April 23, 2007
 

 
TOA President's Update
  

By David Teuscher, MD
President, Texas Orthopaedic Association

 
The importance of your TOA knowing your opinion is the foundation of our ability to represent you and your patients. We are again conducting a survey and ask you take two minutes to complete the questions on your ownership and direction of musculoskeletal healthcare facilities and services. If preventing the prohibition or restrictions on your ability to

invest in your practice and ancillary services is important, please click here to complete the survey and let us know your opinions.

We appreciate you taking the time to let us know your practice and preferences. It is how we can communicate your message to set policy with TMA, AAOS, and AMA; as well as tell your story to the legislators and bureaucrats in Austin and Washington. Recently your responses were solicited to the issue of on call emergency services and the compensation you may or may not receive for your service. If you click here, you can view the results of that survey.

If you have not taken the time to register for the TOA Annual Meeting at the Austin Four Seasons, please do so today by clicking here.  Our scientific session will feature Presidential Guest Speaker Dr. Bernie Morrey, socioeconomic seminars, and packed with cutting edge orthopaedic techniques and knowledge. Plan now to be with us at this fabulous venue May 11th-13th, and invite your favorite mothers to join us for Mothers’ Day brunch on Sunday the 13th. I hope to see you there.
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Texas District by District: Jane Nelson
    

Senator Jane Nelson is a former public school teacher who represents Senate District 12, which includes portions of Tarrant and Denton counties. She joined the Senate in 1992 after two successful terms on the State Board of Education in which she led the fight to correct more than 5,000 factual errors in our public school textbooks.

Senator Nelson is the second highest ranking Republican in the Texas Senate and serves as Chairman of the Health & Human Services

Committee. A strong advocate for patients, Senator Nelson authored Texas' first comprehensive medical privacy law; fought for HMO reform; sponsored reforms to our medical liability system; and authored the "prompt pay" law to improve the health care billing system.

She has also worked to promote preventive health, having returned physical activity to the school day and supported efforts to discourage tobacco use.

She has received numerous awards for her work in health care, including the prestigious Nathan Davis Award from the American Medical Association; Citizen of the Year for Senior Services of Tarrant County; Texas' Best Medicine award from the Texas Medical Association; and "Champion for Children" by the Texas Association of Child Advocacy Centers.

She and her husband, J. Michael Nelson, own and operate a precision aircraft component manufacturing company in Denton County.  They have four adult children (a son and four daughters) and a grandson.

Email Jane Nelson to thank her for her work!
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This Week In Texas: Mignon McGarry Memos

By Mignon McGarry
TOA Legislative Advocate / Memos: Thu Apr. 19 & Tue Apr. 17, 2007
TOA Online Version: All Memos

 

April 19, 2007, Thursday
 Today the Senate unanimously passed comprehensive legislation to reform the Texas Youth Commission. Senator Juan Hinojosa (D- Corpus

Christi) authored the bill.

In another unanimous vote, the Senate approved a bill by Senator Robert Nichols (R-Jacksonville) calling for a two year moratorium on most private toll roads.

Both of these bills now move to the House.

There are already an unusually large number of bills in the Calendars Committee on the House side.

As the weeks go by a bill’s placement on the House calendar becomes crucial.

In the House, all bills reported from a committee are sent to either the Calendars Committee or the Local and Consent Calendars Committee. A committee may recommend by unanimous consent that a measure considered non controversial be sent to the Local and Consent Calendars Committee. All other bills are sent to the Calendars Committee.

The Calendars Committee may place a bill on one of three daily calendars for floor consideration: Emergency, Major State, or General State.

Bills placed on the Emergency Calendar are considered first, in the order in which they appear on the daily calendar. Next in order are measures placed on the Major State Calendar, and the General State Calendar.

A supplemental daily calendar is also distributed each day.  This calendar determines the order for that particular day. As session continues, these House Calendars become longer and longer.  The higher up a bill is on the calendar directly increases its chance of passage.

April 17, 2007, Tuesday
Today the Texas House formally rejected the Senate amendments to their budget bill and the Speaker appointed five conferees to the conference committee that will hammer out a  final budget bill.

The House conferees are;

  • Rep. Warren Chisum (R-Pampa)

  • Rep. Dan Gattis (R-Georgetown)

  • Rep. Ryan Guillen (D-San Diego)

  • Rep. Sylvester Turner (D-Houston)

  • Rep. Lois Kolkhorst (R-Brenham)

Rep. Warren Chisum and Rep. Ryan Guillen are chair and vice-chair respectively of the House Appropriations committee, Rep. Sylvester Turner is speaker pro tem of the House and both Rep. Dan Gattis and Rep. Lois Kolkhorst are veterans of the last conference committee in 2005.

The Senate will announce their five conferees later this week. Currently the House version of the budget contains $150.1 billion over the next two years, while the Senate version sets the amount at $152.6 billion. What’s $2.5 billion between friends?

The big news in the Senate today was the unanimous vote approving Senate Bill 10, Senator Jane Nelson’s (R-Flowermound) Medicaid reform legislation. It is now headed to the House for consideration.
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FDA Panel Rejects Cox-2 Inhibitor
    

A U.S. Food and Drug Administration (FDA) panel has voted 20 to 1 against recommending the drug Arcoxia (etoricoxib) for approval. While nonbinding, FDA usually follows the recommendations of the panel. Arcoxia, a Cox-2 inhibitor, was being touted as a treatment for symptoms of osteoarthritis. One panelist commented that offering Arcoxia for sale would be a “potential public health disaster,” and other panelists stated that patients need better arthritis drugs, not more of

them. Arcoxia was no more effective than 20 pills already on the market, and had a similar cardiovascular risk. For more information click here.

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TSSM President's Update
  

While soccer is a fall sport back east, and year round for most of the world, spring is soccer season here in Texas. The high school season is coming to an end and the busy club season is coming into full swing, with the summer tournament rush just around the corner.

Football, as it is known internationally, is, like its American namesake, fraught with potential injury.  This comes as a surprise to many parents who view it as a “safe” sport for their children.  One study reports a

total of nearly 1.6 million soccer related emergency room visits during a 13 year period in the pediatric population.1

This number may seem like a lot of visits, over one hundred thousand a year on average, but when taken in the context of total players at anyone time it becomes a little more understandable.  Over 600,000 high school athletes participate in soccer annually, and the American Academy of Pediatrics estimates that growth of  soccer participation may be as high as 21.8% annually.2   So, despite many Americans’ dislike of soccer, it appears that it is here to stay.  As athletic trainers and physicians, our ability to assess, treat, and return the patient to play will play an important role in the athletic lives of many of our pediatric patients.

Some of the most common injuries faced by soccer players are knee injuries.  A study of collegiate athletes found that the rate of ACL rupture was 0.12 per 1000 athlete exposures in men and 0.32 per 1000 exposures in women athletes.  These represented a higher rate of ACL injury than in basketball.3 This rate is not that different when compared to rugby, a sport seen as much more physical and dangerous, the rate being 0.07 and 0.36 per 1000 exposures for men’s and women’s rugby respectively.4

By far the most common traumatic injury is the ankle, involving about 36% of total injuries in one study. Overuse injuries were also common, accounting for around 34% of total injuries, with the lower extremity being involved in 84% of the injuries,5 a finding not altogether surprising being that only two players on the field are allowed to use their hand in live play.   However, shoulder injuries are also common, with many high level pros currently out because or coming back from dislocated shoulders.  One must also be aware of the possibility of head injury, both due to repetitive heading the ball, as well as the catastrophic collisions of head with foot, head with head or worse head with goal post.

As soccer grows in popularity, so will our understanding and familiarity with soccer injuries.  Already the US is gaining in soccer stature, with many of our players starring in the world’s best leagues.  So if you are not yet a soccer fan, you want to become one, because chances are you will be seeing more soccer, and soccer players, in the future.

Hope to see you at the annual meeting in Austin!

References
 1. Robert E. Leininger, Christy L. Knox, and R. Dawn Comstock
Epidemiology of 1.6 Million Pediatric Soccer-Related Injuries Presenting to US Emergency Departments From 1990 to 2003
Am. J. Sports Med., Feb 2007; 35: 288 - 293.

2.  American Academy of Pediatrics, Committee on Sports Medicine and Fitness.  Injuries in youth soccer: a subject review. Pediatrics.  2000;105(pt 1):659-661.

3.  Leanne C. S. Mihata, Anthony I. Beutler, and Barry P. Boden
Comparing the Incidence of Anterior Cruciate Ligament Injury in Collegiate Lacrosse, Soccer, and Basketball Players: Implications for Anterior Cruciate Ligament Mechanism and Prevention
Am. J. Sports Med., Jun 2006; 34: 899 - 904.

4.  Johnathan Collett, Helen Dawes and Richard P. Craven
 SHORT COMMUNICATION ON THE INFLUENCE OF POSITION ON ANTERIOR CRUCIATE LIGAMENT INJURY AND RECONSTRUCTION IN RECREATIONAL RUGBY FOOTBALL UNION PARTICIPANTS
 J Sports Sci and Med vol 2 (1) p 30-33.

5.  AB Nielsen and J Yde
Epidemiology and traumatology of injuries in soccer
Am. J. Sports Med., Nov 1989; 17: 803 - 807.
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TOA Deputy Director's Update
 

By Jeseka Wallace
Deputy Director, Texas Orthopaedic Association

 
We want to thank our TOA members who are taking the time to fill out our brief surveys. The latest survey on workers' comp billing and collections (silent PPOs or "ghosting") indicates there is a larger problem than we initially thought. We would like to thank Dr. Stephen Wilson for submitting this short survey. The results are very interesting. Click here to view the Survey Results.

Please take a look at the TOA Home Page and review the items in the Headlines - Quick Links box. You will find the surveys at the bottom of the boxed information. We encourage our members to voice their opinions and let your concerns be known by the TOA Leadership.

Other Texas Orthopaedic Association Surveys:

If you have not registered for the 2007 TOA Annual Meeting May 10-13, please do so NOW! You can view the entire program and register here. The Four Seasons' cut off date was last week but you may still be able to obtain the TOA price - so make your reservations by calling 512-478-4500 today.
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