July 2019

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Cover Story

Wounded Warrior Workforce Enhancement Legislation Introduced as Georgia Tech Deactivates MSPO Program

Will Congress act to provide for the ongoing care of America’s wounded warriors? The unfortunate truth: The need for prosthetic and orthotic (P&O) care is growing in this country, thanks, in part, to events on the other side of the globe—namely, unconventional warfare in Iraq and Afghanistan, although uncontrolled cardiovascular disease and diabetes continue to each play their devastating role.

By Keith Loria and Janice T. Radak


Guest Editorial

The Wounded Warrior Workforce Enhancement Act: A Win-Win for Patients and the Profession

Currently, the Veterans’ Administration (VA) serves more than 90,000 Veterans who have lost limbs and performs more than 12,000 amputation surgeries annually. Additionally, although the number of Veterans with significant, chronic limb impairment is unclear, it is unquestionably large.

By Eve Lee, MBA, CAE, Executive Director, American Orthotic and Prosthetic Association

Feature Articles

Enthesis: Unique Structure Makes Tendon-to-Bone Repairs Complicated

Formed during development, this efficient attachment system cannot be recreated during healing. Many common injuries, such as Achilles tendon and rotator cuff tears, require surgical procedures that reattach the affected tendon to the bone. Stavros Thomopoulos, PhD, director of Carroll Laboratories for Orthopedic Surgery at Columbia University in New York, compares it to trying to attach a rope to a piece of cement.

By Nicole Wetsman

At All Levels and Categories of Cycling: Correct Poor Crank-arm Fit to Relieve Chronic Knee (and Hip) Pain

Consider recommending installation of shorter crank arms on a bike when a cyclist complains of knee or hip pain. After years of bike-fitting, here’s why we’ve concluded that this modification is invaluable. One of the biggest problems in bicycling, I’ve found, is that pain is considered normal. I (RS) am a master bike fitter and an elite cycling coach.

By Rick Schultz, MBA, DBA, and Amy Schultz, PT, DPT, CSCS

A Common Class of Antibiotics Can Lead to Tendon Rupture

Despite Black Box warning for risk of tendinitis and tendon rupture, clinicians continue to prescribe fluoroquinolones. Half of the musculoskeletal injuries in the United States each year involve tendons and ligaments, and of the tendon injuries that can occur, those that strike the Achilles tendon are the most common. Higher rates of participation in…

By Nicole Wetsman

From the Literature

Survey Identifies Quality of Care Indicators for AFO Users

Lower limb orthoses are worn by nearly 2 million Americans of all ages. Certified orthotists have reported spending 59% of their time providing lower limb orthoses, of which 18% is spent providing ankle foot orthoses (AFOs). Despite such a substantial time commitment spent providing patients with lower-limb orthoses, and specifically AFOs, patient satisfaction reporting and quality of care assessment have not been fully documented.

By Laura Fonda Hochnadel

Isokinetic Training + Eccentric Overload = >Muscle Size, >Performance

A team of researchers undertook a study to examine changes in performance and muscle size in young ice hockey players who underwent a program of multiple-joint isokinetic (ISO) resistance training (RT) and eccentric overload (ECC) compared to a control group that underwent a traditional (eg, isotonic) RT program. According to the literature, ISO training and ECC, when…

By Laura Fonda Hochnadel

Excerpt: Shin Splints, Achilles Tendinopathy Top Running-related Diagnoses Among Injured Recreational Runners

The purpose of the present study was to describe the incidence proportion of different types of running-related injuries (RRI) among recreational runners and to determine their time to recovery.

By Benjamin Mulvad, Rasmus Oestergaard Nielsen, Martin Lind, and Daniel Ramskov

Skipping Tops Running for Knee Joint Contact Forces and Metabolic Costs

Running’s high rate of sport-related injury is a prime driver of reduced exercise participation, despite its bountiful health benefits. Skipping—that childhood symbol of carefree whimsy—presents a lot like running, but when compared to running, provides unique benefits: shorter steps, reduced vertical ground reaction forces (GRFs), and lower knee extensor torques.

Gout: Well Known, But Misunderstood

Gout may be well known, but there is a tremendous misunderstanding of what it takes to treat this serious inflammatory disease. Those are among the findings of a recent survey conducted for the Gout Education Society by Wakefield Research. The online survey of 1,000 nationally representative Americans, ages 18+, with an oversampling of 100+ interviews of adults who…

Early Sports Specialization Tied to Increased Injury Rates in College Athletes

Nearly 60 million children and young teens participate in organized athletics each year with ever-increasing numbers of kids specializing in one sport before the age of 14 with hopes of a college scholarship or professional career on the line. However, researchers presenting their work at the American Orthopaedic Society for Sports Medicine/Arthroscopy…

Industry News & Updates

DME MAC Issues Reminder about RT and LT Modifier Usage

CGS, the Durable Medical Equipment Medicare Administrative Contractor (DME MAC) for Jurisdictions B and C has issued a reminder regarding billing right (RT) and left (LT) modifiers on separate claim lines. There are 6 device categories related to lower extremity care: ankle-foot/knee-ankle-foot orthoses, knee orthoses, lower limb prostheses, orthopedic footwear, surgical dressings, and therapeutic shoes for persons with diabetes.

CMS Issues DMEPOS Proposed Rule

The Centers for Medicare and Medicaid Services (CMS) has released a proposed rule containing updates to the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) regulations. CMS also published a fact sheet outlining several major provisions in the rule, which are summarized…

Robotic Cane Improves Stability in Walking

A team of researchers at Columbia (University) Engineering have added electronics and computation technology to a walking cane to transform it into a robotic device that can provide light-touch assistance in walking to the elderly and individuals with impaired mobility. A team led by Sunil Agrawal, PhD, professor of mechanical engineering and of…

Adapttech Gears Up for US Launch

Biomedical startup Adapttech, Birmingham, England, announced that it has appointed Stuart Mead as chairman ahead of the company’s launch in the United States later this year. Mead is the former CEO of Touch Bionics, Livingston, Scotland, and has been appointed for his insight and leadership in the prosthetics sector. Touch Bionics was acquired by Össur, Reykjavik, Iceland, in 2016.

Össur to Acquire College Park Industries

Össur, Reykjavik, Iceland, has signed an agreement to acquire College Park Industries, Warren, MI, a global provider of lower- and upper-limb prostheses and supporting services. College Park has over 140 employees and shows 2018 total sales of $22 million.

SIGVARIS GROUP North America Appoints New President/CEO

SIGVARIS GROUP North America, Peachtree City, GA, has appointed Barbara Osborne as president and CEO, effective May 30. She has over 30 years of diverse business experience in the medical device field with focused capacity in general commercial and management roles. She started her career in accounting and has since held roles such as president and…

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