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Combined meeting covered revision arthroplasty planning, hip preservation
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In this issue, Per Kjaersgaard-Andersen, MD, Chief Medical Editor, Orthopaedics Today Europe, poses questions to Luigi Zagra, MD, European Hip Society past president and Società Italiana dell’Anca president, and Fares S. Haddad, MCh(Orth), FRCS, British Hip Society president elect. Zagra and Haddad chaired the first International Combined Meeting of the British Hip Society (BHS) and Società Italiana dell’Anca (SIdA), which was held 26-27 November 2015 in Milan.
Zagra and Haddad are members of the Orthopaedics Today Europe Editorial Board.
Per Kjaersgaard-Andersen, MD: Why did your organizations decide to collaborate on a meeting?
Luigi Zagra, MD: Progress in science, knowledge and education are possible only at an international level and through collaboration. Everything is global now. Each national tradition has its own excellence and faults. What better than sharing Italian tradition with British scientific method?
Fares S. Haddad, MCh(Orth), FRCS: We decided to hold a joint meeting in order to encourage the exchange of ideas and experiences in the sharing of data between our two societies, and to help enrich education for our trainees and foster future research collaboration. It was initially an aspiration to achieve one of these things, but the meeting managed to do all of that.
Kjaersgaard-Andersen: What types of sessions were held during the meeting? What was the attendees’ overall opinion of the program?
Haddad: The program ran across 2 days and involved more than 600 participants from 49 different countries, more than 300 oral presentations and 170 posters, three awards for the best presentations, one award for the residents, seven symposia, three guest lectures, six crossfires, six instructional courses, five industry symposia, 30 sessions of oral presentations and an educational corner with surgical videos.
Zagra: I would like to report three comments from attendees from different countries. One comment was, “Congratulations on a hugely successful meeting. The faculty and delegates were great quality, and the topics really stimulating.” Another attendee commented, “I go to a lot of hip meetings, and this to me was one of the best. I enjoyed the educational activities and I thought the quality of the presentations was first-rate.” The third comment I want to share is, “I thank you for involving me in this outstanding event that I truly hope will not be the last one of such a kind. I am looking forward to the next round in the United Kingdom.”
Kjaersgaard-Andersen: In what areas of the meeting planning and execution did you, as its organizers, see signs of effective collaboration between the two societies?
Haddad and Zagra: There was collaboration between the two societies at every level — in the inception of the meeting, organization of the mail-outs and the website, evaluation of the trainees and awards, main meeting submissions, chairing of sessions, discussions and overall output of the meeting. Not only was this a scientific and an educational meeting, but also a combined social event.
Kjaersgaard-Andersen: Hip trauma, a topic on the program, was probably selected due to the many hip fractures now being treated. What were the key take-home messages for attendees regarding hip trauma?
Zagra: Older patients need to be treated at the right time, but also in the best way, especially in cases of hip replacement, and they cannot be left to less experienced surgeons or residents after the elective surgery. It was also highlighted that surgical skills and good organization are essential for the treatment of complex cases, not only of femoral neck fractures, but also of the increased number of periprosthetic fractures we are seeing, and for patients at high risk of complications.
Haddad: It became clear during the meeting that trauma is an increasingly relevant topic to all doctors, but particularly to hip surgeons. More hip fractures are presenting to us and more require hip arthroplasty. It became obvious during the meeting that appropriate algorithms are needed for the management of these patients both medically, in terms of bone health, and surgically.
Kjaersgaard-Andersen: From the data presented at the meeting, what main challenges do orthopaedic surgeons face today when they perform primary hip arthroplasty?
Haddad: At present, orthopaedic surgeons face challenges of cost-effectiveness, of choosing the right implant and the right procedure for that patient at the right time.
Zagra: I can add that the capability to avoid and most of all to manage the complications is a challenge. Nowadays, at least in my country, almost every orthopaedic department is able to perform a total hip arthroplasty (THA) in a standard way. How to diagnose and how to address the complications makes the difference. One more important topic is the correct implant selection and surgical technique, or at least what is the most suitable for each individual case without necessarily following the latest trends.
Kjaersgaard-Andersen: What, if anything, was discussed at the meeting about the importance of implants as they relate to successful revision hip arthroplasty?
Zagra: New implants, new diagnostic tools and the correct use of bone grafts in hip revision have improved the outcomes of this challenging surgery in the last decade. But, it was clear the key points remain the technical experience, the correct and — when necessary — the early indication, the preoperative planning and the prevention of complications. A special focus was considered on the diagnosis and treatment of infected THA.
Haddad: There were a number of sessions about revision, evaluating the importance of in-growth components and getting the revision right, planning revision surgery at appropriate centers with appropriate expertise to get sound fixation in biomechanics, and how to avoid complications of instability and infection.
Kjaersgaard-Andersen: Do you have any additional comments about the first combined meeting?
Haddad: The first combined meeting has set the scene for other combined meetings both between BHS and SIdA, as well as with other organizations, as the cultural and intellectual exchange was outstanding and many friendships were formed.
Zagra: For SidA, it was a huge step forward due to the number of attendees and the scientific level of the meeting. Moreover, the presence of so many young colleagues and having all the rooms of the instructional courses full at 7:45 in the morning was surprising.
Kjaersgaard-Andersen: Are there plans to hold a similar meeting in the future?
Zagra and Haddad: Why not? We may be joining forces to try and link up with organizations in other continents, such as the American Association of Hip and Knee Surgeons in the United States, and others. However, to some extent, the experience in hip surgery in European countries is somewhat unique.
- For more information:
- Fares Haddad, MCh(Orth), FRCS, can be reached at University College Hospital, 250 Euston Rd., London NW1 2BU; email: fares.haddad@uclh.nhs.uk.
- Per Kjaersgaard-Andersen, MD, can be reached at Orthopaedics Today Europe, 6900 Grove Rd., Thorofare, NJ 08086, USA; email: orthopaedics@healio.com.
- Luigi Zagra, MD, can be reached at Istituto Ortopedico Galeazzi IRCCS, via R. Galeazzi 4, Milan, Italy; email: luigi.zagra@fastwebnet.it.
Disclosures: Haddad, Kjaersgaard-Andersen and Zagra report no relevant financial disclosures.