MSIA 2010 Fall Conference Presentation

8/8/2019 MSIA 2010 Fall Conference Presentation

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THE FUTURE IS HERETHE FUTURE IS HERE

20102010 Fall ConferenceFall Conference

Rock Financial Show PlaceRock Financial Show Place

Novi, MichiganNovi, Michigan


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Agenda

8:00 8:45 AM Registration & Breakfast

8:45 9:15 AM Welcome / Overview / Business Meeting

9:15 10:00 AM Investigation in Todays Digital WorldTom Dana / DigitalSEAAl Lux / Global OptionsCraig Zamler / Kluczynski, Girtz, Zamler & McCubbrey, P.C.

10:00 10:30 AM Break / Visit Exhibitors

10:30 11:30 AM Workers Compensation Agency

11:30 12:00 PM Legal UpdatesJerry Marcinkoski / MSIA Executive Secretary / Lacey &Jones

12:00 1:00 PM Lunch

1:00 2:00 PM The U.S. Workforce Comes of Age

Dr. Chrisanne Gordon

2:00 2:30 PM Michigan Supreme Court CandidatesJustice Robert Young (Incumbent)Judge Mary Beth Kelly

2:30 3:15 pm Specific Loss Understanding Practical Legal & Medical IssuesRick Lovernick / Conklin BenhamDr.Jack Lennox / Tri-County Orthopedics

3:15 3:30 PM Door Prizes / CEUs / Adjournment


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Agenda







12:00 1:00 PM Lunch







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2010 MSIA FALL CONFERENCE

GOLD SPONSORS

Aetna Workers CompAetna Workers Comp

AccessAccess

Brown Rehab andBrown Rehab and

Review ManagementReview Management

Global OptionsGlobal Options

Great Lakes PTPNGreat Lakes PTPN

HostetlerHostetler--Fontaine &Fontaine &

AssociatesAssociates

ManageAbilityManageAbility


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Audit Committee

Business Meeting

Nomination of Officers Special Recognition

2010 MSIA FALL CONFERENCE2010 MSIA FALL CONFERENCE


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Michigan SelfMichigan Self--Insurers AssociationInsurers Association

AmwayLorraine Climer

AT&TTo Be Determined

City of Grand RapidsMari BethJelks

Consumers EnergyDoug Wright 1stVice Chair

DTE EnergyDoug Green

Ford Motor CompanyJonathan Parker Chairperson

Gerald M. Marcinkoski - Executive Secretary

General Motors LLC

Susan Azar

Ilitch Holdings, Inc.C. Michael Healy Treasurer

Kelly ServicesLesley Zielinski

Marathon Oil CompanyBarbara Parker 2ndVice Chair

MeijerSherri Miller

Smith Haughy Rice & RoeggeDanielle Susser

BOARD OF MANAGERSBOARD OF MANAGERS

AdvisoryGroupAdvisoryGroup

CompaticoLibby Child

Chrysler LLC

Neil Levins

Michigan Chamber of CommerceWendy Block

Parker-HannifinJacey Saylor

Sherriff-GoslinCompanyWilliam Ticknor

Spectrum HealthSteve Ohman

Trinity HealthTeresa Fisk

Wayne State UniversityPamela Galloway

Wayne Co. Airport AuthorityLeigh Stepaniak

Michigan Manufacturing Association

Jennifer Spike


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SPECIFIC LOSS BENEFITSSPECIFIC LOSS BENEFITS

StatuteStatute

MCL 418.361(2)MCL 418.361(2)

Case LawCase Law Lindsay vLindsay v GlennieGlennie Industries, Inc.Industries, Inc.

Cain I & Cain IICain I & Cain II

Trammel v Consumers EnergyTrammel v Consumers Energy

FactsFacts

DecisionDecision


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Jack D. Lennox, D.O.Jack D. Lennox, D.O.

Chairman, Dept. ofChairman, Dept. ofOrthopedic SurgeryOrthopedic Surgery

BotsfordBotsford HospitalHospital

Knee Trauma andKnee Trauma and

Degeneration Resulting inDegeneration Resulting in

Total KneeTotal Knee ArthroplastyArthroplasty


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Knee JointKnee Joint

AA diarthrodialdiarthrodial jointjoint

linedlined

withwith articulararticular cartilagecartilage

and lubricated withand lubricated with

synovial fluidsynovial fluid


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Knee JointKnee JointLigamentsLigaments ACL, PCL,ACL, PCL,

MCL, LCLMCL, LCLMeniscusMeniscus Medial &Medial &

LateralLateral


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OsteoarthritisOsteoarthritis

Loss ofLoss of articulararticular

cartilage to bare bonecartilage to bare bone

associated withassociated with

symptomaticsymptomaticinflammationinflammation

secondary to trauma,secondary to trauma,

birth,birth, malalignmentmalalignment

and/or wear overand/or wear overtime.time.


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OsteoarthritisOsteoarthritis TreatmentTreatment

OptionsOptionsRestRestExerciseExercise strength,strength,

maintenance ofmaintenance of

motion, aerobicmotion, aerobicconditioning, etc.conditioning, etc.

MedicationsMedications

NSAIDsNSAIDs, steroids,, steroids,

glucosamine/glucosamine/chondroichondroi

tintin sulfate, alternativesulfate, alternative

(cherry extract, MSM)(cherry extract, MSM)

InjectionsInjections

corticosteroids,corticosteroids,

viscosupplementationviscosupplementation

((hyaluronichyaluronic acidacid SupartzSupartz,, SynviscSynvisc,,

EuflexxaEuflexxa, etc.), etc.)

Electrical StimulationElectrical Stimulation

-- BionicareBionicare


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OptionsOptions


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OptionsOptionsSurgicalSurgical --

ArthroscopicArthroscopic

meniscoplastymeniscoplasty andand

debridementdebridement


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OptionsOptionsSurgicalSurgical

Joint resurfacingJoint resurfacing

OATSOATS

((OsteochondralOsteochondral

AutograftAutograft

Transfer System)Transfer System)


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Joint ResurfacingJoint Resurfacing --

ACIACI (( AutologousAutologous

ChondrocyteChondrocyteImplantation)Implantation)


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OsteotomyOsteotomy malalignmentmalalignment

VarusVarus bowbow--leggedlegged

ValgusValgus knockedknocked--kneedkneed

Femoral orFemoral or TibialTibial


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OptionsOptionsSurgicalSurgical -- Joint Replacement orJoint Replacement or ArthroplastyArthroplasty

UnicompartmentalUnicompartmental, Bi, Bi--modular, Totalmodular, Total

MetalMetal Titanium,Titanium, CrCOCrCO ( Porous or( Porous or

Cemented)Cemented)

PlasticPlastic Polyethylene, UHMWPolyethylene, UHMW


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OptionsOptions


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OptionsOptions


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PostPost Surgical TKASurgical TKA

22--3 days in hospital3 days in hospital

2 weeks2 weeks walker or crutcheswalker or crutches

2 weeks2 weeks canecane3 weeks3 weeks blood thinner, cant driveblood thinner, cant drive

33--4 weeks4 weeks -- first followfirst follow--up in officeup in office

88--12 weeks formal physical therapy12 weeks formal physical therapy home & outhome & out--pt.pt.

88--16 weeks RTW no restrictions16 weeks RTW no restrictions


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ResultsResults Total KneeTotal Knee

ArthroplastyArthroplasty9898--99 %99 % -- little or no pain @ 2 years postlittle or no pain @ 2 years post--opop

90%90% -- in and functioning @ 20 years postin and functioning @ 20 years post--opop

(revision(revision--10%)10%)

0.50.5--1.0 % infection rate1.0 % infection rate

22--4 % blood clot (DVT)4 % blood clot (DVT)

CMSCMS highest rated elective surgery in USAhighest rated elective surgery in USAWhy did I wait so long?Why did I wait so long? -- most commonmost common

comment postcomment post--opop


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Factors Affecting SuccessFactors Affecting Success --

TKATKABodyBody HabitusHabitusDeformityDeformity

PrePre--Op Loss of Motion/TightnessOp Loss of Motion/Tightness

Number of SurgeriesNumber of SurgeriesCoCo--MorbiditiesMorbidities Diabetes, Vascular, HeartDiabetes, Vascular, Heart

MotivationMotivation

PostPost--op Complications (DVT, Swelling,op Complications (DVT, Swelling,Infection, Medical Issues)Infection, Medical Issues)ScarringScarring

Workers CompensationWorkers Compensation


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The Case (T.T.)The Case (T.T.)

6/846/84 3333 y.oy.o. male working for Consumers Power,. male working for Consumers Power,

twisting injury L knee, arthroscopic surgery,twisting injury L knee, arthroscopic surgery,

symptoms cured. Probably removed cartilagesymptoms cured. Probably removed cartilage

(meniscus)(meniscus)7/967/96 subsequent incidental injurysubsequent incidental injury

12/12/0512/12/05 fell into 3 foot hole in ground covered upfell into 3 foot hole in ground covered up

by snow. Jammed and twisted L knee withby snow. Jammed and twisted L knee with

immediate pain and swellingimmediate pain and swelling1/4/061/4/06 initial treatmentinitial treatment-- physical therapy, off work,physical therapy, off work,

NSAIDsNSAIDs

1/25/061/25/06 symptoms unchanged, MRI orderedsymptoms unchanged, MRI ordered


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2/9/062/9/06 MRI positive (meniscus tear), discussedMRI positive (meniscus tear), discussed

TKA and preTKA and pre--op workop work--upup

3/9/063/9/06 Surgery scheduled, .Surgery scheduled, . osteoarthriticosteoarthritic

changes from original incident in 1984 relatedchanges from original incident in 1984 relatedneed for TKA to December2005 injuryneed for TKA to December2005 injury

4/12/064/12/06 TKA performedTKA performed

4/17/064/17/06 Venous duplex ultrasound orderedVenous duplex ultrasound ordered

negativenegativealso concern for infectionalso concern for infection


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6/15/066/15/06 Mild decreased ROM,Mild decreased ROM,

manipulation under anesthesia (MUA)manipulation under anesthesia (MUA)

scheduledscheduled

7/10/067/10/06 RTW without restrictionsRTW without restrictions

7/19/067/19/06 Last note availableLast note available doingdoing

well, ROM 5well, ROM 5--105105

9/069/06 Voluntary retirement form workVoluntary retirement form work


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ObjectObject -- TKATKA

To provide a stable, painTo provide a stable, pain--free, wellfree, well--

functioning jointfunctioning joint

with minimal bone resection and traumawith minimal bone resection and trauma

that lasts a lifetime.that lasts a lifetime.

In other words, essentially GOOD ASIn other words, essentially GOOD AS

NEW.NEW.


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Post ScriptPost Script

Laws that cover workers injuries and subsequentLaws that cover workers injuries and subsequent

treatment for those injuries (especially jointtreatment for those injuries (especially jointreplacement)replacement)

need to keep up with the times and factor in the vastneed to keep up with the times and factor in the vastmedicalmedical

and surgical advancements that have taken place in theand surgical advancements that have taken place in thelastlast

several decades.several decades.


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Thank YouThank You


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Agenda






11:30 12:00 PM Legal Updates

Jerry Marcinkoski / MSIA Executive Secretary / Lacey &Jones

12:00 1:00 PM Lunch







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MSIA 2010 Fall Conference Presentation