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Phone Number: 610-695-2459

AO VET NA Masters Course-Principles of Deformity Correction: Thoracic Limb

November 2, 2022 - November 4, 2022
Glendale, Arizona, USA

The purpose of this course is to provide the participant with the basic fundamentals of understanding how to assess the alignment of the forelimb of the dog. These principles will then be applied to a number of conditions that arise from pathologic malalignment of the forelimb, such as growth disturbances, angular limb deformation and joint incongruity. Participants will learn a variety of pre-operative assessments and operative techniques in a highly interactive environment involving lectures, workbook exercises, software-based planning sessions and hand-on laboratory experiences.

 
*Attendance / completion of an AO VET Principles in Small Animal Fracture Management course is a prerequisite for the Masters level course since familiarity with instrumentation and techniques will be assumed.

 

REGISTERED PARTICIPANTS ARE REQUIRED TO BRING EITHER A LAPTOP OR IPAD TO THE COURSE IN ORDER TO ACCESS THE COMPUTER SOFTWARE TEMPLATING PROGRAM
 
Target Audience:

 

Enrollment is open to Veterinary residents and practicing veterinarians.

 

Tuition:
Level Name: Participant - Veterinary
Pricing Tier: Attending
Tuition: $2,000.00

Level Name: Participant - Veterinary
Pricing Tier: Resident
Tuition: $1,800.00

Course Prerequisite(s):
  • Principles of Small Animal Fracture Management

Questions:
Email Member Relations
Phone Number: 610-695-2459

Language(s):
English
Professional Level Prerequisite(s):
(No Prerequisites)

Continuing Education Credit: 20.75

AO North America is a Registry of Approved Continuing Education (RACE) Provider (Number 244).

Designation Statement
This program was reviewed and approved by the AAVSB RACE program for 20.75 hours of continuing education credit in jurisdictions which recognize AAVSB RACE approval. Please contact the AAVSB RACE program if you have any comments/concerns regarding this program’s validity or relevancy to the veterinary profession.

The Continuing Medical Education (CME) mission of AO North America (AONA®) is to provide comprehensive multidisciplinary needs based education to surgeons, fellows, and residents in the specialties of orthopedic, hand, craniomaxillofacial, spine, neurosurgery, and veterinary surgery in the areas of trauma (i.e.), operative reduction and fixation), degenerative disorders, deformities, tumors, and reconstruction.

Expected results of AONA's CME activities for surgeons, fellows, and residents are to:
• Increase their knowledge base and surgical skill level
• Improve competence by applying advances of knowledge in patient care in the areas of trauma, degenerative disorders, deformities, tumors, and reconstructive surgical techniques
• Address practice performance gaps by improving management of aspects of traumatic injuries and musculoskeletal disorders (i.e., pre-operative planning to post-operative care)

Upon completion, participants should be able to:
  • Assess the limb alignment of the thoracic limb (both normal and abnormal) in the dog
  • Utilize the determined limb alignment to document and define any malalignment or deformity present
  • Use the map of documented malalignments to develop a pre-surgical plan for correction
Wednesday, November 02, 2022 - 08:00 - 17:10
Schedule
Title
Moderator
Faculty
Welcome and Course Overview
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Room:

 

GEOMETRIC CONCEPTS AND PRINCIPLES OF THE CORA METHODOLOGY
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Introduction to the CORA Methodology - Geometric Concepts
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Define the (3) planes and (6) directions of deformity Define joint orientation Line (JOL) Define axes (anatomic and mechanical) Define joint orientation angle

Workbook Exercise 1: Determining the Normal Alignment of Generic Bones
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Room:

 

Determining the Location and Magnitude of a Deformity - The Anatomy of A 'CORA'
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Determine the location of a CORA Measure the magnitude of a CORA Define the transverse bisecting line Define closing and opening CORAs Define the angulation correction axis (ACA)

Workbook Exercise 2: Using the CORA Method to Assess the Location and Magnitude of a Deformity
Venue:
Room:

 

Coffee Break
Venue:
Renaissance Phoenix Glendale Hotel
Room:
Solana Ballroom Foyer

 

The Graphical Method of Determining the Plane of the Deformity
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Room:

 

Revisit 6 directions of deformities in 3 planes Define the plane of the deformity Define an oblique plane deformity Calculate the magnitude and plane of an oblique plane deformity using the graphical method

Workbook Exercise 3: Using the Graphic Method to Determine the Plane of the Deformity
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Concepts of Osteotomies and Paley's Three Rules
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Define the three elements to consider when doing a correction: CORA, ACA, osteotomy Define Paley Rule #1 – show generic example and then clinical correlate Define Paley Rule #2 – show generic example and then clinical correlate Define Paley Rule #3 – show generic example and then clinical correlate

Workbook Exercise 4: Practicing Virtual Corrections of Deformities with Different Osteotomy Types
Venue:
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Venue:
Renaissance Phoenix Glendale Hotel
Room:
Solana E

 

GEOMETRIC CONCEPTS AND PRINCIPLES OF THE CORA METHODOLOGY (continued)
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Room:

 

Circular External Skeletal Fixators (CESF) Introduction and Concepts
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Provide an overview of the CESF system and in general, how it works to provide stability Discuss the general applications / uses of the CESF system Define how CESF systems can be used to treat angular and length deformities

CESF Nomenclature and Systems
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Identify the different parts of a CESF device and their uses Outline the appropriate application of a CESF Provide tips and tricks to the effective application and use of a CESF on an appendicular long bone

CORA Plane of Deformity as it Relates to CESF Application
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Identify the different parts of a CESF device and their uses Outline the appropriate application of a CESF Provide tips and tricks to the effective application and use of a CESF on an appendicular long bone

Workbook Exercise 5: Designing a Hinged CESF Frame to Correct an Oblique Plane Deformity
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Room:

 

Coffee Break
Venue:
Renaissance Phoenix Glendale Hotel
Room:
Solana Ballroom Foyer

 

Lab A Planning: Determining the Magnitude and Location of a Frontal Plane Deformity - PVC
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Room:

 

Lab B Planning: Determining the Magnitude and Location of an Oblique Plane Deformity - PVC
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Travel to Lab
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Lab A: Correcting a Frontal Plane Deformity with a Hinged CESF Frame - PVC
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Lab B: Correcting an Oblique Plane Deformity with a Hinged CESF Frame - PVC
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Adjourn for the Day
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Welcome Reception
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Thursday, November 03, 2022 - 08:00 - 17:20
Schedule
Title
Moderator
Faculty
APPLICATIONS OF PRINCIPLES TO THE RADIUS AND ULNA
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Room:

 

Physical Examination of the Canine Forelimb Focusing on Alignment and Deformity Assessment
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"Define the alignment of the normal forelimb from gross appearance using anatomic landmarks Demonstrate the effect of a uniapical radioulnar deformity on the gross appearance of the forelimb Demonstrate the effect of a biapical radioulnar deformity on the gross appearance of the forelimb Demonstrate the effect of limb shortening on the gross appearance of the forelimb Discuss compensatory postures associated with various forelimb deformities"

Assessing Alignment of the Normal Humerus and Radius/Ulna using Radiography
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"Using the JOL, JOA and axes, define the alignment of a normal canine humerus in the frontal / sagittal planes Using the JOL, JOA and axes, define the alignment of a normal canine radius and ulna in the frontal / sagittal planes Using the JOL, JOA and axes, define the alignment of a normal canine metacarpus in the frontal plane Using the JOL, JOA and axes, define the normal overall forelimb alignment and its relationship to the elbow"

Workbook Exercise 6: Determining the Normal Alignment of the Humerus and Radius/Ulna
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Determining the Location, Magnitude and Plane of Uniapical Radioulnar Deformities Using Radiography
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"Review the determination of the JOL, and axes on an angulated radius / ulna using normal JOAs in radiographs Determine the location, magnitude and plane of the deformity on an angulated radius (uniapical)"

Workbook Exercise 7: Determining the Location, Magnitude and Plane of a Uniapical Radioulnar Deformity
Venue:
Room:

 

Coffee Break
Venue:
Renaissance Phoenix Glendale Hotel
Room:
Solana Ballroom Foyer

 

Lab C and D Planning: Determining the Location, Magnitude and Plane of an Oblique Uniapical Radioulnar Deformity
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Room:

 

Lab C and D Explanation and Overview
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Travel to Lab
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Lab C: Correcting and Oblique Uniapical radioulnar Deformity Model with a CESF an Opening Wedge Osteotomy
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Lab D: Correcting an Oblique Uniapical Radioulnar Deformity Model with ORIF and Closing Wedge Ostectomy
Venue:
Room:

 

Venue:
Renaissance Phoenix Glendale Hotel
Room:
Solana E

 

APPLICATIONS OF PRINCIPLES TO THE RADIUS AND ULNA (continued)
Venue:
Room:

 

Torsion-Angulation Deformities of the Radius/Ulna: Assessment with Gross Examination and Radiographs
Venue:
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"Define bone ‘torsion’ and distinguish it from limb ‘rotation.’ Review methods of quantifying torsional deformities of the radius and ulna from gross examination Review the artifactual miscalculation of angulation measurement in radiographs of torsion-angulation deformities. Present the segmental radiographic technique of estimating CORA magnitude in torsion-angulation deformities"

Workbook Exercise 8: Planning a Correction of a Radius/Ulna Torsion-Angulation Deformity with Radiographs
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Computed Tomography of the Normal Radius/Ulna
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"Review the interpretation of a CT scan of a normal radius / ulna. Provide technical tips for acquiring an appropriate antebrachial CT scan Review applications of CT scans of the radius / ulna – different viewing and formatting possibilities"

Torsion-Angulation Deformities of the Radius/Ulna: Assessment with Computed Tomography (CT)
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"Review the indications for when to CT scan a radioulnar deformity Review the methodology for determining the location, magnitude and plane of the deformity from CT Provide a method for surgical planning of torsion-angulation deformity correction from CT"

Workbook Exercise 9: Planning a Correction of a Radius/Ulna Torsion-Angulation Deformity with CT
Venue:
Room:

 

Coffee Break
Venue:
Renaissance Phoenix Glendale Hotel
Room:
Solana Ballroom Foyer

 

Lab E Planning: Determining the Location, Magnitude and Plane of an Oblique Uniapical Torsion-Angulation Deformity
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Room:

 

Lab E Explanation and Overview
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Travel to Lab
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Lab E: Correcting an Oblique Uniapical Torsion-Angulation Deformity with either CESF or ORIF and Osteotomy of Choice
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Friday, November 04, 2022 - 08:00 - 16:30
Schedule
Title
Moderator
Faculty
COMPLEX DEFORMITIES AND OTHER TOPICS ON FORELIMB ALIGNMENT
Venue:
Room:

 

Biapical Radioulnar Deformities of Chondrodystrophic Dogs: Assessment and Description of Condition
Venue:
Room:

 

"Define multiapical and biapical deformities Demonstrate how to quantify the location, magnitude and plane of biapical radioulnar deformities Review the most common biapical deformity manifestation of the radius/ulna Review the effect of chondrodystrophic biapcial deformities on the elbow and carpus Review concepts of biapical correction – single level versus double level correction"

Biapical Radioulnar Deformities - Correction with ORIF
Venue:
Room:

 

"Provide overview of the goals of double level correction of biapical deformities Review technical approach to executing double level closing wedge ostectomies of the radius Review technical aspects of stabilizing the double level correction with open reduction and internal fixation (ORIF) Review aftercare and outcome with double level osteotomy and ORIF"

Biapical Radioulnar Deformities - Correction with CESF
Venue:
Room:

 

"Review the advantages of treating biapical deformities with CESF Review the technical approach of designing a CESF frame to correct a biapical deformity via double level osteotomy Review aftercare and outcome with double level osteotomy and CESF"

Workbook Exercise 10: Determining the Location and Magnitudes of Biapical Deformities
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Room:

 

Radioulnar Incongruency: Short Radius - Identification and Strategies for Treatment
Venue:
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"Define the ‘short-radius’ elbow incongruity syndrome Discuss accurately diagnosing a shortened radius Review potential sources of a shortened radius Provide treatment options for correction of a short radius to improve elbow incongruity"

Radioulnar Incongruency: Short Ulna - Identification and Strategies for Treatment
Venue:
Room:

 

"Define the ‘short-ulna’ elbow incongruity syndrome Discuss accurately diagnosing a shortened ulna Review potential sources of a shortened ulna Provide treatment options for correction of a short ulna to improve elbow incongruity"

Coffee Break
Venue:
Renaissance Phoenix Glendale Hotel
Room:
Solana Ballroom Foyer

 

Other Radioulnar Deformities: Premature Closure of the Lateral Aspect of the Distal Radial Physis
Venue:
Room:

 

"Define premature closure of the lateral aspect of the distal radius Demonstrate different clinical presentations and gross appearance of the condition Review diagnostic imaging findings (radiographs and CT) of the condition Review clinical manifestations of the premature closure of the lateral aspect of the distal radial physis Demonstrate treatment options for the condition."

Other Radioulnar Deformities: the Dysostoses: Radial Hemimelia, Ectrodactyly
Venue:
Room:

 

"Provide the system of nomenclature used for classifying the dysostoses Define the most common dysostoses affecting the forelimb of the dog Review the condition of radial hemimelia Review the condition of ectrodactyly Provide overview of surgical reconstruction options including when to and when not to do surgery"

Advanced Concepts: Software Advances in Assessment and Virtual Planning of Radioulnar Deformities
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"Provide overview of software planning options to quantitate radioulnar deformities and execute virtual corrections. Review advantages and disadvantages of the different systems including costs, learning curves and accuracy Demonstrate examples of the different systems"

Advanced Concepts: 3D Printing and Surgical Planning of Radioulnar Deformities
Venue:
Room:

 

"Provide overview of 3D printing from CT scan technology Review the uses of 3D printing radioulnar deformities Review accessibility and costs of different printing options Demonstrate examples of performing rehearsal surgeries on 3D models prior to surgical correction of radioulnar deformities Review advantages and disadvantages of utilizing 3D printing technology for deformity quantification and surgical planning"

Venue:
Renaissance Phoenix Glendale Hotel
Room:
Solana E

 

COMPLEX DEFORMITIES AND OTHER TOPICS ON FORELIMB ALIGNMENT (continued)
Venue:
Room:

 

Advanced Concepts: 3D Printed Cut Guides and Templates for Correction
Venue:
Room:

 

"Review the concept of 3D printed osteotomy guides for radioulnar deformity correction Provide overview of how the guides are fabricated to allow the performance of accurate osteotomies Demonstrate the use of 3D printed guides in the correction of a radioulnar deformity Review the accessibility and costs of pursuing 3D printed guides as a treatment option"

Timing of Radioulnar Deformity Correction: Juvenile Versus Adult Surgical Intervention
Venue:
Room:

 

"Define the difference between juvenile and adult patients presenting with radioulnar deformities Discuss treatment strategy differences in the young versus the skeletally mature patient presenting with a radioulnar deformity Review advantages and disadvantages of non-surgical versus surgical management of radioulnar deformities at the different ages Provide overview of decision making when presented with immature patients with emerging deformities."

What is the Evidence: Relationship of Forelimb Alignment to Medical Compartment Disease of the Elbow
Venue:
Room:

 

"Provide definition of medial compartment disease of the canine elbow Review potential etiologies of this condition Review literature on the impact of overall limb alignment and elbow congruity on medial coronoid disease and medial compartment syndrome Review the literature on the efficacy of corrective osteotomies used to treat medial compartment disease of the elbow."

Venue:
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Coffee Break
Venue:
Renaissance Phoenix Glendale Hotel
Room:
Solana Ballroom Foyer

 

Venue:
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Faculty Disclosure:

It is the policy of AO North America to abide by the Accreditation Council for Continuing Medical Education Standards for Commercial Support. Standard 2: “Disclosures Relevant to Potential Commercial Bias and Relevant Financial Relationships of Those with Control over CME Content,” requires all planners, including course directors, chairs, and faculty, involved in the development of CME content to disclose their relevant financial relationships prior to participating in the activity. Relevant financial relationships will be disclosed to the activity audience. The intent of the disclosure is not to prevent a faculty with a relevant financial or other relationship from teaching, but to provide participants with information that might be of importance to their evaluation of content. All potential conflicts of interest have been resolved prior to the commencement of this activity.


Off-Label / Experimental Discussions:

Some medical devices used for teaching purposes and/or discussed in AO North America’s educational activities may have been cleared by the FDA for specific uses only or may not yet be approved for any purpose. Faculty may discuss off-label, investigational, or experimental uses of products/devices in CME certified educational activities. Faculty have been advised that all recommendations involving clinical medicine in this CME activity are based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients.

All scientific research referred to, reported or used in this CME activity in support or justification of a patient care recommendation conforms to the generally accepted standards of experimental design, data collection and analysis.


Disclaimer:

AONA does not endorse nor promote the use of any product/device of commercial entities.  Equipment used in this course is for teaching purposes only with the intent to enhance the learning experience.

 


Conflict of Interest Resolution Statement:
When individuals in a position to control or influence the development of the content have reported financial relationships with one or more commercial interests, AO North America utilizes a process to identify and resolve potential conflicts to ensure that the content presented is free of commercial bias.

Liability Statement:
AO North America faculty and staff assume no personal liability for the techniques or the use of any equipment and accessories used for teaching purposes in the laboratory. The certificate provided pertains only to the participants’ completion of the course and does not, in any way, attest to the proficiency of the participants’ clinical experience.


In-Kind Support
AO North America gratefully acknowledges in-kind support for equipment and technical staff from DePuy Synthes, IMEX, and vPOP.

Educational Grant
AO North America gratefully acknowledges funding for its education activities from the AO Foundation.  The AO Foundation receives funding for education from Synthes GmbH.