CommentaryFrom OT Europe

Presidential highlights review theme, symposia at EFORT Congress in Lisbon

Another great EFORT Congress just concluded. This one, which was held in Lisbon, was the 20th EFORT Congress. As president of EFORT starting June 2018 and ending immediately after the Congress in Lisbon, it was a special event for me, as might be expected.

Per Kjaersgaard-Andersen, MD
Per Kjaersgaard-Andersen

I am happy that the EFORT educational and scientific concept of our congress, which is the only large congress in Europe that covers all aspects of orthopaedics and traumatology, again proved its value through the 6,000 congress participants, high-quality sessions and dedicated participation from the medical industry, all of which occurred against the spectacular backdrop of Lisbon.

The main theme this year was “Registries & Impact on Practice.” More than 10 sessions were organized to cover this aspect of orthopaedic and traumatology practice. The Australian Orthopaedic Assocation (AOA) was the Guest National Society in Lisbon. As the AOA has one of the largest joint arthroplasty registries in the world — the AOA National Joint Replacement Registry or AOANJRR — the “Metal-On-Metal Hip Arthroplasty Outcomes: Remaining Problems” symposium was organized in conjunction with AOA and AOANJRR representatives. The session taught us that a few implants are responsible for most of bad outcomes with metal-on-metal (MoM) hip bearings and all designs with MoM bearings have inferior clinical outcomes compared to conventional bearings. Also, patients who undergo revision of implants with MoM bearings have a higher risk of re-revision, mainly due infection and aseptic loosening. Finally, the longer-term toxicity of elevated chrome and cobalt in serum is still not fully understood and, to be cautious, patients with high and/or increasing serum levels should be monitored and followed meticulously.

Data that change orthopaedic practice

In a symposium on “Do Surgeons Trust Registry Data,” reports from both the AOANJRR and the Swedish Hip Arthroplasty Registry showed surgeons change their practice following reports from their national joint replacement registry on the performance of implants and surgical techniques, as well as after they receive reports on their own patients’ outcomes.

Another congress highlight was the symposium organized by the EFORT Foundation that focused on patient safety by way of the topic, “Impact of Smoking on Outcomes After Orthopaedic and Trauma Surgery.” Smoking is an underestimated problem and one I am glad was addressed in Lisbon to communicate the information that smoking in the perioperative period has a major negative impact on the outcome of orthopaedic procedures. Wound healing, deep infection, loosening of implants and reduced bone healing are among the factors discussed that affect patients who smoke.

This year’s full day on advanced THR and TKR included topics that once again were attractive to congress participants because the main auditorium for this session was nearly full of European joint replacement surgeons. With input from the European Hip Society, European Knee Society and European Knee Associates, subjects such as problems in younger patients, periprosthetic femur fractures, new technology and hot topics were covered.

Unfortunately, terroristic attacks have come to the European area in recent years. Therefore, EFORT regularly creates educational sessions to education the orthopaedic and trauma community about how to handle mass casualty incidents. Trauma surgeons debated in Lisbon about the latest terrorist events and taught attendees how to set up appropriate organizations.

Specialty societies support

The EFORT Congress is supported by the European Orthopaedic and Traumatology Specialty Societies. Besides assisting with speakers for sessions that the EFORT Scientific Committee organized, the organization also educated attendees at its own sessions held during the congress. This arrangement gave the EFORT Congress the feeling of a true orthopaedics and traumatology meeting and the advanced scientific knowledge provided by the specialty societies increased the value of them.

The EFORT Congress is the event at which the greatest number of researchers and clinicians worldwide may present their work. A total of 800 free papers and 1,200 posters were presented during the congress. Several Poster Walking Sessions were organized each day. I had the opportunity to take one of these “walks” and witnessed good discussions. This concept has come to stay. At the meeting, awards were given to the 10 best posters and the seven best free papers.

Those who either missed the EFORT Congress or missed a session or two of interest can access that information at the EFORT website.

Disclosure: Kjaersgaard-Andersen reports no relevant financial disclosures.

Another great EFORT Congress just concluded. This one, which was held in Lisbon, was the 20th EFORT Congress. As president of EFORT starting June 2018 and ending immediately after the Congress in Lisbon, it was a special event for me, as might be expected.

Per Kjaersgaard-Andersen, MD
Per Kjaersgaard-Andersen

I am happy that the EFORT educational and scientific concept of our congress, which is the only large congress in Europe that covers all aspects of orthopaedics and traumatology, again proved its value through the 6,000 congress participants, high-quality sessions and dedicated participation from the medical industry, all of which occurred against the spectacular backdrop of Lisbon.

The main theme this year was “Registries & Impact on Practice.” More than 10 sessions were organized to cover this aspect of orthopaedic and traumatology practice. The Australian Orthopaedic Assocation (AOA) was the Guest National Society in Lisbon. As the AOA has one of the largest joint arthroplasty registries in the world — the AOA National Joint Replacement Registry or AOANJRR — the “Metal-On-Metal Hip Arthroplasty Outcomes: Remaining Problems” symposium was organized in conjunction with AOA and AOANJRR representatives. The session taught us that a few implants are responsible for most of bad outcomes with metal-on-metal (MoM) hip bearings and all designs with MoM bearings have inferior clinical outcomes compared to conventional bearings. Also, patients who undergo revision of implants with MoM bearings have a higher risk of re-revision, mainly due infection and aseptic loosening. Finally, the longer-term toxicity of elevated chrome and cobalt in serum is still not fully understood and, to be cautious, patients with high and/or increasing serum levels should be monitored and followed meticulously.

Data that change orthopaedic practice

In a symposium on “Do Surgeons Trust Registry Data,” reports from both the AOANJRR and the Swedish Hip Arthroplasty Registry showed surgeons change their practice following reports from their national joint replacement registry on the performance of implants and surgical techniques, as well as after they receive reports on their own patients’ outcomes.

Another congress highlight was the symposium organized by the EFORT Foundation that focused on patient safety by way of the topic, “Impact of Smoking on Outcomes After Orthopaedic and Trauma Surgery.” Smoking is an underestimated problem and one I am glad was addressed in Lisbon to communicate the information that smoking in the perioperative period has a major negative impact on the outcome of orthopaedic procedures. Wound healing, deep infection, loosening of implants and reduced bone healing are among the factors discussed that affect patients who smoke.

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This year’s full day on advanced THR and TKR included topics that once again were attractive to congress participants because the main auditorium for this session was nearly full of European joint replacement surgeons. With input from the European Hip Society, European Knee Society and European Knee Associates, subjects such as problems in younger patients, periprosthetic femur fractures, new technology and hot topics were covered.

Unfortunately, terroristic attacks have come to the European area in recent years. Therefore, EFORT regularly creates educational sessions to education the orthopaedic and trauma community about how to handle mass casualty incidents. Trauma surgeons debated in Lisbon about the latest terrorist events and taught attendees how to set up appropriate organizations.

Specialty societies support

The EFORT Congress is supported by the European Orthopaedic and Traumatology Specialty Societies. Besides assisting with speakers for sessions that the EFORT Scientific Committee organized, the organization also educated attendees at its own sessions held during the congress. This arrangement gave the EFORT Congress the feeling of a true orthopaedics and traumatology meeting and the advanced scientific knowledge provided by the specialty societies increased the value of them.

The EFORT Congress is the event at which the greatest number of researchers and clinicians worldwide may present their work. A total of 800 free papers and 1,200 posters were presented during the congress. Several Poster Walking Sessions were organized each day. I had the opportunity to take one of these “walks” and witnessed good discussions. This concept has come to stay. At the meeting, awards were given to the 10 best posters and the seven best free papers.

Those who either missed the EFORT Congress or missed a session or two of interest can access that information at the EFORT website.

Disclosure: Kjaersgaard-Andersen reports no relevant financial disclosures.