Siebert 1Letter from the President, Prof Werner Siebert

Dear Members,

Now it is just a matter of days until our EHS 12th Congress in Munich takes place. Therefore, I will not write much here, except to say that if you are not registered yet, you can still do it online. There is still time.

A highlight for me personally will be the invited combined symposium on the Wednesday 6th September where EHS joins the AAKKS (American Association of Hip and Knee Surgeons) to offer you a variety of case based discussions from Primary and Primary DDH to Revision and Infection. Also, THA & Sport: Part I is Effects of high/mild/low impact sports in artificial joints, while Part II is a Debate: My Preferred Option, covering The MODEL for the young OA active patient and The BEARING for the young OA active patient, ending with Part III, Discussion & Open Questionnaire. Topics that we are all interested in, from some of the top names in the world.

On the Thursday, I am looking forward to the AFACOT / SOTEST Symposium – The French perspective. Topics include: Is metalback useful for a polyethylene insert? and Necrosis and interest of dual mobility, to name just two.

I am really excited about the congress as a whole and there is such a wide and wealthy program that I am confident – whatever your particular interest in the hip may be -you will come home extremely satisfied after attending this event.

I greatly look forward to this wonderful opportunity to meet our members in person. It is a time for hip experts from all over the world to come together in Munich to share their knowledge, learn knew aspects of our ever-changing and advancing speciality, to catch up with all our colleagues and, of course, to make this the best ever EHS congress to date. See you there!

Your EHS President, Werner Siebert

Letter from the Secretary General, A Prof Eleftherios TsiridisLefteris smaller

Dear Members,

I hope you have all found some time during the month of August to relax a little bit from our very demanding profession, ready to visit the EHS Congress in Munich refreshed for Autumn and eager to dive back into the science of the hip.

All our members are cordially invited to the EHS General Assembly on Thursday 8th September 2016, from 1.30-2.30pm in Saal 13a, in the congress centre. Also, please come and visit Samantha Stokes or myself at Booth 7, anytime during the congress.

Below you will read an update on hip surgery today in Philadelphia from our American member, Javad Parvizi, who is participating in our congress next week. Also, you can read a report from our Italian member, Gianluca Cusmá, who visited hip surgery centres in China. Thanks to both for these words.

EHS Secretary General, A Prof Eleftherios Tsiridis

It is clear that the US healthcare is undergoing gargantuan changes. The time will tell if these changes stand to benefit our patients or limit access to those in real need

INTERNATIONAL EHS Member from USA, Javad Parvizi


James Edwards Professor of Orthopaedic Surgery
Sidney Kimmel School of Medicine 
Rothman Institute at Thomas Jefferson University

Philadelphia, USA

Total joint arthroplasty (TJA) continues to evolve. The major developments in the US in this arena happen to relate to economics of performing TJA. The “bundling” reimbursement method implemented by the US government has sent many centers searching for ways to minimize the economic impact of TJA. The latter has brought two major changes. One, and an appropriate one, has been efforts to identify patients who would be at higher risk of complications in the 90-day postoperative period, and hence resulting in a higher cost to the Accountable Care Organizations (ACOs). The ACOs have also implemented strategies to deal with postoperative issues to limit readmission and reoperation on patients undergoing TJA. Efforts to reduce cost of TJA has resulted in many centers to reduce the hospital stay for patients by even offering outpatient TJA. A few studies presented at the recent meeting of the AAOS demonstrated that outpatient TJA may be a viable option, at least in high volume arthroplasty centers, on a select group of patients.

The second change, and perhaps not so appropriate one, is the theoretical tendency to avoid offering surgery to patients who may be at higher risk of complications. This “cherry picking” is in total contrast to the intentions of the Obamacare, that was introduced to broaden the access to healthcare for all. The time will tell on what the ACOs will do with the group of patients at higher risk of complications. One necessary and critical step at the moment is the dire need to develop proper and valid risk stratification methods that will allow tiered reimbursement based on the risk status of the patients.

It is clear that the US healthcare is undergoing gargantuan changes. The time will tell if these changes stand to benefit our patients or limit access to those in real need.

I didn't meet any western people for 3 weeks - working, eating, travelling and sharing experiences only with Chinese colleagues and patients - and this was the difficult but also amazing aspect of my travel

EHS Member from Italy, Gianluca Cusmà


MIlan, Italy

In China only the public health system is available. They have quite big hospitals with all departments. But due to the limited capacity of doctors to move abroad to join congresses or courses, they have a lack of update. So they often invite surgeons from a western country for a period in order to have an in locum refreshment of techniques.
The hospital of Yanghzou, a 6-million people city, with a 2000-bed capability, has 4 floors dedicated to orthopaedics and trauma. In one of these floors they have a joint replacement center headed by an open-minded 50-year-old doctor named Xiong.
He asked the management of the hospital to find a European surgeon to update and train his team. They shared a formal request and asked also the Italian Experts Association, who let me know about this opportunity.
So I accepted and moved to China, partially using my Christmas holidays, for 3 weeks. Every morning I was in the OR to front 2/3 difficult joint replacement cases (only hips and knees) and in the afternoon we had a speech around a particular related topic: Short stems in primary THA; Vitamin-E-enriched poly for THA; Femoral reference technique as a simple way to match safe zone in THA; Tantalum devices and augments for THA complex acetabular revisions; Bilateral one stage THA with a mini invasive postero lateral approach; Uni plus patello femoral arthroplasty as an alternative to TKA in youngs; Bi-cruciate sparing TKA; Managing TKA revision with a 360° free positioning stemmed implant… this are the ones I remember now.
I didn’t meet any western people for 3 weeks – working, eating, travelling and sharing experiences only with Chinese colleagues and patients – and this was the difficult but also amazing aspect of my travel.
On two occasions, Dr Xiong asked me to perform with him surgeries in small Chinese Traditional Medicine hospitals situated in the country hundreds of kms from the city and it was a nice way to understand the complexity and the particular aspects of that wide nation.
In conclusion, this is an experience I recommend to every doctor who is very skilled in his own field and curious to understand the real Chinese life style with no filters.
See you in Munich.