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EFORT ExMEx Osteoporotic Fractures, Budapest: 19 – 20 April, 2013
Osteoporotic fractures: from initial surgery to implant revision
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The upcoming EFORT ExMEx Forum in Budapest will deal with the challenges of joint reconstruction surgery as well as arthroplasty in osteoporosis patients. Two osteosynthesis demonstration surgeries will be among the program highlights.
Increasing life expectancy and sedentary lifestyles have contributed to a growing incidence of osteoporosis, mitigated to a degree in some countries by public health campaigns alerting the population to the importance of prevention and early treatment of the disease. The fact remains that for orthopaedic surgeons the optimal treatment of osteoporotic fractures is an ongoing challenge in delivering quality care, especially to the older population. The upcoming EFORT ExMEx Forum in Budapest is an opportunity to review the most recent advances in the epidemiology, diagnosis and therapy of osteoporotic fractures. “Elderly patients generally present with various types and grades of co-morbidity, and require closer observation in the pre- and postoperative period,” says Professor Laszlo Hangody, chairman of EFORT ExMEx Forum and Clinical Professor at Semmelweis University and Uzsoki Hospital, as well as Director of Traumatology at the Traumatology Center, Péterfy Sándor Hospital. Biomechanical considerations in approaching treatment of fractures will be given attention at the Budapest meeting as well.
“As total hip and knee replacement surgeries have become routine interventions in the past decades, that has naturally led to an increase in the number of periprosthetic fractures in osteoporotic patients as well,” says Prof Hangody. Thus the Budapest meeting will dedicate considerable time to the latest techniques in revision total hip arthroplasty, assessing bone stock quality and areas such as plating of periprosthetic fractures.
Acute demo surgeries to focus on implant revision
Two demonstration surgeries will be presented in Budapest, one on osteosynthesis or implant revision following periprosthetic fracture, the other dealing with osteosynthesis following hip or proximal humeral fracture in an osteoporotic patient. “As these are considered acute surgeries, the technique we demonstrate will depend on the cases we will actually have at that time,” says Professor Hangody. “We have altogether 430 beds in our two centres ensuring we will have eligible patients for the demonstrations.” However, recordings of various types of operative treatments of osteoporotic fractures have been made in advance, should any unexpected difficulty arise in having an appropriate surgical case on hand at the Forum. Hungary itself has three companies manufacturing state-of-the-art implants for total hip and knee replacements and revision surgeries, for the national and international market. These will be used during the demo surgeries.
But since prevention is proverbially the best cure, ways to prevent periprosthetic fractures are also on the agenda at the Budapest ExMEx Forum. Prof Hangody says, “In Hungary, the focus has shifted to preventive treatment of osteoporotic cases. It is always more effective, and cheaper, to perform a preventive elective surgery at a suitable time and with the proper instruments and techniques than to attempt to reconstruct the shattered bone fragments of an osteoporotic fracture.”
Surgical intervention as the optimal solution
The issue of conservative versus surgical solutions in a range of fractures, including osteoporotic vertebral fractures, will also be given a thorough airing at the ExMEx Forum in Budapest. The stress of surgery is clearly a special issue in the treatment of osteoporotic fractures since such a high proportion of patients in this field are elderly. But surgery remains for many the best option, says Professor Hangody. “Advances in anaesthetic techniques enable us to treat most elderly patients surgically,” he says. “Conservative treatment usually means immobilization, in effect leaving the patient bedridden, with the consequent complications, e.g. deep vein thrombosis and pressure sores, which seriously compromise the recovery of the patient.”
Meanwhile it is hoped Forum guests will also take the opportunity to enjoy the many attractions of Budapest during their free time. The following website gives an excellent summary in English of the many delights of this historic city on the Danube: http://visitbudapest.travel/
- info
- ExMEx Forum Budapest: Osteoporotic fractures
- 19 – 20 April 2013
- www.efort.org/exmex/budapest2013