels are within several blocks of the Westin, and they offer prices similar to TOA’s room block rate.

Some of the hotels include:

  • Homewood Suites (next door)
  • Hampton Inn Riverwalk
  • Home2Suites Riverwalk
  • Drury Plaza Riverwalk
  • Hyatt Regency Riverwalk
  • Hotel Valencia Riverwalk
  • Embassy Suites San Antonio Riverwalk
  • The St. Anthony
  • Wyndham San Antonio Riverwalk
  • Hotel Havana

This is a small sample of downtown San Antonio hotels with availability.

  • Overnight Valet is 43.00 (plus tax) Event Valet is 25.00 (plus tax)
  • There is a self parking garage across from the hotel but it is not managed by the hotel. They charge by the hour.


Registration is OPEN! – Click here!

General Sessions

TOA members can click here to register to attend all of the Friday and Saturday general sessions.

Coding Course
Friday’s coding course features a separate registration fee that includes your workbook and registration is open, click here.  

Non-Member Attendees
(choose one)
1) To attend either the Coding Course (Friday Feb 7) or
2) General Sessions (Friday Feb 7 + Saturday Feb 8) + Friday Night Reception

February 7, 2020

9:00 AM to 4:00 PM
Coding Course Learning From Complications: Clinical Presentations (Zapata Room)
Led by Margi Maley of Karen Zupko & Associates
*Additional registration fee required – includes workbook.

  • Relative Value Units
    What are they?
    How are they used to track production of employed physicians?
    How are they used to create a fee schedule?
  • Medical Necessity
    What payors know and how they use it to deny or recapture payments.
    Just because it is in the note, it doesn’t mean that it was necessary to make a diagnosis or treat a problem!
  • 2020 Coding Update
    What’s new?
  • 2021 E/M
    The biggest CPT change in 25 years – get ready!
    New and established patient visits.
    Medical decision making.
  • E/M Category and Levels of Service
    We still have to use it.
    Category of E/M service.
    Relaxed Medicare documentation guidelines (important).
    Level of service documentation – history, exam, medical decision making, and note annotation.
  • Modifiers 24, 57, and 25
    High-risk audit area.
    Modifier 25 with E/M services and joint injections.
    Prevent denials with good documentation.
    When shouldn’t E/M services and procedures be reported together?
    Appeal strategies for E/M and office procedures.
  • Global Surgical Package
    AAOS Global Service Data Guide/NCCI.
  • Surgical Modifiers
    Surgical coding examples: sports, shoulders, arthroscopy, and joint
  • Fractures
    What is restorative care?
    Fractures in the ER, urgent care, and the office.
    Fracture treatment shared by NPPs and the physicians.
    Is Modifier 57 significant and supported by documentation?

9:00 AM to 12:00 PM (No CME for this Event) (Villa Room)
Strategic Planning Session
Led by Darren Smith of Cima Strategic Services

What physician leaders and administrators should do BEFORE and AFTER you have created a great strategic plan (to lead, work with the physicians and administrators, and govern the strategy).

The workshop is included in your registration.  Registration is requested.  Visit TOA’s registration page to add your registration.

It is designed for practice administrators and orthopedic surgeons who lead their practices. The workshop will teach you:

  • How to create a business frame to achieve alignment.
    Learn to create your WHY, Mission, WHO, WHAT & HOW.
  • How to earn buy-in at all levels of the organization.
    How to identify the people who will help execute.
  • How to create accountability for strategy execution.
    What do you measure and how do you measure.   
  • HOT SEAT opportunity.
    Participants take turns receiving feedback on their newly created business frame and plans for earning buy-in and creating accountability.

The result is great strategy execution and better results.

1:00 PM to 2:00 PM
Latest Legal Issues for Orthopaedic Practices (Villa Room)
Led by Christopher B. Reed, JD of Weaver Johnston & Nelson PLLC

  • Navigating Texas’ new Out-of-Network billing and patient collection law
    a. This session would include a review of SB 1264 that went into effect on January 1, 2020 that grants certain consumer protections to patients with non-emergency, out-of-network physician, lab, and diagnostic claims, including a prohibition on balance billing patients. This session will summarize the new law, explore the new mandatory arbitration procedure between insurers and OON providers, the new UCR database the law requires TDI to establish, as well as the required notice and waiver by the patient of the bill’s consumer protections to allow the provider to balance bill them.
  • Telemedicine and Telehealth: What is the state of Telemedicine in Texas and how changes in the Medicare Fee Schedule is providing physician practices greater opportunities to interact with patients via telephone and realtime communication technology and bill for the same through Medicare and commercial health plans.
  • Insurance audits for “fee forgiveness” of patients and the current state of Texas and federal law after Humble Surgical Center and North Cypress Medical Center: We will explore recent trial and appeals cases in Texas and across the country examining insurers attempt to recoup claims paid to providers that failed to collect a patient’s co-pay, deductible, and co-insurance obligations. We will highlight important considerations for your practice’s patient collection and discounting policies and procedures, as well as highlight recent activity to amend ERISA to address the issue.

CADAVER LAB (No CME for this Event)
February 7, 2020
303 Pearl Parkway (Avenue A and Emma Koehler)
12:00 PM – 2:00 PM | 3:00 PM – 5:30 PM | 6:00 PM – 9:00 PM

February 7, 2020

7:20 AM – 7:55 AM

  1. Early Outcomes of Osteochondral Allograft in the Skeletally Immature Knee
    Breann Tisano, MD
  2. Incision Site Subcutaneous Fat Thickness and 90-day Complications for Direct Anterior and Posterior Approach Total Hip Arthroplasty
    Gregory Sprowls, MD
  3. Early Radiographic Outcomes for Mini-Fragment Fixation of Pilon Fractures
    Jorge DeLeon, MD
  4. Musculoskeletal Oncology: Analysis of Content and Comparison between MSTS Recognized and ACGME Accredited Fellowship Program Websites
    Jorge DeLeon, MD
  5. Osteoporosis and the Female Athlete
    Alexis Rounds, MD
  6. Femoral Tunnel Fixation for Medial Patellofemoral Ligament Reconstruction in the Growing Patient is Safe for Future Growth
    Bruno Gross, MD
  7. Improved Outcomes in Patients With Positive Metal Sensitivity Following Revision Total Knee Arthroplasty
    Brett Brazier, DO

12:45 PM – 1:00 PM

  1. New Surface Anatomical Landmarks can Guide Pedicle Screw Placement Using Cortical Bone Trajectory
    Nikhil Shelke, MD
  2. Scoliosis Surgery in Beals Syndrome is More Challenging and Results in Higher Rates of Complications
    Jaclyn Kapilow, MD
  3. The Utility of Obtaining a CT Scan at 6 Months to Assess Fusion Mass and Impending Pseudoarthrosis Following a Posterior Vertebral Column Resection for Severe Spinal Deformity
    Kendall Anigian, MD

5:00 PM – 5:15 PM

  1. Inferior Tilt of the Baseplate Decreases Impingement-Free Range of Motion in Reverse Shoulder Arthroplasty – A 3-D Digital Motion Analysis
    Midhat Patel, MD
  2. Intraoperative Computer Navigation is Associated with Increased Glenoid Baseplate Screw Length and Use of Augmented Baseplates in Reverse Total Shoulder Arthroplasty
    Charlie Wilson, MD
  3. Design and Retrospective Application of a Spine Trauma DVT Prophylaxis Protocol on Level 1 Trauma Center Patient Database
    Jonathan Dawkins, MD

February 8, 2020

7:25 AM – 7:55 AM

  1. 30-day Readmission and Reoperation After Total Elbow Arthroplasty: A National Database Study
    Holt Cutler, MD
  2. Increased Articular Exposure of the Lateral Elbow Joint with the Anconeus Approach Compared to the Kocher Approach: A Cadaver Study
    Holt Cutler, MD
  3. Standardized Care Pathway for Total Knee Arthroplasty Improves Outcomes in Minority Patients
    Daniel Gelvez, BS
  4. Deep Venous Thrombosis and Analysis of Prophylaxis for Orthopaedic Trauma Patients Admitted to Honduras’ Largest Public Health Care Center
    Taylor Bates, MD
  5. Outcomes of Failed Lumbar Disk Arthroplasties
    Taylor Bates, MD
  6. Spinal Balance and Lumbar Curve Stability after Selective Thoracic Fusion in Idiopathic Scoliosis
    Aaron Gebrelul, MD
  7. Septic Interphalangeal Joint Secondary to Retained Rattlesnake Fang
    Daniel Gelman, MD

12:45 PM – 1:15 PM

  1. Utility of Advanced Imaging in Evaluation of Delirium After Arthroplasty
    Wells Stewart, MD
  2. Oxidized Zirconium Total Knee Arthroplasty Implant Failure In a Patient With Knee Instability
    Lydia Kore, MD
  3. Peri-Implant Subtrochanteric Fracture after Cannulated Screw Fixation of Femoral Neck Fractures: A Case Series and Biomechanical Analysis
    Brian Page, MD
  4. Lack of In-Brace X-Rays in Compliant AIS Patients Wearing Full-Time TLSO Braces Associates with Failure
    Isabel Alvarez, BA
  5. Analyzing the Postoperative Outcomes in Pediatric Orthopaedic Surgery Diabetic Patients
    Farzam Farahani, BSA

February 6, 2020 – 2:30 pm to 4:30 pm
Bus will leave from the San Antonio Westin Riverwalk at 1:15 p.m.

The San Antonio Military Medical Center will host a special visit for TOA members at the Center for the Intrepid. The two-hour event will include CME.

Due to security, all attendees:

  • Must register by January 13, 2020.
  • Provide their driver’s license, full name, and date of birth to TOA by January 13, 2020
  • Take the bus to the Center for the Intrepid.

February 7, 2020 – 6:30 pm to 9:30 pm

Attendees and their guests are invited to TOA’s Friday night dinner party at the Pearl Stable in the Pearl Brewery complex.  The event will be catered by San Antonio’s Paloma Blanca.  

Click here to purchase dinner tickets for attendees and their guests. Your ticket includes both dinner and drinks.

Buses will leave on a regular basis from the San Antonio Westin Riverwalk.

6:30 p.m. – 8:30 p.m. – Dinner • 6:30 p.m. – 9:30 p.m. – Drinks

Thank you to our Sponsor!


Title  Sponsor


Platinum Sponsor



Gold Sponsors




Silver Sponsors

Alafair Biosciences, Inc.

Atticus Medical Billing Solutions



Cumberland Pharmaceuticals, Inc.



Flexion Therapeutics

FUJIFILM SonoSite, Inc.

FX Shoulder USA


IlluminOss Medical, Inc.

Konica Minolta Healthcare


MTBC, Inc.

OsteoCentric Technologies

Quatris Healthco

Robin Healthcare

Sharecare, Inc.



The DaVinci Orthopedic Pillow

Verata Health

Vericel Corporation



All faculty members and planning committee members participating in this educational program are expected to disclose to the program audience any significant financial interest and/or other relationship with the manufacturers and providers of commercial products and/or services discussed in their presentation, and their relationship or financial interest in any commercial contributor to the educational activity.

Please visit the AAOS Disclosure Information web page to see updated disclosures for all 2020 faculty, staff and planning committee members.

Possible CME Credits for 2020

CME hours are pending.  Based on the last five years, TOA estimates 13.05 CME hours to be awarded but until the Agenda is final that is subject to change.  At the moment the CME for the two days of General Session is at 15.92 CME hours.

CME ethics hours will be awarded.

CME is waiting for Texas Medical Board guidance related to the state’s new opioid CME prescribing mandate.   However, TOA expects to offer CME to fulfill the mandate.