THE FUTURE IS HERE - MSIA 2010 Fall Conference

“THE FUTURE IS HERE”
2010 Fall Conference

Rock Financial Show Place
Novi, Michigan
Agenda
8:00 – 8:45 AM Registration & Breakfast
8:45 – 9:15 AM Welcome / Overview / Business Meeting
9:15 – 10:00 AM Investigation in Today’s Digital World

Tom Dana / DigitalSEA
Al Lux / Global Options
Craig 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 Updates

Jerry 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 Candidates

Justice Robert Young (Incumbent)
Judge Mary Beth Kelly
2:30 – 3:15 pm Specific Loss – Understanding Practical Legal & Medical Issues
Rick Lovernick / Conklin Benham
Dr. Jack Lennox / Tri-County Orthopedics
3:15 – 3:30 PM Door Prizes / CEUs / Adjournment

Agenda


12:00 – 1:00 PM Lunch



2010 MSIA FALL CONFERENCE
GOLD SPONSORS
Aetna Workers’ Comp Great Lakes PTPN

Access
Hostetler-Fontaine &
Brown Rehab and Associates
Review Management
ManageAbility
Global Options
2010 MSIA FALL CONFERENCE
• Audit Committee
• Business Meeting
• Nomination of Officers
• Special Recognition
Michigan Self-Insurers’ Association
Gerald M. Marcinkoski - Executive Secretary
BOARD OF MANAGERS
Amway General Motors LLC Parker-Hannifin

Lorraine Climer Susan Azar Jacey Saylor
AT&T Ilitch Holdings, Inc. Sherriff-Goslin Company

To Be Determined C. Michael Healy – Treasurer William Ticknor
City of Grand Rapids Kelly Services Spectrum Health

Mari Beth Jelks Lesley Zielinski Steve Ohman
Consumers Energy Marathon Oil Company Trinity Health

Doug Wright – 1st Vice Chair Barbara Parker – 2ndVice Chair Teresa Fisk
DTE Energy Meijer Wayne State University

Doug Green Sherri Miller Pamela Galloway
Ford Motor Company Wayne Co. Airport Authority

Jonathan Parker – Chairperson Leigh Stepaniak
Advisory Group
Compatico Michigan Chamber of Commerce Smith Haughy Rice & Roegge
Libby Child Wendy Block Danielle Susser
Chrysler LLC Michigan Manufacturing Association
Neil Levins Jennifer Spike
Agenda


12:00 – 1:00 PM Lunch



Agenda


12:00 – 1:00 PM Lunch



Agenda


12:00 – 1:00 PM Lunch



Agenda


12:00 – 1:00 PM Lunch



Agenda


12:00 – 1:00 PM Lunch



Agenda


12:00 – 1:00 PM Lunch



Agenda


12:00 – 1:00 PM Lunch



Agenda


12:00 – 1:00 PM Lunch



SPECIFIC LOSS BENEFITS
Statute
– MCL 418.361(2)
Case Law
– Lindsay v Glennie Industries, Inc.
– Cain I & Cain II
– Trammel v Consumers Energy
Facts
Decision
Knee Trauma and
Degeneration Resulting in
Total Knee Arthroplasty
Jack D. Lennox, D.O.
Chairman, Dept. of
Orthopedic Surgery
Botsford Hospital
Knee Joint
A diarthrodial joint
lined
with articular cartilage
and lubricated with
synovial fluid
Knee
Ligaments – ACL, PCL,
Joint
MCL, LCL Meniscus – Medial &
Lateral
Osteoarthritis
Loss of articular
cartilage to bare bone
associated with
symptomatic
inflammation
secondary to trauma,
birth, malalignment
and/or wear over
time.
Osteoarthritis
Osteoarthritis
Osteoarthritis – Treatment
Options
Rest Injections –
Exercise – strength, corticosteroids,
maintenance of viscosupplementation
motion, aerobic (hyaluronic acid –
conditioning, etc. Supartz, Synvisc,
Medications – Euflexxa, etc.)
NSAID’s, steroids, Electrical Stimulation
glucosamine/chondroi - Bionicare
tin sulfate, alternative
(cherry extract, MSM)
Options
Options
Surgical -
Arthroscopic
meniscoplasty and
debridement
Options
Surgical –
Joint resurfacing –
OATS
(Osteochondral
Autograft
Transfer System)
Options
Surgical –
Joint Resurfacing -
ACI – ( Autologous
Chondrocyte
Implantation)
Options
Surgical –
Osteotomy – malalignment
Varus – bow-legged
Valgus – knocked-kneed
Femoral or Tibial
Options
Surgical - Joint Replacement or Arthroplasty
Unicompartmental, Bi-modular, Total
Metal – Titanium, CrCO ( Porous or

Cemented)
Plastic – Polyethylene, UHMW

Options
Options
Post – Surgical TKA
2-3 days in hospital
2 weeks – walker or crutches
2 weeks – cane
3 weeks – blood thinner, can’t drive
3-4 weeks - first follow-up in office
8-12 weeks formal physical therapy –
home & out-pt.
8-16 weeks RTW no restrictions
Results – Total Knee
Arthroplasty
98-99 % - little or no pain @ 2 years post-op
90% - in and functioning @ 20 years post-op
(revision-10%)
0.5-1.0 % infection rate
2-4 % blood clot (DVT)
CMS – highest rated elective surgery in USA
“Why did I wait so long?” - most common
comment post-op
Factors Affecting Success - TKA
Body Habitus
Deformity
Pre-Op Loss of Motion/Tightness
Number of Surgeries
Co-Morbidities – Diabetes, Vascular, Heart
Motivation
Post-op Complications (DVT, Swelling, Infection,
Medical Issues)
Scarring
Worker’s Compensation
The Case (T.T.)
6/84 – 33 y.o. male working for Consumer’s Power,
twisting injury L knee, arthroscopic surgery,
symptoms cured. Probably removed cartilage
(meniscus)
7/96 – subsequent incidental injury
12/12/05 – fell into 3 foot hole in ground covered up
by snow. Jammed and twisted L knee with
immediate pain and swelling
1/4/06 – initial treatment- physical therapy, off work,
NSAID’s
1/25/06 – symptoms unchanged, MRI ordered
The Case (T.T.)
2/9/06 – MRI positive (meniscus tear), discussed
TKA and pre-op work-up
3/9/06 – Surgery scheduled, “…. osteoarthritic
changes from original incident in 1984 … related
need for TKA to December 2005 injury”
4/12/06 – TKA performed
4/17/06 – Venous duplex ultrasound ordered –
negative
also concern for infection
The Case (T.T.)
6/15/06 – Mild decreased ROM,
manipulation under anesthesia (MUA)
scheduled
7/10/06 – RTW without restrictions
7/19/06 – Last note available – “doing
well”, ROM 5-105
9/06 – Voluntary retirement form work
Object - TKA
To provide a stable, pain-free, well-
functioning joint
with minimal bone resection and trauma

that lasts a lifetime.
In other words, essentially “ GOOD AS

NEW”.
Post Script
Laws that cover worker’s injuries and subsequent
treatment for those injuries (especially joint replacement)
need to keep up with the times and factor in the vast

medical
and surgical advancements that have taken place in the last
several decades.
Thank You
Agenda


12:00 – 1:00 PM Lunch



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“THE FUTURE IS HERE”

2010 Fall Conference

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

9:15 – 10:00 AM Investigation in Today’s Digital World

10:00 – 10:30 AM Break / Visit Exhibitors

10:30 – 11:30 AM Workers’ Compensation Agency

11:30 – 12:00 PM Legal Updates

12:00 – 1:00 PM Lunch

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

2:00 – 2:30 PM Michigan Supreme Court Candidates

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

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

9:15 – 10:00 AM Investigation in Today’s Digital World

10:00 – 10:30 AM Break / Visit Exhibitors

10:30 – 11:30 AM Workers’ Compensation Agency

11:30 – 12:00 PM Legal Updates

12:00 – 1:00 PM Lunch

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

2:00 – 2:30 PM Michigan Supreme Court Candidates

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

Aetna Workers’ Comp Great Lakes PTPN

Amway General Motors LLC Parker-Hannifin

AT&T Ilitch Holdings, Inc. Sherriff-Goslin Company

City of Grand Rapids Kelly Services Spectrum Health

Consumers Energy Marathon Oil Company Trinity Health

DTE Energy Meijer Wayne State University

Ford Motor Company Wayne Co. Airport Authority

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

9:15 – 10:00 AM Investigation in Today’s Digital World

10:00 – 10:30 AM Break / Visit Exhibitors

10:30 – 11:30 AM Workers’ Compensation Agency

11:30 – 12:00 PM Legal Updates

12:00 – 1:00 PM Lunch

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

2:00 – 2:30 PM Michigan Supreme Court Candidates

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

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

9:15 – 10:00 AM Investigation in Today’s Digital World

10:00 – 10:30 AM Break / Visit Exhibitors

10:30 – 11:30 AM Workers’ Compensation Agency

11:30 – 12:00 PM Legal Updates

12:00 – 1:00 PM Lunch

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

2:00 – 2:30 PM Michigan Supreme Court Candidates

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

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

9:15 – 10:00 AM Investigation in Today’s Digital World

10:00 – 10:30 AM Break / Visit Exhibitors

10:30 – 11:30 AM Workers’ Compensation Agency

11:30 – 12:00 PM Legal Updates

12:00 – 1:00 PM Lunch

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

2:00 – 2:30 PM Michigan Supreme Court Candidates

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

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

9:15 – 10:00 AM Investigation in Today’s Digital World

10:00 – 10:30 AM Break / Visit Exhibitors

10:30 – 11:30 AM Workers’ Compensation Agency

11:30 – 12:00 PM Legal Updates

12:00 – 1:00 PM Lunch

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

2:00 – 2:30 PM Michigan Supreme Court Candidates

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

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