AO Dialogue 1|12

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AO Dialogue 1|12 The newsletter for the AO community

The future of publishing at the AO Foundation has arrived

Fractures of the Pelvis and the Acetabulum to be published on electronic platforms How the future became a reality

The seminal work on Fractures of the Pelvis and the Acetabulum—Principles and Methods for Management is about to get a facelift. AO Edu­ cation and AOTrauma agreed with AO editors Marvin Tile, David Helfet, James Kellam and Mark Vrahas to release the fourth edition of Tile’s influential book. This time however, the surgeons and AO Education agreed that it is of paramount importance to make this new release of the book as electronically accessible as possible for its audience. This commitment lead to the commission­ ing of two significant new projects; the first a

video project that will make available all the appropriate surgical exposures for pelvic and acetabular fracture fixation and the second is a mobile application for emergency pelvic fracture management. The content generated by this project can also be utilized by the AO Surgery Reference application as well as future AOTrauma Courses on Pelvic and Acetabular Fractures. According to book editor and video surgeon Jim Kellam: “This project represents a unique opportunity for the AO to assemble a group of surgical experts with a master team of video­ [ continued on page 2 ]

Table of contents New publishing concept  1 ECTES   5 Meet the Experts  6 AO Center 20th Anniversary  8 Clinical Divisions 11 Service Units

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Norbert Haas  16


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The future of publishing at the graphers to produce the professional highquality digital videos of these approaches so important for the success of this surgery. This will benefit many surgeons and patients in the future. It is also unique as it represents the chance for AO Education to produce a text book with as much electronic support as possible.” It all started with the book

The management of pelvic and acetabular trauma has become a subspecialty within or­ thopedic traumatology. The fourth edition of the Pelvic and Acetabulum book intends to convey the management principles for patients with pelvic and acetabular injuries. It provides guidelines for the systematic examination and critical assessment of the patient, x-rays, and special investigations to enable the surgeon to understand the complex injuries better. With this understanding, the surgeon will be able to formulate a rational treatment plan, not only of the bony and articular trauma, but also of the accompanying soft-tissue and visceral damage. Cristina Lusti, Project Coordinator Educational Media, AO Education remarks that: “AO Educa­ tion always tries to satisfy the changing needs

of the surgeons. Therefore we have started to make our publications available on different platforms, printed books and e-books, and to produce helpful add-ons, for example Apps, videos of surgical approaches, and more. The project ‘Fractures of the Pelvis and Acetabu­ lum’ is the first of its kind. As project coordi­ nator it is a great pleasure to work with such enthusiastic and experienced editors, a fantas­ tic AO team, and to coordinate, in conjunction with Robin Greene and Mike Redies, not only a book but an outstanding suite of products.” The book is intended for surgeons in training, general surgeons, orthopedic surgeons, and the specialist orthopedic trauma surgeon. Chapters dealing with the emergency management of b the polytraumatized patient with a pelvic in­ jury, and those on decision-making in the acute situation will provide guidance for surgeons in training as well as the general and orthopedic surgeon. The specialist surgeon with a particu­ b interest in pelvic and acetabular trauma lar will find this book a complete reference text for all aspects of management for these diffi­ cult fractures. Management will be described for every fracture type starting with patient

Reviewing the quad-split feeds (a feed from each of the four cameras) as the live coverage is captured All rights reserved. Any re­p roduction, whole or in part, without the publisher’s written consent is prohibited. Great care has been taken to maintain the accuracy of the information contained in this publication. However, the publisher, and/or the distributor and/or the editors, and/or the authors cannot be held responsible for errors or any consequences arising from the use of the information contained in this publication. Some of the products, names, instruments, treatments, logos, designs, etc. referred to in this publication are also protected by patents and trademarks or by other intellectual property protection laws (eg, “AO”, “TRIANGLE/GLOBE Logo” are registered trademarks) even though specific reference to this fact is not always made in the text. Therefore, the appearance of a name, instrument, etc. without designation as proprietary is not to be construed as a representation by the publisher that is in the public domain.

Impressum AO Dialogue 1|12 Editor-in-Chief: James F Kellam Managing Editor: Olga Harrington Publisher: AO Foundation Design and typesetting: Manuel Kurth and AO Foundation, Communication and Events Printed by: BUDAG AG, Switzerland Editorial contact address: AO Foundation, Clavadelerstrasse 8, CH-7270 Davos Platz, Phone: +41 81 414 28 14, Fax: +41 81 414 22 97, E-mail: dialogue@aofoundation.org Copyright © 2012, AO Foundation, Switzerland


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AO Foundation has arrived continued…

selection for nonoperative and operative care, preoperative planning, and detailed descrip­ tions of surgical techniques, postoperative care and possible complications. Each chapter closes with a summary and key learning points. Step-by-step surgical approaches

In order to realize the surgical approach proj­ ect, experts in pelvic and acetabular fracture surgery had to spend three days performing the approaches on anatomical specimens. Supported by Keith Mayo, Head of the AO TK System Pelvic Expert Group, five AOTrauma surgeons—Jim Kellam, Stephen Sims, Michael Stover, Mark Reilly and David Stephen—con­ tributed their time and expertise to the project. In addition an appropriate filming venue was required along with a highly-skilled video pro­ duction crew. The Academy for Medical Train­ ing and Simulation (AMTS) in Lucerne, Swit­ zerland was selected as the venue and the AO Education’s video production team provided the filming expertise using state-of the-art equipment from KARL STORZ - ENDOSKOPE.

The pelvic and acetabular fracture fixation sur­ gical approaches is the first clinical video pro­ duction at the AO following a new, high-end, visual approaches teaching concept devised by a task force comprised of leading AO pelvic surgeons, AO Education and AOTrauma mem­ bers. This new concept combines high-end film footage of the surgical approaches combined with 3-D animation and 3-D modeling of each anatomical layer of the approach. When the twelve, 20-30 minute-long, videos are pub­ lished on hand-held devices there will also be interactive elements included. From March 6–9, 2012, the six surgeons ran two operating room (OR) tables in parallel, in the same room. Over these three days twelve approaches were filmed by Robin Greene, Manager Video and Visual Media, AO Edu­ cation and his video production team at the AMTS. This was a challenging undertaking for everyone involved but the AO Education project leaders—Robin Greene and Cristina Lusti—had meticulously planned the three day

AO Trauma surgeons, AO Education project leaders and the video production team ready for action


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The future of publishing …end filming and with the support, dedication and hard work of the surgeons, the AMTS team, KARL STORZ - ENDOSKOPE, and Med Visu­ als, the video production was a huge success. Keith Mayo describes this project as “the op­ portunity to provide the orthopedic commu­ nity and, in particular, those interested in pelvic and acetabular fracture surgery with a comprehensive high quality repository of surgical approaches.” All the surgeons involved remarked that this type of project could only be delivered by AO Education. No other organization has the abil­ ity to first assemble the group of surgeons, vid­ eographers and book editors, and then provide them with the level of support that ensures they can all contribute their best work as part of a well-organized and professional process. This is what AO Education does best. Providing the highest quality video footage and coverage is of paramount importance to the success of this project so the AO video team opted to use three full high definition, broadcast-quality, cameras set up at each of the OR tables. This was further enhanced by the endoscopy camera connected to the exo­ scope from KARL STORZ - ENDOSKOPE, the VITOM® 25 SYSTEM. In order to ensure that the surgeons at each OR table, as well as the director, were all able to see what the cameras were filming, and to also ensure that the very best coverage was being captured, quad-split feeds (a feed from each of the four cameras split into four quadrants) were set up on all reference monitors. Greene, who managed the complex video pro­ duction process, said, “The detail and quality delivered from this high-resolution system is phenomenal and provides visualization in open surgery by making use of available

endoscopic components from KARL STORZ - ENDOSKOPE.” Making decisions in the emergency room

The final element of the new multi-platform publishing concept is a mobile application which will assist surgeons with decision mak­ ing in emergency situations. The target audi­ ence for this product is different from that of the book, it takes the user to where the book starts; it is aimed exclusively at trauma sur­ geons and residents in the emergency room (ER), no pelvic surgery is discussed and it has no overlap with the surgical approaches videos. ER surgeons are faced with emergency patients as soon as they arrive in a hospital and must know how to establish what is wrong quickly and effectively. The App starts by taking the examining surgeon through the physical clini­ cal exam and then moves on to the most signifi­ cant diagnostic tool which is the interpretation of x-rays. It gives detailed descriptions of what steps need to be taken to stabilize a patient and stop bleeding. The portability of the App means that surgeons can use it as a quick reference guide in pressurized situations. Mike Redies, Manager Strategy and Knowledge Translation, AO Education says: “The App for tablet computers and smartphones will empha­ size the AO Foundation’s goal to assist surgeons where their greatest need is—in their daily work. The App will make emergency decision making available at a surgeon’s fingertips and in their moment of greatest need.” When will this be on our shelves

The planned date for publication of the text book, the videos, and the App is mid-2013. The videos will be made available on a dedi­ cated publishing server while the App will be delivered on multiple platforms—PC, mobile, Google Android, and most importantly, iPad.


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13th European Congress of Trauma and Emergency surgery in Basel A personal report Dominik Heim, Frutigen, Switzerland

ESTES, the umbrella organisation for 27 Eu­ ropean national societies of trauma and emer­ gency surgery, reunited at this 13th Congress, not only its members, but also many other so­ cieties, participating in the scientific program with guest symposia and workshops. Quite an important role at this congress was played by the AO on several occasions. There was a wellvisited AOTrauma booth of in the foyer, where lots of questions were answered during coffee breaks. There were many more questions raised at the AO Symposia “Tribute to the AO”, the past was reviewed by Peter Matter, former AO Foundation President, the complex present and its actual structure was presented by Niklaus Renner, AOTrauma chairman, and a look into the future was given by Suthorn Bavonrata­ navech, Pre-President Elect. Sessions such research on skeletal trauma in collaboration with the European orthopaedic research,the AOTrauma Guest Symposium, presenting the AO’s infection and osteoporosis program, and a curtain-up session on trauma and rescue systems in Asia with five speakers from AO­ Trauma Asia illustrated the importance of the AO as a truly global network for trauma today.

are dealt also with in very animated sessions such as “How I do it” for early risers in the morning, the “12 to 12” at noon time for late risers and many other sessions with pragmat­ ic keynotes followed by free papers). ECTES points the finger at weary points of our daily life, be it the problem of geriatric fractures or increasing numbers sports injuries. ECTES also deals with natural disasters such as earth­ quakes and terrorist attacks with the help of organizations such as the Red Cross, the Global Risk Forum (GRF) and many other national and international organizations. Thus a very important part of this congress was dedicated also to the paramedics and nurses. (L-R) N Renner, P Matter, D Heim, R Babst and S Bavronratanavech

Lots of contacts were made and renewed during these days in Basel between many organiza­ tions and societies, something that is essential to overcoming the many problems in trauma and health care in today’s world. ECTES 2012 showed quite clearly in the session “WHO de­ cade of action on road safety” that lots of effort has to be made to improve a situation that is likely to worsen further in the years to come. This sort of informed debate is typical for ECTES, this Congress does not hide the prob­ lems and looks to deal with hot topics. It is not simply a set of scripts on how to deal with this and that organ lesion (although these problems B Wicki from AOCID presents “Epidemiology; the extent of the disaster”

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Meet the Experts A popular component in the Technology Innovations Program Aradhna Sethi, AO Dialogue

Part of what makes the AO Foundation unique in the world of orthopedic surgery is the process by which it develops new techniques, method­ ology and products to address orthopedic needs to improve patient care. An “Expert Group” of experienced surgeons diagnoses and dissects the problem to develop solutions that meet the clinical challenges. The new devices or improvised ones then undergo rigorous testing at the AO Technical Commissions (TK System). Once approved, the product is introduced into an appropriate course for teaching purposes. However, the know-how of this cutting edge technology, until recently, was limited to only those who at­ tended courses where these new developments were specifically being talked about. Steve Schelkun, the former AOTrauma Education Commission Chairperson says, “In the past, the exposure was very limited. We also noticed that almost all surgeons are interested in the latest innovations in patient care, but, perhaps, were not be able to take the time to attend a course. And so, we thought of a faster and better way to introduce these innovations to a much broader audience—by way of the Technology Innovation Programs.”

XX

XX

Schelkun continues, “The first Innovations Project in 2010 related to the LCP Variable Angle Dual Column Distal Radius Plate at the Davos courses. Attendance was amazing and comments were favorable. We showcased the TK process through a clinical problem by the Hand Expert Group (HAEG), and presented the clinical results from two surgeons who performed many of the first clinical trials. We approached this from an education standpoint and stressed the clinical problem, proposed solution, results of the clinical trials, indica­ tions, and surgical techniques. The session concluded with tips, tricks and techniques to maximize good results and minimize po­ tential pitfalls.” This event spelled success for the Technology Innovations Programs (TIP). An addition to the TIP was the “Meet the Experts” component that was introduced at the Davos Courses 2011. Since a large number of specialists fly in from around the world for the Davos Courses, this is the ideal venue to ensure maximum exposure to the new and recent technological innova­ tions that had been approved by the TK. Says Claas Albers, Director, TK System, “This new series of daily workshops gave the Davos course participants a fantastic opportunity to get


AO Dialogue  1|12

in touch with dedicated experts in their fields, get to know the latest AOTK approved tech­ nology and, most importantly, ask questions about their clinical applications. The experts, in return, received the first feedback, which can turn interesting for further developments in the future.” Expert opinions

Juan Gerstner Garces, foot and ankle ex­ pert said, “I presented the newest reamers and plate for first metatarsal-phalangeal fu­ sion, the principle of compression through the new plate of mid-foot fusion, using a model of plastic and the compression device, and the mesh plate. I think it is very useful concept since everybody at the session has a clear and focused live presentation of the most advance equipment in the field. Everyone sees this as a didactic demonstra­ tion on tool-use, implant location and indica­ tions, guided by experienced surgeons who developed and use this equipment in their daily practices.” “People have real interactions through these sessions. They are invited to freely ask ques­ tions pertaining to the demonstration and cases that are shown in the prologue. The equipment is available to use, feel and see in the plastic

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models and in the real case box, just before they are released for practical exercises. So they really get a good idea of what the future in trauma management will look like.” Based on his interactions with the audience, Garces continues, “At first, people seemed to feel slightly intimidated to participate and ap­ proach the table. But within a few minutes of presenting cases and showing the equip­ ment, they started to get closer and interact better with me, expecting to get some answers from the questions raised after they reached a comfort level with the tools and plates. It was a matter of time before I found myself giving answers to three or four people at the same time! Questions ranged from topics on indica­ tions and locations to tips and tricks and com­ plications of living cases. He concluded, saying: “I think people liked it very much; although I would like to have more time to interact.” Paulo Barbosa, who presented on Intramedul­ lary Nailing, says, “The session is very useful and helpful. It offers them new and precise information in a conversational format by way of short and focused presentations. This makes the “package” very useful.”

Joint Symposium with the Chinese Orthopaedic Association 2011

Luiz Vialle presents at the Global Spine Congress 2011, in Barcelona


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Celebrating 20 years The origins of the The AO Center building celebrates its twentieth anniversary this year. Before 1992, the fast-growing AO had various institutions, labs and offices scattered across Davos and Bern. A single, purpose-built, location was an absolute necessity to house the activities of research, development, AO International, Technical Commission (TK) and documentation under one roof, offering less cramped working conditions to the scientists, collaborators and staff and contributing to better communication between the key functions. The AO started its surgical research activity in Davos in 1959, the same year the Labor f端r Experimentelle Chirurgie Davos (LECD, in English: Laboratory for Experimental Surgery Davos) was established here. Over time this lab evolved into two discrete units called the AO Research Institute Davos (ARI) and AO Development Institute (ADI). It was also in Davos that the first ever AO Course was held in 1960. Since then our highly-respected AO faculty has been training thousands of medi-

cal professionals in state-of-the-art treatment methods and tools for bone healing and better patient care here in Davos. After lengthy discussions the Board of AO Trustees decided to build an AO-owned center in Davos as it was the most appropriate location for the AO headquarters. Davos was by that time already synonymous worldwide with AO research and the flagship courses. In addition Davos had three world-renowned scientific institutions at that time: Swiss Institute for Asthma and Allergy Research, Institute for Snow and Avalanche Research and the World Radiation Center . There were a couple of architectural approaches proposed for the actual site of the AO Center. One looked like a mushroom farm combined with octagonal elements in a way that would result in optimal communication between groups and their collaborators; for technical and financial reasons this idea was shelved. The proposal to shape the center like the well-known Toblerone chocolate was ulti-


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at Clavadelerstrasse AO Center in Davos mately selected. The team of architect Jakob Zweifel realized the AO Center in Clavadelerstrasse in just over two years, from groundbreaking in April 1990 to inauguration in June 1992 with the dedicated daily commitment from the AO representatives Berton Rahn and Manfred Klebl. The AO Center has had a significant impact on the AO Foundation since its inception; it functions as the headquarters for course management as well as for AO Education, ARI, important parts of AOCID, AO Exploratory Research the four AO clinical divisions, the AO Technical Commission (AOTK), and the AO Foundation’s support units. The AO has always been at the vanguard of research into osteosynthesis as well as many other fields which affect the future of orthopedic and trauma surgery. Advances made in the field of osteoporosis, cell biology, infection, and biomechanics at the AO Research Institute in Davos illustrate the extent of the research expertise developed here over the decades.

Berton Rahn (left) and Manfred Klebl

A futuristic project proposal that was ultimately rejected

The AO Center building on the day of inauguration


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Celebrating 20 years at the AO Center …continued The past 20 years in Davos have also seen many cutting-edge devel­ opments in the field of education. This is where new teaching and learning methodologies are developed, world-renowned faculty is trained by experts, modern technology is adapted for medical profes­ sionals’ needs and from where innovative treatment options emerge. With the AO Center closely linked to the Davos Congress Center and the broader “Science City Davos”, the AO Foundation has forged a global reputation as a world-leading center for the advancement of patient care. From Davos the organization brings its vision of excellence in the surgical management of trauma and disorders of the musculoskeletal system to the world. Two AO Foundation founders, Peter Matter (President of AO International 1993-1999 and of the AO Foundation 2000-2002) and Stephan Perren (Head of AO Research 1967-1995 and Chair­ man of the AOTK 1982-1997) gave generously of their time and expert knowledge of the AO’s history to help create a com­ memorative book “The Center of the AO Foundation Network 1992-2002” to celebrate this occasion. These surgeons played an important role both in the realization of AO Center building and the development of the AO and, together with contributors from the AO service units and other Davos luminaries, deliver a detailed insight into the importance of the launch of the AO Center twenty years ago to the continuing success of the AO. Excerpted from “The Center of the AO Foundation Network 1992-2012”

1992 – 2012  The Center of the AO Foundation Network

Davos

1992

2012

The Center of the AO Foundation Network

Groundbreaking for the AO Center building

Stephan Perren and Peter Matter, editors of the commemorative book


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From the Clinical Divisions AOTrauma Transforming modern surgical education

With new Chairpersons in place for the AOTrauma International Board and the AOTrauma Education Global Commission, Niko­ laus Renner, Kodi Kojima and the entire board has set out to steer AOTrauma to implement changes for further inventiveness and effectiveness. And, in keeping with its mission to further improve care of the injured, AOTrauma has set the wheels of change in motion—starting with education. The AOTrauma Education transformation, championed by the AOTrauma Education Commission, in cooperation with AO Edu­ cation, targets the evolving needs of our surgical community. The idea is to design a program of activities and resources that make up an educational portfolio for each surgeon group to meet surgeons’ needs when required. Enhancing conventional educational training with newly tar­ geted programs like the Faculty Education Program and Chair­ person Education Program, AOTrauma has improved ways to coach its faculties. There has also been an increase in both the quantity and quality of AOTrauma courses worldwide. Anatomi­ cal specimens are now part of select masters’ courses. The strategic shift in delivery of education includes powerful leveraging of the latest technologies to support a wide range of just-in-time channels, and a wide distribution of live and asynchronous activities to the homes and offices of the trauma community.

Masters’ level course with anatomical specimens

With more webinars and webcasts, AOTrauma offers the unique opportunity to present a significant clinical topic to a worldwide audience, where participants not only watch the demonstration, but can also ask questions and get real-time answers. Many of the AO books are now being digitalized and can be purchased easily at the Thieme e-Book Store (http://ebookstore. thieme.com). With new Apps for the iPhone and Google Android like the AO Surgery Reference and Traumaline—a database of clinical evidence with summarized information on relevant specialty literature— AOTrauma Education is racing ahead in the digital world. Knowl­ edge is now just a click away. AOTrauma Community Development initiated the AOTrauma Membership Sponsoring Program in October 2011. The aim of this ongoing program is to enable young talent from developing countries to benefit from the AOTrauma community. Today, there are 17 sponsors for AOTrauma membership. With a stronger reach within the network and improved methods and channels to transmit education, AOTrauma moves forward to provide the best to the trauma community.

A computer screenshot from a live webinar


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From the Clinical Divisions AOSpine Global academic collaborations advance AOSpine

AOSpine is effectively collaborating with other spine societies to deliver educational activities and research projects; thus, further­ ing its mission to improve patients’ lives. Luiz Vialle, Chairman of the AOSpine International Board, says: “We are committed to broaden the global landscape and engage in an open discussion with surgeons, researchers, and educators of other spine societies worldwide. Through this free and open exchange of academic viewpoints and perspectives, in a context of mutual respect, we promote our high academic standing within the field of spine care. Our aim to establish synergies with external spine associations is to continue leveraging our academic network, while simultaneously advancing and disseminating knowledge and practical application results to our members and to the wider spine community globally.”

AOSpine Europe and AOSpine Middle East and Africa: In these

regions, AOSpine is offering educational sessions at SpineWeek, EFORT, and the Pan-Arab Orthopedic Congress. Furthermore, AOSpine is actively engaged with, among others, the German Spine, Neurosurgical, and Orthopedic Societies, the Italian Spine Society, and the Austrian and Portuguese Orthopedic Societies. AOSpine North America: Luiz Vialle and Jens Chapman, Chair­

man of AOSpine North America, will present at the Global Spine Forum at the annual meeting of NASS. AOSpine Latin America: Collaboration projects are being under­

taken with the Brazilian Spine Society, the Mexican Spine Society, and the Argentinean Spine Society.

Collaboration highlights

AOSpine Asia Pacific: This region has established strong coopera­

AOSpine’s Knowledge Forum on Deformity recently joined forces

tion with local spine societies such as the Chinese Orthopaedic Association, the Ho Chi Minh Spine Society, and the Philippine Spine Society.

with the Scoliosis Research Society (SRS) to conduct a multicenter study evaluating risks and complications associated with Adult Spinal Deformity surgery. Additionally, the Knowledge Forum on Spinal Cord Injury & Trauma held a symposium at a global SCI conference, Interdependence 2012, hosted by the Rick Hansen Foundation.

Joint Symposium with the Chinese Orthopaedic Association 2011

With collaborations such as these, AOSpine hopes to make a significant impact in improving patient care worldwide.

Luiz Vialle presents at the Global Spine Congress 2011 in Barcelona


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…continued AOCMF

AOVET

New directions for AOCMF Education

Its role in the Medical Research Environment

AOCMF is hosting a retreat in South Africa on November 2-3, 2012 for the members of its various Boards.

Animals retain a pivotal role in drug and device validation and safety testing, despite being replaced in some studies with nonanimal techniques, a reduction in numbers used in other studies, and refinements in investigational processes.

This retreat will focus on the future direction that AOCMF educa­ tion intends to steer towards. Topics will include: 1. Continued development of AOCMF Principles Courses, 2. Development of small group discussion opportunities, 3. Curriculum development, 4. Future role of Cadaver courses, 5. Educational quality assessment, 6. E-learning and web-based learning, 7. Opportunities to visit other international centers to further advance skills, 8. Course support material, 9. Develop­ ment of teaching videos, 10. Expansion of the AOCMF Cranio­ maxillofacial Trauma & Reconstruction journal, 11. Discussion of the most meaningful way of teaching maxillofacial principles in underprivileged countries, 12. Discussion of a potential AOCMF Master of Science Program, 13. Future efforts and opportunities for faculty development, 14. Means of integrating neurosurgeons and oculoplastic surgeons into the AOCMF network.

AOCMF European Faculty Retreat from 2010 in Italy

AOVET considers one of its primary responsibilities, under the roof of the AO Foundation, to ensure animal health and welfare by establishing and advocating ethical standards for animal ex­ periments. This includes the selection of optimal animal models, educating the public about the need for animals in research or moving forward investigational policies at national and inter­ national levels. In order to achieve this goal, AOVET closely collaborates with the seven veterinarians that are engaged in the Preclinical Services Program of the AO Research Institute. The team has a unique and diverse background, including longstanding experience in veterinary surgical practice, laboratory animal care, veterinary anesthesia and orthopedic laboratory research.

Dr Rico Vannini performs surgery


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From the AO Service Units AO Clinical Investigation and Documentation (AOCID)

AO Education

AOCSC program - pilot phase now finished

AO connects with the global medical education community

The AO Clinical Study Center (AOCSC) qualification program, a concept whereby clinics implement AOCID-developed standard­ ized approaches to the conduct of clinical research, wound up its pilot phase at the end of 2011. The results from this intensive phase were analyzed both internally and by external experts in early 2012. Preparations are underway for the full global rollout of this very well-received program.

Every four years leading experts representing continuing medi­ cal education organizations (the Alliance for Continuing Edu­ cation in the Health Professions, the Association for Hospital Medical Education, the Canadian Association of Continuing Health Education, and the Society for Academic Continuing Medical Education) gather at the global peer-reviewed CME Congress to discuss the big trends in medical education and to exchange best practice cases. The June 2012 congress, in To­ ronto, focused on developments in medical simulation, safety and quality improvement, assessment of clinicians, optimizing learning, and interprofessional continuing education. More than 700 clinicians and educators came together to share their insights and network—among them recognized academics in the field such as Don Moore as keynote speaker, who is also a valued contributor to the external expertise network of AO Education.

Good Clinical Practice (GCP) courses in 2012

AOCID developed an accredited Good Clinical Practice Course to meet the needs of investigators who conduct or wish to conduct clinical trials. In addition to private courses booked by clinics for their employees, AOCID is offering two courses which are open to all. A one-day course will be held at the AO Foundation offices in Zurich on September 7, 2012. A second course spread over two half-days is taking place between the AO Davos Courses at the Con­ gress Center in Davos on December 6-7, 2012. You can find more information and registration details by visiting the new dedicated web page for all GCP course activities: www.aofoundation.org/gcp. New study coordinators’ course

AOCID’s new three day course for study coordinators is scheduled for September 27-29, 2012 at the AO Foundation offices in Zurich, Switzerland. This exciting new concept will cover GCP and other issues of relevance to study coordinators. An educational visit to a renowned research hospital also forms part of the program. For more information please email: aocid@aofoundation.org.

(AOE)

AO Education had an oral presentation in the area of best practice exchange and also a poster presentation. AO Education curricu­ lum developers Mike Cunningham and Jane Wiedler presented on the topic of “Global implementation of a competency-based curriculum for spine surgeons”, endorsed by AOSpine surgeons Larry Rhines and Carlo Bellabarba (both AOSNA)—triggering a lively discussion around the AO curriculum planning approach and the challenges in implementing a curriculum on a global basis.

Biyu Rui, Shanghai Sixth People’s Hospital, completed a fellow­ ship on tibial plateau fractures in spring 2012. He was followed by Cumhur Kilinçer, Edirne, who investigated outcome measures in spine surgery.

AO Education regularly submits abstracts to leading medical edu­ cational conferences like these, presenting our work done with the clinical divisions as well as findings from our own educational research to demonstrate AO’s professionalism and leadership in education. Our next stop is the annual congress of the Association for Medical Education in Europe (AMEE) to be held in August 2012 in Lyon, France where two presentations have already been accepted by the review panel.

Biyu Rui, the first-ever AOCID Research Fellow from China

Mike Cunningham and Jane Wiedler at the CME Congress in Toronto

AOCID Clinical Research Fellows from China and Turkey


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AO Research Institute Davos

(ARI)

ARI collaborates in projects funded by the 7th Framework Programme (FP7) of the European Commission

ARI continues to demonstrate its international academic compe­ tence through the attainment of major EU project funding with a total budget of around two million euro. BALI (Biofilm Alliance) is funded by the program HEALTH. The

consortium aims to develop novel tools to control bacterial bio­ films on implanted medical devices by targeting both the preven­ tion and treatment of biomaterial-associated infections. GAMBA (Gene Activated Matrices for Bone and Cartilage Regen­

eration in Arthritis) is a project funded in the nanotechnology call. The consortium designs a novel gene-activated matrix platform for bone and cartilage repair with a focus on osteoarthritis-related tissue damage. Fig 1 Disc herniation with leaking nucleus

NPmimetic (Biomimetic nano-fiber based nucleus pulposus

regeneration) develops a polymer based gel for minimally invasive disc regenerative treatment by combining nano-fibrous scaffolds with bioactive injectable nano-polymers (Figure 1 and 2). BIODESIGN is an international alliance of 21 global recognized

opinion leaders in the field of regenerative medicine of skeletal muscle, cardiac muscle and bone. The aim is to design, develop and validate optimized biomaterials in a modular format based upon natural molecules, which are known to normally provide regenerating instruction. ARI aims to develop optimize in vitro and in vivo models for bone.

Fig 2 Cell development in nano-biopolymer on day one (upper row) and day seven (lower row)

ArtiVasc (Artificial vascularised scaffolds for 3D-tissue regenera­

tion) is working on developing standardized processes for scaffold production and to cultivate vascularized skin rapidly and inexpen­ sively. The project is contributing to improving and accelerating patient treatment in emergencies and to reducing animal testing to an absolute minimum. Fellow, Biomaterials Science and Engineering (FBSE)

At the recent World Biomaterials Congress, Geoff Richards Director ARI received this prestigious honor which recognizes members of world biomaterial societies who have gained excellent professional standing and high achievements in the field of biomaterials science and engineering (Figure 3). Fellows are accomplished members and role models and are expected to foster and support the professional development of the field as a practical and intellectual endeavor.

Fig 3


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From the President Norbert Haas talks to AO Dialogue My view James F Kellam Editor-in-Chief james.kellam@aofoundation.org

Prof Haas, the 2012 Trustees Meeting takes place in Davos and is the last of your twoyear tenure as president, what are your aspirations for this event?

There are some challenges ahead for the AO Foundation on account of the merger between our industrial partner Synthes and Johnson & Johnson. We don’t know exactly what changes will arise but we need to prepare well for this future coopera­ tion; our current contracts are valid for the next four years. During the Trustees Meeting we will make decisions regarding governance, compliancy and funding to ensure the AO Foundation develops further. This meeting coincides with the 20th anniversary of the AO Center Building in Davos. It will be an opportunity for the Trustees and the AO Employees to celebrate this occasion together. The most important activities of the AO will be presented during a tour through the build­ ing, and Trustees will provide feedback and medical guidance to ongoing projects. How important is Davos to the AO Foundation?

First of all the AO Foundation really is a global organization; our associates, part­ ners and friends are spread throughout the world and we want to improve patient care worldwide. For more than 50 years Davos has been the center of AO research, development, education and administration. Twenty years ago we moved to the new building in Davos because of the organizations rapid growth. And despite the regional AO Offices around the world, the AO Center in Davos will remain the headquarters of the AO. In Davos we use the Congress Center for the annual Davos Courses with approximately 2,000 medical professionals in attendance. These courses are legendary in the surgical world. And in Davos we have also several other events like the Exploratory Research Symposium and the eCM congress. Davos could be called the knowledge center of orthopedic surgery and I am happy to have the Trustees Meeting again in this very excellent location. What should have been achieved by the end of the Trustees Meeting?

We should have made the right decisions and I am sure we will. We should have had interesting sessions, presentations and activities and enjoyed close contact with the AO employees. And we also should have had fun establishing friendships and good cooperation between the 191 Trustees; their contribution to the AO is very important as they are the AO’s parliament and our ambassadors. At the end of my term I want to hand over to my successor an elite academic organization with sound financial planning, constant growth, an excellent reputation worldwide and a spirit of unity and camaraderie.

Thank you This year the AO Foundation is celebrating the 20th Anniversary of the opening of the AO Center in Davos. The establishment of this center was a turning point for the organization. Its “Toberlone-like” structure soon became the worldwide symbol for the AO Foundation network. It rapidly became a mecca for surgeons and scientists involved in bone fracture healing to come and nteract with other medical professionals, learn from experts and disseminate their knowledge. However, what is sometimes forgotten when one looks at the bare bones structure is what exactly happens inside the building; the AO Center has always been driven by a group of dedicated individuals. These people range from top research scientists to animal care individuals to engineers to administrators, accountants, CEO’s, and many other people who are and have been instrumental in ensuring that the AO Foundation lives up to its mission of providing quality patient care. What is also important is the dedication of these individuals to the surgeons and operating room personnel who have been involved in the AO Foundation. As one, who has had the privilege of working with the staff at the AO for many years, I appreciate the quality of work, the enthusiasm of purpose and overall dedication to the mission of the organization and its surgeons. As we celebrate the 20th Anniversary of the AO Center this year, I believe that this is the right moment to also celebrate the people behind the scenes who have made it possible for us to be the best AO surgeons we can be, by providing the infrastructure to carry out our tasks and goals.


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