Calling for applicants!

The European Hip Society is delighted to announce the call for applications from young European hip surgeons. Two fellows will be selected for a two-week intensive fellowship training in Switzerland during the Autumn of 2026 and a fund will be awarded to each for expenses. This prestigious opportunity is aimed at enhancing expertise in hip surgery and fostering collaboration among leading professionals in the field.

 

Deadline for apps: 28th February 2026

Decision announced: End of March 2026

Applicant criteria

• 40 years old or younger
• Active membership in EHS, reflecting ongoing engagement with the society’s activities (not mandatory)
• Based in Europe
• European orthopaedic specialists with academic potential & an interest in high level knowledge of hip surgery

Selection Process

The selection will be conducted in two stages:-

1. Initial Evaluation: Applicants will be assessed based on the following criteria:
   • Commitment to Hip Surgery: Demonstrated dedication to the management of hip disorders through clinical practice and related activities. Experience in  educational activities within the field of hip surgery
   • Publications: Authorship of scientific publications related to hip surgery
   • Previous Fellowship Training: Completion of fellowship training in hip surgery
   • Collaborative Work: Engagement in multidisciplinary and international collaboration on complex hip surgery cases
   • Professional Development: Active pursuit of continuing education and participation in professional development activities

   2. Interview Stage: The top four candidates from the initial evaluation will be invited to participate in an online interview with members of the EHS EduCom

As you know, this is an excellent and invaluable opportunity for young surgeons to meet and observe at close hand top experts in our field.

It is possible that no application may be considered suitable and the committee’s decision on all matters will be final.

Non EHS members are welcome to apply, so please tell the young doctors in your hospital who want to specialise in the hip joint.

Good luck!

Read about the EHS Travelling Fellowship 2025 to SpainRead about the EHS Travelling Fellowship 2024 to Denmark

This Fellowship took place in Spain, in two leading areas of orthopaedic surgery: Madrid and Malaga. Dr Stijn Bolink, Hip and Trauma surgeon at Deventer Hospital, the Netherlands, and Dr Andrea D’Amelio, Hip and Trauma surgeon at AOU Città della Salute e della Scienza di Torino, Italy, present their report…

The EHS Travelling Fellowship to Spain started on 4th of May 2025 in Madrid, and ended on 17th of May in Malaga. In Madrid, we alternated visits to the hip units of La Paz University Hospital and La Princesa University Hospital for a total of seven days. After taking the high speed train from Madrid to Malaga, we spent three consecutive days at the Virgen de la Victoria University Hospital.

Madrid

La Paz University Hospital
Affiliated to the Autonomous University of Madrid (UAM)
Host: Prof Eduardo García-Rey

La Paz Hospital is a large tertiary centre and one of the most renowned institutions in Spain. We had the opportunity to assist in a variety of hip arthroplasty surgeries with different hip surgeons from their orthopaedic department. This included robotic-arm assisted (MAKO) primary THA, several complex primary cases like severe DDH and post-traumatic protrusio acetabuli, and various revision cases using different implants and different surgical techniques, e.g.:-

• 3D printed model-assisted surgery
• bone impaction grafting techniques
• modular stems
• dual mobility cups

Furthermore we visited the hospital’s 3D lab to get a better understanding of the clinical applications of 3D model printing in orthopaedic surgery, and we were able to try out their Virtual and Augmented Reality (VAR) applications in preoperative simulation and intraoperative navigation. In addition, we visited the biomedical research institue IdiPAZ, where Gema Vallés Pérez showed us around and presented some of the past and current research projects that were conducted in association with the hip unit of La Paz Universitary Hospital.

La Princesa University Hospital
Affiliated to the Autonomous University of Madrid (UAM)
Host: Prof Jose Cordero Ampuero

La Princessa is located in the centre of Madrid, providing medical care to a rather frail elderly population. Apart from its elective surgeries, a particularly large number of hip fractures are treated here. At La Princessa, Prof Jose Cordero-Ampuero and his team of consultants and residents allowed us to assist in many hip fracture surgeries, and elective primary and revision THA.

As fellows, we both presented our current research projects that was followed by a fruitful discussion with exchange of knowledge and ideas afterwards. We particularly enjoyed the vibrant athmosphere at la Princessa and the commitment of the entire team to provide excellent patient care.

Malaga

Virgen de la Victoria University Hospital
Affiliated to the University of Malaga
Host: Prof Plácido Zamora Navas

At Virgen de la Victoria University Hospital in Malaga, Prof Plácido Zamora Navas and his team of hip surgeons really took the time to make us feel comfortable and become part of their team. We attended morning and afternoon lists of elective hip surgeries, with regular primary THAs, one case of failed hip fracture surgery treated with a modular stem, one chronic PJI that was converted into a girdlestone and a Vancouver C periprosthetic fracture for ORIF. Between surgeries we discussed many complex cases and shared our experiences. We also had the opportunity to visit the Ibima Health Research Institute. In the end, Malaga turned out to be a great place to finish our travelling fellowship.

Apart from all the clinical and research related exchange of knowledge, skills, ideas and comparisons between countries, we had a fantastic gastronomic experience thanks to the many dinner invitations by the staff members of each institution. Moreover, in our spare time we very much enjoyed the Spanish culture and lifestyle in the beautiful cities of Madrid and Malaga.

We’d like to thank the European Hip Society for allowing us to have this great experience, with a special thanks to Samantha Stokes for all her help and support. Lastly, we’d like to thank our terrific hosts: Prof Eduardo García Rey, Prof Jose Cordero Ampuero and Prof Plácido Zamora Navas and their colleagues. Your hospitality and compassion have made this travelling fellowship such a wonderful experience. Muchisimas gracias a todos!

 

If you are interested in applying to an EHS Fellowship, watch out for the next announcement after summer & email us to join the mailing list samstokesehs@gmail.com

Read about the EHS Travelling Fellowship 2024 to IrelandRead about the EHS Travelling Fellowship 2024 to DenmarkRead about the EHS Travelling Fellowship 2023 to ItalyRead about the EHS Travelling Fellowship 2023 to Sweden (delayed due to pandemic)

In October 2024, Dr Ana Moreira Ferrão (Centro Hospitalar Universitário de Lisboa/Lisbon, Portugal) and Dr Juan Miguel Rodríguez Roiz (Quiron Aribau, Quiron Badalona Hospital/ Barcelona, Spain) accomplished the European Hip Society Travelling Fellowship to Ireland. This programme is offered to two young surgeons with specific interest in hip surgery, after a meticulous selection from the EHS education committee. Read their rich report here:-

Dublin

WEEK 1

We started the fellowship in the vibrating city of Dublin. First stop: the National Orthopaedic Hospital, Cappagh for the first two days. Cappagh Hospital is a public elective hospital for orthopaedics.

Mr Adrian Cassar-Gheiti who gave us a warm welcome, showed us around the hospital and took us to Operating Theatre (OR). We were able to see four cases including a bilateral total hip arthroplasty (THA) performed by posterior approach, a primary THA non-cemented and a THA revision for aseptic loosening of the cup, exchanged by a dual mobility cup. After finishing the OR, we had an enriching discussion with Mr Cassar-Gheiti about the differences between implant designs for THA, the importance of calliper systems to ensure the correct offset and length and the relevance to plan and individualize every case we perform.

The second day was also in Cappagh Hospital. We were able to scrub in for three THAs with Mr Cassar-Gheiti performed by posterior approach. We were also able to see the calliper system in action : for estimate the leg length and the offset, in the beginning of the surgery, Mr Cassar-Gheiti inserted a pin in the iliac crest, to measure the length from the pin to the greater trochanter; this procedure is repeated after the trial components are inserted to check for final length and offset. They use local intra-articular infiltration analgesia (LIA) in all cases, and oral tranexamic for first 48 hours postoperative.

After finishing OR, Mr Adrian gave us a tour around the hospital and we were very impressed to find big names in orthopaedics who have visited and made presentations in the hospital, such as Dr Ganz, Dr Wagner, Dr Allgower, Dr Rockwood and a lot more, and who are remembered by a commemorative plaque.On the third day, we were hosted by Prof Joe Queally in Saint James Hospital, one of the biggest public hospitals in Dublin. Prof Queally gave us a tour around the hospital, and we had a lot of discussion about septic THA loosening. After that, we were able to go to OR, and see some surgeries, the biggest one was a complex revision for a cemented Charnley THA with septic loosening. The efficiency of the OR surprised us, and we were also amazed by the safety of the TOR system for cleaning up the cement from the femur canal and acetabulum.

On the fourth day we were with Prof Queally again, but now in his private practice, in Beacon Hospital, an impressive and modern hospital. We were able to assist in three THA cases: first a cemented Exeter from STRYKER and two uncemented THAs. During this day, we discussed the correct technique for cementing as in some places it is becoming a “lost art,” but necessary for some cases, especially for the older patients with osteoporotic bone. The fourth case was a trauma one: a tibial plateau fracture submitted to osteosynthesis.

The first weekend was at leisure. We had the pleasure to share a dinner with our two Dublin hosts and we also met Mr Derek Bennett.

We made the greatest possible benefit of our free time to enjoy and get to know Dublin:  we visited the Temple Bar, the Trinity College library, the oldest one in Ireland and were impressed by Gaia (the spectacular illuminated sculpture of Earth). We also went to the Guinness Beer factory and store, explored the Phoenix Park (the biggest urban park in Europe), which gave us the feeling of nature and freedom. We walked around the city, shopped in Grafton Street, and had a very Dubliner experience.

Limerick, Galway, Castlebar – Mayo County

WEEK 2

Next we travelled to the west of Ireland, to Bon Secours Hospital in Limerick, where Prof Eric Masterson hosted us. On our arrival, Prof Masterson picked us up from the hotel and did a brief sightseeing tour of town. After this, he invited us to his house and we had a fantastic dinner in Adare, a typical small village nearby.

In the morning, we were able to scrub in five cases, two TKAs and three THAs, by direct lateral approach (Hardinge). For knees, he uses subvastus approach for most of the cases. We learned Profs Masterson’s tips and tricks for this approach. We also discussed with him details and designs (Zimmer/Biomet), as Prof Masterson is part of the design team of the G7 cup.

After this, we started in The Galway Clinic with Mr Derek Bennet, an impressive private hospital with a lot of accreditations (like Joint Commission) and a warm atmosphere. We scrubbed with Mr Bennet in six cases, all THA by modified lateral approach (Hardinge). He showed us how to section and repair the gluteus medius to avoid a limping gait. We were impressed by the fast OR turnover between cases and the quick synchronization with all the team.

After OR that night, Mr Bennet organized a nice dinner in a typical seafood restaurant in Galway city center, with him and Mr John Kelly.We spent our second day in The Galway Clinic with Mr Kelly, learning Direct Anterior Approach. There were five THAs scheduled for that day, and we were able to scrub in all. Mr Kelly taught us all the technical tips and tricks that he designed over time to be more efficient, like the use of a DAA double offset instrumentation and the Medenvision® grippers. These instruments self-attach to the surgical table and to a Homman elevator, so they stay in place without human assistance. As noted previously, the turnover in the OR was very efficient.

Then we travelled to the north of Ireland to Mayo, a beautiful county in a rural environment, surrounded by nature everywhere.

The next morning, we went to Mayo University Hospital, a public busy hospital in the city of Castlebar, hosted by Mr Derek Bennett. Again, we did a small tour around the hospital and then we went to the OR, where we scrubbed in three revision arthroplasties. All the cases were well-planned and for every case the assistant surgeon wrote on a blackboard the step by step for the surgery to be performed. This habit helps a lot, especially the nurses and assistant team, in knowing exactly the plan. The first case was a failed osteosynthesis of a proximal femur fracture treated by DHS, requiring extraction and hybrid THA implantation with a cemented stem. The second case was the second stage revision of a septic failure of THA, taking out the hip spacer and implanting a new THA (non-cemented). In the last case, we saw the first stage revision of an infected TKA, with the implantation an articulating knee spacer.

After the OR we participated in the orthopaedics team meeting, to discuss the cases for the next week.

At the end of the day, we went to Westport (Mr Bennet’s hometown) to have dinner in a nice restaurant with all the team and the Zimmer Biomet representatives.

In the morning, the Zimmer Biomet team organized a visit to their factory in Galway, where almost 80% of all the Zimmer hip implants used in Europe are produced. They show us the 3D printers for the implants and the next steps in the manufacturing. Every implant is revised, one by one, by a human expert before advance in the fabrication process, ensuring the quality of the final product.

Final destination: Cork

On the last weekend we travelled south to the coastal city of Cork.

We made a pleasant trip to the Ring of Kelly, Killarney town and Killarney National Park, an amazing Irish treasure with a lot of wildlife and stunning, wild landscapes.

On Monday we went to Mater Private Hospital in Cork, for a full OR day with our host Mr Karuppiah Mahalingam. We were able to scrub in five cases, all THA by “bikini” approach, including one bilateral THA. Mr Mahalingam has been doing DAA for almost 20 years and has the greatest number of simultaneous bilateral THA done by this approach worldwide.

He gave us many tips and showed us the Alexis soft tissue skin retractor, a useful tool to avoid muscle damage during the acetabular reaming. After the OR we went to Kinsale, where Mr Mahalingam lives. There, he shared with us a nice lecture about bikini DAA approach, and we went for dinner in a beautiful place close to the sea.On our last day of the fellowship, we spent all day in the OR with Mr Nikos Davarinos and Mr Mahalingam. Together, they had six THA by bikini approaches, two TKAs by subvastus approach and one anterior cruciate ligament reconstruction, and we had the chance to alternate between the two ORs.

After two and a half weeks, it was hard to accept that this amazing adventure was over. We found in Ireland an impressive culture with warm and kind people. Everywhere we went, we felt more than welcome and appreciated. The natural beauty of this country is out of this world, and we know we must return to explore it deeper.

We are incredibly grateful to the European Hip Society for giving us this amazing opportunity to gain experience and to grow as surgeons and as humans. Both of us are better surgeons now, applying a lot of the knowledge learned in our practice. We are also grateful to all the big surgeons who hosted us and taught us tips and tricks with such kindness. Finally, we would like to express our gratitude to Ms Samantha Stokes, who made this fellowship possible, with all her help, support, and kindness.

We, the fellows, had an amazing experience together, sharing many things in common, especially the passion for hip surgery, and for sure, we started a friendship that will last forever.Read about the EHS Travelling Fellowship 2024 to DenmarkRead about the EHS Travelling Fellowship 2023 to Sweden

This Fellowship took place in Denmark, in 3 leading areas of orthopaedic surgery: Vejle, Aarhus and Copenhagen. Dr Jetse Jelsma from The Netherlands and Dr Corinne Zurmühle from Switzerland, present their report…

Vejle 

Our fellowship started in Vejle, a city with a population just over 60,000 inhabitants. The word ‘Vejle’ derives from the old Danish word wæthel, meaning “ford” of “wading place” due to its location at a busy crossing over Vejle River. Professor Claus Varnum brought us together for a meet and drink on Sunday 7th of April at ToRVEhallerne, a trendy spot with a large range of gins. We discussed about personal experiences and differences in training and healthcare between Denmark, the Netherlands and Switzerland. A good start for the week!

During our week at Lillebaelt Hospital in Vejle the focus was placed on fast-track and day-case arthroplasty as well as robotic-assisted arthroplasty. The concept of outpatient hip prosthetics through a posterolateral works good and is well established in Vejle. Completely new territory for us fellows. The team showed us their piriformis-sparing posterolateral approach, robot-assisted and navigated hip arthroplasties to optimize cup and stem position.We experienced the journey of the patient from outpatient clinic to surgery and postoperative care in day-case surgery. The consultation hours have been optimized to such an extent that only necessary, efficient consultations are carried out. Impressive workflow and patient flow was interesting to see. The well-established study nurses are certainly one of the working horses in that patient flow. An open-minded atmosphere and philosophy of the team helps to optimize the process. Interesting discussions about country specific standards led us to many valuable discussions. Large differences were found between the three countries in postoperative thrombosis prophylaxis. These findings prompted a rethink of country-specific circumstances and traditions. Furthermore, we would be informed about the nationwide study on perioperative antibiotic prophylaxis, which will provide us with important findings on single versus repeated administration of antibiotic prophylaxis in the coming years. we are looking forward to the results. As a nice and personal end to the week in Vejle, we enjoyed a hip team dinner at Jacobsen with ‘traditional’ Danish food before heading on to Aarhus.

Aarhus 

Our second week took place at Aarhus. The second biggest city of Denmark with ±300,000 inhabitants and a population of 800,000 within 30 minutes from the center of the city. Aarhus is known as Smilets By (lit. City of Smiles). The Aarhus University Hospital is number 23 on the list of 2,400 hospitals in 30 countries. A new, modern hospital with ±10,000 employees and ±850 beds, in service since 2018. The hospital is the result of a series of mergers between the local hospitals. It covers such a large area that in-hospital bikes and scooters are frequently used. Not getting lost was one of the most important tasks every day. Fortunately, there were good situation maps or computers on every level that showed you the way, including the walking distance.

The team around Prof Stig Jakobsen focus especially on the complex hip arthroplasties and hip preservation surgery. We were introduced to the fluoroscopy-guided minimally invasive transartorial approach for periacetabular osteotomy and their postoperative management of those patients. In many of the revision hip arthroplasties or complex deformities three-dimensional visualization and planning is very helpful. A visit to the in-hospital 3D printer laboratory allowed us to understand this additional potential of the collaboration with engineers. Discussion led us to integration of research in daily business and foundation of projects in different countries. The different options like research in the free time, reserved research time, grants or other sponsors are reality in the different countries. The research unit at Aarhus University Hospital works on different topics with especial focus on infections of the musculoskeletal system. Study setting allows to study effects in pig models to better understand distribution of antibiotics in the perioperative situation. Thanks to Mads Bue for showing us the research lab.

After a private city tour by Stig Jakobsen in Aarhus we enjoyed a delicious dinner at “Den Rustikke” – a wonderful place with menus based on local suppliers and sustainability.

Copenhagen 

The last week took place at Bispebjerg Hospital in the capital of Denmark in Copenhagen with its ±600,000 inhabitants. A collaboration with the Rigshospitalet allows to treat hip patients with classical hip arthritis, young patients with hip preservation and complex trauma and infection cases. Professor Søren Overgaard showed us his way of very efficient performance of periacetabular osteotomy. Insights how customized cups prothesis can be used in complex cases were possible. To complete the hip preservation surgery, insights of hip arthroscopies by a sports surgeon was part of our experience. Lively discussions on diagnostics and treatment options for young patients with femoroacetabular impingement and hip dysplasia were very welcome.

The very scientific program at the end of the fellowship with participation in a research meeting, various scientific presentations and reflections on our own country-specific traditions, as well as future study ideas, were very valuable contents of the last week together with the team around Søren Overgaard. The sushi dinner with Prof Overgaard and Prof Cecilia Rogmark even gave us a brief insight into the hip traumatology and working conditions in southern Sweden.

In general, these three weeks have shown Denmark at his best. A well-organized country which is also reflected in its health care. The surgeons have 30 minutes to see patients in outpatient clinic, which results in clear explanations, no unnecessary imaging and high patient satisfaction. Procedures are categorized into three groups nationwide: regular (primary THA), specialized (hip arthroscopy) and highly specialized (PAO). The specialized and highly specialized procedures are only allowed in certain centers, creating expertise in those centers. The balance between private life and work is perfect due to the 37h/week contract (on loan, except in private). Working days were approximately from 08:00 – 15:30. We experienced a tremendous hospitality in all centres and from all surgeons. It was a once in a lifetime experience.

‘Mange tak’

Thank you very muchRead about the EHS Travelling Fellowship 2023Read about the EHS Travelling Fellowship 2019Read about the EHS Travelling Fellowship 2018Read about the EHS Travelling Fellowship 2017

This Fellowship took place in Sweden, in 3 leading areas of orthopaedic surgery: Orebro, Gothenburg & Stockholm. Our two fellows, Mr Mazin Ibrahim from London, UK and Dr Sufian S Ahmad from Hanover, Germany present their report…

It was a delightful experience to be part of the European Hip Society travelling fellowship to Sweden. We would like to express our heartfelt appreciation to the society for granting us this wonderful opportunity and extend our gratitude to EduCom Chairman, Prof Gosta Ullmark, who oversees the EHS Fellowship programme, and Samantha Stokes, who played a crucial role in helping to organize the fellowship. We also express our sincere gratitude to the hosts who generously devoted their time to accommodate us despite their demanding schedules. They not only welcomed us into their institutions but also provided us with valuable insights into their culture.

Orebro

The journey started in Orebro, where we were welcomed by our host Prof Per Wretenberg, who took us for a tour in Orebro Hospital and introduced us to the department. He hosted a dinner in his house with his wife Maria in the evening accompanied by some of his colleagues. We had a great dinner and a great exchange of knowledge, culture and funny stories.

The following two days in the arthroplasty department in Lindesbergs started early in the morning with a departmental meeting to discuss the cases for the day and we joined Prof Wretenberg in the operating room doing fantastic revision cases, including a revision of a diaphyseal fixation stem which had sunk to another larger stem and required an extended trochanteric osteotomy to remove the old stem. Other cases included primary total hip replacement and a fixation of periprosthetic fracture and others. We enjoyed the city and the hospital and the generosity of the Swedish culture.

Gothenberg

Next we boarded a train to Gothenberg. Our host, Assoc Prof Maziar Mohaddes, warmly welcomed us upon our arrival. In the evening, we dedicated time to devising a clear plan for the upcoming days.

The following day, we had the privilege of visiting Molndal Hospital, where we were greeted by Prof Henrick Malchau. Throughout the day, we had the opportunity to observe three intricate hip revisions in the operating room, all of which were skilfully performed by Prof Malchau. We benefited immensely from his wisdom and expertise. Particularly impressive was his execution of a trochanteric osteotomy to reshape the proximal femur in a complex revision case with pelvitrochanteric impingement, a technique he acquired directly from Sir Charnley himself.

Moreover, we engaged in fascinating discussions on topics such as cup failure, exploring diverse interests and geographical variations. Notably, in Germany, cranial segmental defects are commonly associated with previously implanted threaded cups, whereas in Sweden, cemented cups often lead to more manageable contained defects.

Following this, we had the opportunity to visit Capio Spine Centre Goteborg, a private hospital, where we joined Assoc Prof Mohaddes in observing surgical cases. We exchanged knowledge and experiences, engaging in discussions on surgical approaches and other aspects related to hip replacement surgery.

Later that day, we received a delightful invitation from the team to partake in an exciting brewery experience. This experience took place at the Gothenburg New Brewery and provided us with a very pleasant cultural encounter. The evening was a memorable one, filled with delectable food and enjoyable company. The brewery owners were exceptionally welcoming, providing us with entertaining insights into the beer-making process and its history.

On the weekend we enjoyed going to the city centre of Gothenburg to visit all the nice places like the art museum where we enjoyed Picasso and Van Gogh artwork. We walked through this pleasant city and enjoyed visiting the harbour and the opera house.

We again joined Prof Malchau in another revision hip which was a first stage revision hip for infection, and we used a dynamic spacer using the cemented stem and cemented cup.

Stockholm

We boarded the train to Stockholm, our final destination. The train provided us with a comfortable journey, complete with a Wi-Fi connection, which afforded us the opportunity to engage in discussions and knowledge-sharing.

We received a warm welcome from Prof Olof Skoldenberg at Danderyd Hospital. We joined the departmental daily XR meeting and had the pleasure of meeting the rest of the team, who graciously welcomed us. The meeting involved a multitude of cases for discussion, and we were divided to attend different operating theatres. The cases ranged from complex revisions to challenging primary procedures.

Our day ended late, coinciding with a snowstorm — an immersive first-hand experience of the Swedish winter weather! Remarkably, we also had the chance to reconnect with an old friend, Dr Mohanad Al-Bayati, an orthopedic surgeon from Huddinge Ortopedi and Sodermalmsortopedi clinics. Dr AL-Bayati kindly invited us to share a special fish meal.

We had the privilege of joining Prof Skoldenberg in the operating room for a revision case. During the procedure, we performed an extended trochanteric osteotomy to remove and replace a cemented stem by modular system, achieving excellent cone-in-cone fixation (Restoration, Stryker stem). Following this, we successfully addressed a case of periprosthetic fracture by utilizing a long NCB plate for fixation.

During the day, we enjoyed an exceptional lunch at the patient’s hotel restaurant and had the opportunity to meet other surgeons from various specialties.

In the evening, Prof Skoldenberg hosted a dinner at a delightful oriental restaurant in Stockholm city center. We were joined by Ihsan, another specialist in the arthroplasty department. To return to our hotel, we had the pleasure of experiencing the Swedish subway system.

On the final day, we participated in the arthroplasty meeting, engaging in discussions about complex cases and the hospital’s DVT prophylaxis protocol. We had the chance to exchange protocols from our respective organizations. Following the meeting, we joined the operating room for the last revision case, which involved extracting a Corail stem implanted seven years prior. Surprisingly, the procedure went smoother than expected, with the stem easily removed, giving us an early day off with a perfect result.

Saying goodbye to the hospital marked the end of our fellowship. It was an amazing and highly successful experience. Throughout our time, we participated in more than 10 complex revision hip cases, as well as other challenging primary cases. We exchanged valuable knowledge and experiences and established plans for further research collaboration and fellowship exchanges between our countries. We extend our heartfelt gratitude to the European Hip Society for providing us with this exceptional opportunity.Read about the EHS Travelling Fellowship Italy 2023Read about the EHS Travelling Fellowship UK 2019Read about the EHS Travelling Fellowship Turkey 2018Read about the EHS Travelling Fellowship France 2017

This Fellowship took place in Italy, in 3 leading areas of orthopaedic surgery: Bologna, Turin & Milan. Mr Syed S Ahmed of Tunbridge Wells Hospital, UK & Dr Nicholas Beckmann of Heidelberg University Hospital, Germany, present their report…

We are delighted and grateful to have been awarded the prestigious EHS Travelling Fellowship and it was extremely exciting to finally travel to Bologna, Turin and Milan, after a long delay caused by the pandemic.

Bologna 

The fellowship commenced in Bologna – a town with a fascinating history and home to the oldest university in the world. Professor Binazzi (EHS EduCom) met us at the Villa Erbosa Hospital and we spent the day watching some complex primary hip replacements with a novel lateral approach in supine position. We then discussed several complex cases including management of the dysplastic hip. It was really useful to see the complications the unit had dealt with recently and learn from them. Prof Binazzi then took us for an authentic Italian dinner in the centre of town which was amazing!

The next day Prof Binazzi accompanied us to visit the Rizzoli Institute – founded in the XIXth century by the famous Bolognese surgeon, Francesco Rizzoli, who bought the convent and the hill of San Michele in Bosco. He left it in his will to the Province of Bologna to be used as an orthopaedic hospital. The library has 1,095 journals currently on its shelves, most beginning at their first issue. It was captivating to read a JBJS from 1903! The library also has one of the only remaining Schultess devices to measure scoliosis and the first arthroscopy set used in knee arthroscopy. In the special collection of the ‘Putti Donation’ are 2,457 ancient books of medicine, including hundreds of 16th century books. During the rest of our stay in Bologna we visited the Sala Rusconi – the oldest university in the world and the 2nd oldest anatomic operating theatre.

Turin

We then travelled to the city of Turin. The university hospital is a major trauma centre and Prof Massè’s team was ever welcoming. We very soon felt part of the orthopaedic team there. Our surgical experience included dealing with hip dislocation following a posterior wall fracture and a revision hip replacement for instability. Prof Massè then discussed management of some complex cases with his team and us. It was exciting to share ideas and learn how they managed dysplasia, adults with lifelong Perthes and discuss complex hip reconstructions. We then visited the city of Turin and had a lovely dinner with Prof Massè and his team.

Milan

Upon arriving at the charming city of Milan, it was immediately evident how cosmopolitan and diverse it is! We spent our time in Milan at IRCCS Galeazzi Institute with Prof Zagra (EHS SciCom Chairman & Past President) and Humanitas University Hospital with Prof Grappiolo (EHS Member).

Prof Zagra took us through some of the complex cases he had recently seen in clinic and we spent the day performing a few challenging hip arthroplasties. In the evening we attended a SICOT webinar hosted by Prof Zagra himself on ‘My worst complication after a THA’ attended by expert hip surgeons from across the world.

Prof Grappiolo and his team performed 15 cases in three theatres during our day at Humanitas. It was inspirational to watch how efficiently they managed to run flip lists and perform complex cases in multiple theatres.During our time in Milan we visited the Duomo Cathedral and enjoyed learning of its fascinating history and architecture. We also visited the Galleria Vittorio Emanuele II designed in 1861. It houses shops and cafés with some of the best coffee we have ever had! Prof Zagra also had us over for a very lovely dinner which was extremely kind and hospitable of him.

Our time in Italy was absolutely brilliant. We enjoyed Italian food, drinks and lots of Gelato!

We would like to thank the teams of each of our hosts who made our travel easy and were very helpful during our stay specifically:
Prof Masse’s team – Drs Andrea D’Amelio (EHS Member), Matteo Giachino and Michele Nardi to name a few – all of whom we hope to see at the next EHS Congress in Bern on October 2023!

Prof Zagra and Prof Grappiolo’s teams which included Dr Rocco D’Apolito and Assoc Prof Mattia Loppini (EHS EduCom).

Prof Binazzi for looking after and checking in on us right through our fellowship.

And thank you to the EHS secretary Samantha Stokes – your encouragement, support and amazing organisational skills made the entire fellowship possible!Read about the EHS Travelling Fellowship 2019Read about the EHS Travelling Fellowship 2018Read about the EHS Travelling Fellowship 2017

This Fellowship took place in Portugal, in three leading centres for orthopaedic surgery: Lisbon, Braga and Porto. Dr Iker Uriarte of Forua, Spain and Dr Adrian Cassar-Gheiti of County Mayo, Ireland, present their report…

After a considerable 2-year delay due to the COVID-19 pandemic, we managed to travel during 2022 and were very fortunate to have met fantastic hosts across Portugal including Prof Paulo Rego and Prof Pedro Dantas in Lisbon, Dr Joao Tinoco and Dr Eurico Bandeira Rodrigues in Braga, and Dr Jorge Cruz de Melo and Dr Fernando Leal in Porto.

Week 1: Lisbon

We were welcomed in Lisbon by Prof Rego at the Hospital da Luz Lisboa. He showed us various techniques in hip preservation surgery and discussed cases with various pathologies requiring osteotomies around the hip, that included patients with DDH, Perthes disease and post traumatic deformities. We assisted during hip arthroscopies with labral repair and femoral osteoplasty and multiple THA through a modified direct lateral approach. After two days of surgery, we were invited to ‘A Vela’ to experience the local seafood cuisine. We had a lovely dinner with Prof Dantas and Prof Rego where they shared their vast clinical experience, as well as kept us entertained for the night.

Next we visited Prof Dantas at the Hospital CUF Descobertas, where we assisted in multiple hip arthroscopies for labral repair and femoral osteoplasty and total hip arthroplasties through a mini posterior approach. Prof Dantas went through clinical cases and the indications for hip preservation surgery, THA and complex revision hip arthroplasty.

We had one free day to explore the beauty of Lisbon city and its culture. We walked around the centre and visited the Santa Justa lift, Rua Augusta Arch and walked up the hill to visit Sao Jorge Castle to enjoy fantastic views of Lisbon. We also visited the charming Bairro Alto, with its steep streets and traditional restaurants.

Week 2: Braga & Porto

We took the train to the historical city of Braga to commence our second week of fellowship in the North of Portugal. Over the weekend we had some free time to explore the multiple historical sites and experience the local cuisine of Braga – well known for its religious heritage and the most ancient university of Portugal.

In Braga, we were welcomed by Dr João Tinoco and Dr Eurico Bandeira Rodrigues at the Hospital de Braga. The team prepared a presentation of the cases we were going to participate in during our visitation which ranged from hip arthroscopy to revision hip arthroplasty. We assisted in hip arthroscopy and hip resurfacing procedures and discussed the current indications and contraindications of hip resurfacing.

The next day, Dr Tinoco performed 2 complex THA revisions for aseptic loosening of both cup and stem and we assisted in acetabular reconstruction using a combination of a highly porous cup, augments and revision stem.

Next we travelled by train to Porto, and were welcomed by Dr Jorge Cruz de Melo, Dr Fernando Leal and Manuel Padin from The Porto Hip Unit at Hospital da Luz Arrabida, who are well known for organizing the Porto International Hip Meeting, and had organised full days of surgery for us to attend.

Dr Jorge Cruz de Melo took us through multiple procedures, commencing the day with a revision of a MOM THA, followed up by a series of THAs through the direct anterior approach, including a bilateral case. Dr Cruz de Melo explained his interest in DAA and showed us patients’ testimonials of the success he had with this approach and shared his tips and tricks to successfully use this approach for THA. This was followed by a series of arthroscopic sciatic nerve decompressions and piriformis release – it was quite interesting to see this novel technique in the management of buttock pain from piriformis syndrome. At the end of the day we observed a proximal hamstring avulsion reattachment as well, which was meticulously done through an arthroscopic technique.

On our last day of our fellowship Dr Cruz de Melo took us for a clinical ward round to see the post operative patients and discussed multiple post operative rehabilitation programs, which was followed by further primary THA through the modified DAA approach.

With our 2-week fellowship ending we found some free time to travel around Porto, walk through the Luis I Bridge, and visit the touristic Ferreira and Calem wine cellars in Vila Nova de Gaia for some Porto wine tasting and go for a stroll along Matosinhos beach where we enjoyed some excellent traditional Portuguese sea food.

Thanks

We are grateful to our departments, Department of Orthopaedic Surgery, Hospital Galdakao-Usansolo, Bizkaia, Spain, and the National Orthopedic Hospital Cappagh, Dublin, Ireland for providing us time to enjoy and learn from this unique experience. Adrian would like to thank Prof Allan E Gross (Mount Sinai Hospital, Toronto, Canada) and Prof John O’Byrne (National Orthopaedic Hospital Cappagh, Dublin, Ireland) and Iker would like to thank Prof Maziar Mohaddes (Sahlgrenska University Hospital, Gothenburg, Sweden) and Dr Matt Wilson (Royal Devon and Exeter Hospital, Exeter, UK) for their great support during the application process.

We feel extremely honoured to have received this opportunity and been selected for this fellowship and to finally be able to travel after 2 years of pandemic. We would like to express our gratitude to the European Hip Society and the Portuguese Hip Society, in particular Prof Pedro Dantas for organising it. Special thanks go to Ms Samantha Stokes for the excellent communication, patience and organization of the entire endeavour. Finally, we thank all those who hosted us during these 2 weeks, we left Portugal full of knowledge and made new friends along the way and we look forward to meeting again at the next Porto International Hip Meeting. We want to highlight the great relationship and friendship created between the 2 of us, Iker and Adrian, and the large amount of time we enjoyed sharing experiences and knowledge in diverse aspects of hip surgery. We think this is one aspect of the fellowship that makes it so special.Read about the EHS Visiting Fellowship 2019 to SwitzerlandRead about the EHS Visiting Fellowship 2018 to The NetherlandsRead about the EHS Visiting Fellowship 2017 to GermanyRead about the EHS Visiting Fellowship 2016 to GreeceTo join our mailing list for the announcement of the next EHS Fellowship, please send your request to samstokesehs@gmail.com

by Dr Wim Rijnen, Orthopedic Surgeon, Radboud University Medical Centre, Nijmegen, The Netherlands

From 2-20 September 2019, I had the privilege to attend the British Hip Society (BHS) travelling fellowship in the United Kingdom. This was the first time that a fellow from the European Hip Society (EHS) could apply for this travelling fellowship. I was together with Brian Fuller, a fellow from the American Hip Society. In 2.5 weeks we travelled from London all the way to Glasgow. It was a fantastic experience, we had the opportunity to meet the most prominent hip surgeons in the UK, share experiences and discuss cases. I would like to thank the board of the EHS for selecting me for this fellowship, the BHS for organizing the fellowship and a special thanks to professor Fares Haddad for giving a EHS fellow the opportunity to attend this fellowship and taking care for us during our travelling in the UK.

The first day of the fellowship started in London. We were welcomed in the University College in London (UCL) by Mr Sujith Konan [EHS Visiting Fellow 2016]. After a visit at the outpatient department, there was a meeting with the hip fellows from the UCL to discuss complex cases. The next day started again in the UCL with a program in the operating theatre with robotic assisted hip surgery. Then we went to the Royal London Hospital where we were welcomed by Mr Pramod Achan. There was an academic meeting with the orthopedic staff. In the Good Samaritan, a pub around the corner, the meeting proceeded, and after dinner Mr Achan took care of us showing London by night. The next day, we visited Stanmore hospital. There was a start with a multi-disciplinary infection meeting. After that we went to theatre for a revision case with a patient specific made implant. After visiting the Stanmore retrieval lab, we went back to the city of London and travelled to Exeter.

In Exeter, we were welcomed by Mr Matt Wilson, Mr Matthew Hubble, Mr John Charity and Mr Andrew (John) Timperley. We had the ability to see different kinds of surgery, a femoral bone impaction grafting, a robotic assisted hip surgery, the SPAIRE approach and got tips and tricks in properly cementing a hip prosthesis. The next day, Mr Wilson had organized a cadaver workshop combined with interesting presentations about the impressive Exeter philosophy. Later that day, after attending theatre again, we travelled to Cardiff. […continued…]“Having time to talk about hip surgery with people that do things differently or sometimes more the same is very beneficial. It makes you think about the way you are dealing with surgical difficulties and can be very reflective”[…continued…] Mr Steve Jones was our host in Cardiff. On Saturday morning, he had organized an acetabular revision operation, followed by presentations about acetabular revisions and instability of the hip. Later that afternoon, we went to a Rugby match, had a great dinner and spent some time with the local Welsh people. After visiting Cardiff castle on Sunday, we travelled to Nottingham.

Mr Andrew Manktelow took us for a drink in the oldest pub in the UK after which we had a great dinner. On Monday morning, there was a very interesting video conference with hip surgeons in surrounding regional hospitals. Cases were discussed and plans made for surgery. This was followed by an infection and staff meeting. Then we saw very interesting and complex cases at the outpatient department. The day was ended with some interesting cases in theatre after which we travelled to Liverpool.

In Liverpool, we were guests at the meeting of the British Orthopedic Association. We had the opportunity to meet new people, saw interesting presentations, including the Charnley Lecture by Professor Henrik Malchau and the Robert Jones Lecture by Professor John Skinner. On Tuesday night, we attended a very nice dinner of the BHS board in Liverpool town.

Mr Anil Gambhir took us to Wrightington on Thursday. In Wrightington, we went to the centre for hip surgery, where Charnley did his first hip operations. Mr Gambhir took us to the impressive theatre were we could assist him in some surgical procedures. Mr Bodo Purbach gave us a tour through the famous Charnley museum and took through some interesting cases. After that, we went back to Liverpool where we were the guest of a dinner of the Low Friction Society. The next day, there was a meeting of the Low Friction Society which we attended and gave presentations. In the afternoon, we went back to Wrightington for hip surgery.

On Saturday the 14th of September, professor Haddad had organized tickets for a football match at Manchester United. We saw them beating Leicester city. Mr Gambhir took us to a superb Indian restaurant in Manchester. Then we travelled to Sheffield.

Mr Andy Hamer was our host in Sheffield. He took us to a pub in the peak district where we had dinner withfour more orthopaedic surgeons. The next day we went to a factory tour. Two different factories were visited where hip prosthesis were manufactured. Very interesting to see all different steps in the process. In the afternoon we met Dr Rob Townsend, a microbiologist in Sheffield. With him, we had an inspiring talk about the treatment of prosthetic joint infections. After an academic meeting with the orthopaedic staff, we went in town for a great dinner. The next day, we went into theatre and left again to travel to Glasgow.

In Glasgow, Mr Dominic Meek and Mr Sanjeev Patil were our hosts. On Wednesday 18th September, Mr Patil gave us a great presentation about adolescent hip surgery. In the afternoon Mr Meek performed a stem and cup revision in a patient with acetabular and femoral bone defects. The next day, we did some sightseeing of Glasgow and went to visit the Golden Jubilee National Hospital. There was a final academic meeting after which we went in town for our final dinner of the fellowship. Different surgeons from different hospitals in Glasgow came by for a great evening. Brian and myself had a final beer before we flew back home on Friday 20th September.

This travelling fellowship was inspiring, intense and a great experience. We had interesting conversations with different orthopedic surgeons throughout the country. Many new friendships were made with colleague hip surgeons. Having time to talk about hip surgery with people that do things differently or sometimes more the same is very beneficial. It makes you think about the way you are dealing with surgical difficulties and can be very reflective. We had the opportunity to see many different people working in theatre, outpatients and meetings. I took lots of new ideas and thoughts with me back home to explore in my daily practice.

The man I travelled with, Brian Fuller, became a new and very respected good friend. Together we had great fun, good laughs and interesting discussions about our orthopaedic work. My cementing practice and his American cementless one were very controversial, we managed to come together in that quite a bit. We will stay in touch for sure.Read about the EHS Visiting Fellowship 2018

EHS Travel Fellowship 2019 Report by Alex Brunner and Loris Perticarini  (Alex writes…)

We would like to thank the European Hip Society for giving us the opportunity to perform this fellowship. We had a very rewarding time in the UK.

26.03.2019: Circle Hospital Reading

The first stop on our journey was Reading, a large town in Berkshire about 50km from London. There we visited Circle Reading, a private hospital offering a wide spectrum of elective orthopaedic surgeries. In the morning we met Mr Tony Antrade, a senior orthopaedic consultant with many years of experience in hip arthroscopy.

We attended him during a number of arthroscopic procedures including arthroscopic labral repairs, resection of cam deformities, and fixation of a partial tear of the gluteus medius tendon.

During the procedures, we had the opportunity to discuss some of our own cases with Mr Andrade and he was very committed to share his experience.

We also got in touch with new technologies such as the MiEye2 needle arthroscope, which may be used in clinic to perform minimally invasive life arthroscopy of joints with the patient wide-awake and watching. Mr Andrade furthermore invited us to the London Hip Meeting planned April 3^rd 2019.

In the afternoon we joined Mr Tom Polland who performed another arthroscopic surgery on a patient with cam-impingement.

Since we had only one day to visit Reading we said goodbye at around 5pm and took the train to our next stop Exeter.

27.03.2019 – 29.03.2019: Exeter Hip Unit

The Exeter stem represents one of the most famous orthopaedic implants for total hip arthroplasty in the world. Therefore, we were quite excited to visit the “Exeter Hip Unit” in the Princess Elisabeth Orthopaedic Centre in Exeter. This is the place where Professor Robin Ling developed and implanted the first Exeter stem in 1970.

In the morning Mr Mathew Hubble, a senior consultant, picked us up at our hotel. Initially we visited Nuffield Hospital, a private hospital located next to the Princess Elisabeth Orthopaedic Centre just across the street. There we met Professor John Timperly performing a primary total hip replacement via SPAIRE approach using a MAKO robot (Stryker). Thereafter, we joined Matt Hubble again who performed another MAKO procedure using a piriformis sparing approach. After a rich lunch we moved to the Exeter Hip Unit in the afternoon. Mr Matthew Wilson welcomed us at his office and gave us a short guide across the unit. Afterwards we joined the radiological review meeting usually taking place every Wednesday afternoon. We discussed the postop cases of last week and the preop cases of next week and got to know almost the whole surgical staff of Exeter Hip Unit.

In the evening, the guys took us out for dinner J.

The following two days we saw a number of primary and revision cases including a complex dysplasia, a severe osteoarthritis in a coxa profunda requiring impaction bone grafting, and removal of a kiwi spacer that had been in situ for more than 5 years.

We further got to know the Exeter recovery program allowing patients to be discharged one day after THA surgery.

After three delightful days we left Friday evening and took the train to Bristol Temple Meads.

 

29.03.2019 – 05.04.2019: Bristol Southmead Hospital

Mr Richard Baker picked us up at Bristol Temple Meads Railway Station in the evening of the 5^th of April.

Richard is a consultant for orthopaedic surgery with special interest in hip and knee arthroplasty and the chief editor of “Hip International”. He had organized the EHS fellowship and we were looking forward to meeting him. After driving us to our apartment situated directly next to the Brightside ground cricket field Richard took us out for dinner.

The next morning we joined him in the Spine private hospital to see a revision THA after failed fracture fixation and a total knee replacement, again with the MAKO robot.

The afternoon was off and we took a walk to the city centre to get more familiar with Bristol’s pub scene J.

Monday morning Richard picked us up again and introduced us to the orthopaedic staff at Southmead Hospital.

Southmead Hospital is a large NHS hospital, situated in the north of Bristol, providing level 1 trauma care and the complete spectrum of elective orthopaedic surgery.

During the first two days we attended Mr Richard Baker and Mr Stephen Eastaugh-Waring during primary THA and hip arthroscopy. Furthermore, we met Mr Michael Kelly, a trauma surgeon, who demonstrated to us the Bristol concept of open fracture treatment. Tuesday night we went out for dinner with Richards’s registrars Henry and Oli and his fellow James. Thanks guys for that great evening!

Wednesday morning we had to get up early to catch the train to London at 5am. Two hours later we arrived at the Queen Elizabeth II Centre close to Westminster to visit the London Hip Meeting. An international faculty, including Adolfo Lombardi (USA) and Carsten Perka (Germany), presented current concepts in diagnosis and treatment of hip pathologies. We spent the whole day there and arrived back in Bristol late in the evening.

The next day we attended Mr Jason Webb during a complex total hip replacement for a fracture and a revision for infection. At night the consultants took us out for dinner. The restaurant was located close to the house where the famous pirate Blackbeard was born in 1680…. Very exciting!!!!

A final highlight was the visit of the Bristol University research centre. We met Professor. Asley Blom who leads the analysis team of the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man, which represents the largest joint registry in the world. Based on the data from this registry Professor Blom and his team perform epidemiological basic research. During our visit they presented to us current results from their research including data regarding implant survival and infection management.

After this very interesting Friday morning it was time to say goodbye to everybody. We went to the railway station in the afternoon and took the train north.

08.04.2019 – 09.04.2019: Wrightington Hospital

After a great weekend in Manchester including a visit to Old Trafford stadium and the famous “Alberts Schloss” Bar we took the train to Wigan on Sunday evening to visit Wrightington hospital. Wrightington is a very historical place. It is the hospital where Sir John Charnley developed and performed his first total hip replacements in the 1960s. Paul Siney, a research fellow who works for Professor Wroblewsky, picked us up at the hotel and took us to the Centre for Hip Surgery. This historical place includes a museum were you can find a nice exhibition of different types of historical hip and knee prosthesis as they were used during the first and second half of the 20^th century. Several patients’ charts from the early days and an original issue of Charnleys book “Low friction arthroplasty of the hip” can also be found there. Furthermore, a model of the original “Green House” as it was used by Sir John Charnley to reduce bacteria load in the air during surgery has been re-built at the entrance area of the hospital.

Nowadays, Wrightington hospital is the largest Orthopaedic hospital in the North West of England performing more than 1000 joint replacements each year.

Paul gave us a comprehensive guide through the museum and eventually brought us into theatre were we met Professor Tim Board. Tim is a senior consultant specialized on hip arthroplasty. We spent the whole day with him performing several un-cemented (unusual for the UK) total hip replacements. At night he took us out for dinner. The next day we met Mr. Bodo Purbach. Bodo is a German surgeon who came to Wrightinton 25 years ago to learn hip replacement surgery from John Charnleys follower Professor Wroblewski. He still performs the original Charnley procedure including a lateral approach to the hip with trochanter osteotomy. We attended him during two procedures (one primary and one revision). Bodo gave us a great review of the development of total hip replacement surgery during the last thirty years. Thank you Bodo for your great commitment. You turned this day into one of the most rewarding during our fellowship. Unfortunately, we had only two days in Wrightington so we left Tuesday afternoon to travel south again.

10.04.2019 – 12.04.2019: Birmingham

Wednesday morning at 8am we entered our last station the Royal Orthopaedic Hospital in Birmingham. This hospital is one of the largest specialist orthopaedic units in Europe offering planned orthopaedic surgery to national and international patients.

At the entrance we met Mr Michael Parry who was our contact person for Birmingham. Michael is a consultant specializing in tumour surgery and lower limb arthroplasty.

He gave us a quick guide around the place and took us into theatre. There he introduced us to Mr Callum McBryde a consultant specializing in hip surgery. During the next two days we joined Callum into theatre. He performed a number of hip resurfacings and one hip arthroscopy. Between the surgeries he spent a lot of time to discuss with us his experiences regarding hip resurfacing and told us about current research projects that are recently undertaken to develop a resurfacing without metal on metal bearing.

The final day we visited the hip indication meeting on Friday morning and got to know most of the consultants specializing on hip surgery.

After three very rewarding days we had to say goodbye and went to the airport to travel back home. After three weeks abroad we were both looking forward to seeing our families again.

Overall, the fellowship was a very rewarding time, which broadened our minds in many ways.

We would like to thank all the people who made these three weeks such an unforgettable experience.

In particular:

 

Reading

Mr Tony Andrade, Mr Tom Polland

 

Exeter

Prof. John Timperley, Mr Mathew Hubble, Mr Matthew Wilson, Mr AL-Assam Kassam,

Mrs Harriette Branford White

 

Bristol

Mr Stephen Eastaugh-Waring, Mr Sanchit Mehendale, Mr Jason Webb, Mr Michael Whitehouse, Prof. Ashley Blom

 

Wrightington

Prof. Tim Board, Mr Bodo Purbach, Paul Siney

 

Birmingham

Mr Michael Parry, Mr Callum McBryde

 

Our very special thanks go to Mr Richard Baker who put so much commitment into the organization of the fellowship. We felt very much welcome all the time. Thanks Richard!

Looking forward to see some of you soon at the next EHS congress.

Alex and Loris

 

THE ENDRead the EHS Travelling Fellowship 2018 ReportRead the EHS Travelling Fellowship 2017 Report

This Fellowship took place in Switzerland, in three leading centers for orthopaedic surgery: Bern; Lausanne and Zurich. Dr Vittorio Bellotti of Barcelona, Spain and Dr Vahit Emre Ozden of Istanbul, Turkey, present their report…

We started the fellowship at Inselspital in the elegant Bern, the sacred temple of knowledge about hip preservation surgery. On the first day in Bern, we were warmly received by Prof Siebenrock Secretary Miss Karin Haueter that accompanied us to the Hip Surgery Department. We had the honour to meet Prof Klaus Siebenrock in his office, that is a place full of books and history about the Bernese school of hip surgery. Then we moved to the morning conference of his department, where all elective and emergencies cases of the orthopaedic surgery department were discussed with all the staff. We had a tour of the hospital and Prof Siebenrock showed us their new designed emergency department including operating theatres.In the operating theatre, our first case was undergoing a Bernese Periacetabular Osteotomy in a patient who had an anterior unstable hip after two previous arthroscopies. In another operation room, Prof J Bastian performed a primary THA by trans-gluteal approach for a complex case in a morbid obese patient who had liver transplant. On the second day, we started directly in the operating room. Among others, there was an interesting case of pubic nonunion after PAO. Prof Siebenrock performed osteosynthesis by Stoppa approach. Then we had the opportunity to observe a case of complex femoracetabular impingement treated by surgical hip dislocation and trochanteric osteotomy; Femoroacetabular osteochondroplasty with labral reconstruction was performed by Dr Bastian and Dr Steppacher.  At the end of the day Prof Siebenrock hosted us in his house and we had a great typical Swiss dinner with his lovely family and doctor Bastian, Dr Steppacher and Miss Hueter. After dinner we organized a very funny and amazing foosball (soccer table) championship, where on eliminatory bases Dr Ozden won a bottle of Swiss wine!Our third day started in outpatient clinic, and it was amazing. We had the opportunity to observe and discuss with all the doctors of the staff all the patients admitted to the outpatient clinic. As a reference center, we had a chance to discuss about the diagnosis, clinical examination and treatment options for patients with complex hip pathologies.  On the last day of Bern, we had the opportunity to present ourselves and our professional work to all the department during the morning meeting; in the same day we were invited to assist at the Swiss OrthoGeriatric Day, a very good and interesting meeting by Dr Johannes D Bastian.

That same day we travelled by train to our next step: the beautiful Lausanne. Dr Julien Stanovici received us in an interesting meeting in the Olympic Museum of Lausanne, and after that arranged a small welcome party with his young and active  team. They really showed a great hospitality starting from the first moment and during all the stay.

In the first day at the CHUV – Centre Hospitalier Universitaire Vaudois – Dr Julian Stanovic performed a complex case of total hip arthroplasty using custom made femoral stem with bikini incision, it was an amazing case and we learned many tips and tricks about anterior direct approach. In the other operating room Dr Alexander Antoniadis performed Hardinge approach in a case with post traumatic arthrosis with implant removal. Then, we had another case with Dr Stanovici, an acetabular component revision by anterior approach in an unstable hip. In the afternoon we moved to another building of the hospital and Dr Julian Favre and Dr Jolles-Haeberli presented us the amazing SwissBioMotion Lab and their investigation projects, including the testing of a robot for primary and revision prosthetic surgery. At the same day we met Prof Dr Julien Wegrzyn, who gave us an interesting and extensive small group conference about dual mobility. At night Prof Brigitte Jolles Haeberli organized for us a fantastic dinner in a very nice restaurant in Bourg-en-Lavaux, with great views of the lake Leman, where we had the chance of tasting a Swiss typical dinner with delicious deer meat.On the second day at Lausanne, we visited the out-patient clinic and had the opportunity to assist with the patient informative conference, that was scheduled twice a month, where all patients who were going to have a replacement surgery were informed by the team including nurses, orthopedic surgeons, ergo and physiotherapist, and anesthesiologists. Dr Julian Stanovici then took us around the ergo and physical therapy center and talked about their post-operative rehabilitation program. In the afternoon we visited again the Swiss BioMotion Lab with Dr Julian Favre. They gave a talk about the in Vivo 3D analysis cartilage analysis using CT arthrography, and about a novel MRI -based knee cartilage biochemical composition analysis probing OA pathogenesis. We visited then the fully equipped gait analysis laboratory of the CHUV.

The third day started in operating room, where Dr Stanovici performed two total hip arthroplasties by bikini approach, one of them in a case of obese patient. In the same afternoon we moved by train to our third and last stop: the brilliant and modern Zurich.The first day at Schultess Klinik in Zurich started with the meeting with our genial host: Prof Dr Hannes Rudiger. He was very kind with us and gave us the opportunity to assist in the operating room on all three days in Zurich, where after the morning meeting with all the staff, we moved to the operating room, where he always had scheduled minimum four or five cases of total hip replacement by anterior bikini approach, with several bilateral cases. It was like participating in an intensive total anterior approach hip replacement master course.

One night of the stay in Zurich Prof Rudiger invited us to dinner in a traditional meat restaurant in old town Zurich where they served us a delicious typical sSwiss dinner with a tasting Swiss beer. We had a delicious meal and intimate conversation with a giant of hip and tumours surgery, and a very funny and amazing man.

During our stay in Zurich we had the opportunity to meet and participate in surgery cases with Prof Micheal Leunig, an impressive and elegant surgeon who made us feel comfortable in every moment, and always available to talk about the all cases.After two weeks it was difficult to leave and realize that the experience was now over.

The fellowship was amazing and unbelievable in every aspect. For those dedicated to hip surgery, Switzerland is a country that means a lot, because much of the old and modern knowledge about hip surgery comes from this beautiful, variegated and mysterious country. A place where diversity is accepted, where the intersection of cultures is perhaps the strong and distinctive point.

Probably they were and will be the landscapes and the mountain air, and the good wine and cheeses, and the chocolate, to stimulate the minds of great surgeons and researchers towards new discoveries and to consolidate the milestones of the knowledge of hip surgery.

We would sincerely like to thank the European Hip Society for this opportunity. We are now richer, in hip knowledge and as persons. And we, the fellows, will be friends forever.

Thanks to Prof Klaus Siebenrock for sharing with us his enormous knowledge and smile, in Bern we learned to observe and consider all the aspects of the hip joint, as in a 4 D vision.

Thanks to Dr Julien Stanovici, to be in the same time a great surgeon and a very close friendly person, and to make us feel at home in Lausanne.

Thanks to Prof Rudiger, for being a genius, and for probably being the fastest and most precise surgeon we have ever met, and to be at the same time so serious and funny. We learned a lot with him.

And finally a special thanks to Mrs Samantha Stokes, our incredible and 24/24 hours available EHS Secretary, that assisted us before, during, and after the fellowship.APPLY TO EHS Visiting Fellowship 2020 NOWRead about the EHS Visiting Fellowship 2018Read about the EHS Visiting Fellowship 2017Read about the EHS Visiting Fellowship 2016

The Netherlands: Nijmegen – Delft – Breda – Maastricht – Nijmegen 

In October 2018, Dr Pedro Santos Leite (Centro Hospitalar e Universitário do Porto, Portugal) and Dr Mattia Loppini (Humanitas University, Humanitas Research Hospital, Italy) performed the European Hip Society Travelling Fellowship. This programme is offered to promising young surgeons with specific interest in hip surgery. It was a great honour for us to be selected. We would like to thank the ExCom of the European Hip Society (EHS), and Prof Willem Schreurs, who finished his role as President of the EHS this year. Dr Mattia Loppini would like to thank Prof Guido Grappiolo, the Head of his department, and Prof Eleftherios Tsiridis, the Secretary General of EHS, for their support during the application process. Dr Pedro Santos Leite would like to thank Prof António Oliveira, the Head of his department for all the support. Finally, a really special thanks to Mrs Samantha Stokes, for her precious help and care before, during and after the fellowship.

This Travelling Fellowship was organized by Prof Willem Schreurs resulting in a two-week program including centres of excellence in hip surgery in The Netherlands.

The first week of our trip was spent in Nijmegen, the oldest city in the Netherlands. In this beautiful city, located in the east, close to the German border, we had the opportunity to visit three different centres.

Radboud University Medical Centre (UMC) was our first stop in the first two days and Prof Willem Schreurs and Dr Wim Rijnen our hosts. The orthopaedic department of this centre is one of the most experienced worldwide using bone impaction grafting. We had the privilege of participating in two acetabular revisions with bone impaction grafting with Prof Schreurs, who showed us all relevant tips and tricks. During the afternoon of this intensive first day, we had a scientific meeting in the orthopaedic department with a lecture of Prof Schreurs on bone impaction grafting philosophy and clinical results of this technique. We also had the opportunity to give a talk to the team about our clinical and research activities with an inspiring discussion on different strategies for the management of severe acetabular bony defects, periprosthetic joint infection and types of fixation in primary hip replacement. After this meeting, we had a fabulous dinner in a famous restaurant in Nijmegen with Dr Wim Rijnen, Dr Gijs van Hellemondt and Dr Enrico de Visser who were also our hosts in Nijmegen. On Tuesday [9^th October], we participated in two more acetabular reconstructions with bone impaction grafting with Dr Wim Rijnen as team leader.

The third day was very special. Dr Gijs van Hellemondt picked us up in the morning at Sint Maartenskliniek, a large orthopaedic hospital in Nijmegen, where we had the possibility to collaborate in a complex surgery, a revision of a severe acetabular defect with a 3D printed implant. Dr Gijs and his colleague Dr Maarten Spruit have a very significant experience with this technique, with more than 80 cases treated so far. We also had the chance to discuss extensively with Dr Gijs the best strategies to have a good exposure of the acetabular side and to get the proper position of the custom implant, advantages of this technique and its results.

In the afternoon, we attended the international session organized by the EHS during the congress of the Dutch Orthopaedic Society in Rotterdam. The programme included interesting talks such as the future of Dual Mobility cups from EHS President Prof Jean-Alain Epinette (Bruay-Labuissière, France); the restoring of bone defects with 3D-printed metal cups form Prof Gunnar Flivik (Lund, Sweden) or bone grafting from Dr Wim Rijnen (Nijmegen, Nederland); the use of long modular stems in revision surgery from Prof Roberto Binazzi (Bologna, Italy); the Warwick agreement on arthroscopy for femoroacetabular impingement from Dr Enrico de Visser (Nijmegen, Nederland).             [continued… scroll down]

On Thursday, we spent all day with an excellent surgeon, Dr Enrico de Visser at the CWZ Hospital Nijmegen, and joint preserving hip surgery was the main topic. We assisted to a surgical hip dislocation (for femoral neck/acetabular rim osteoplasty and labral reattachment) and two hip arthroscopies. In the evening, we had a nice dinner with Dr de Visser and other people of the OR enjoying traditional food and local beer.

On Friday, we came back to Sint Maartenskliniek and participated in surgery including complex femoral and acetabular revisions. Dr Gijs van Hellemondt was definitively a very enthusiastic host. He taught us many tips and tricks on femoral revision surgery, presented Sint Maartenskliniek’s flow-chart for the management of femoral revision and finally surgical strategies for the management of abductor deficiencies. We had also the possibility to make a guided tour in the hospital that is equipped with top innovations in rehabilitation field, such as GRAIL (Gait Real-time Analysis Interactive Lab) and exoskeleton robots.

The weekend was free to enjoy Amsterdam. Here, we visited all the best attractions of the city. Sunday evening we had a nice dinner in Delft to finish this break before a second busy week.

On Monday, 15^th October, we visited Dr Stephan B. Vehmeijer, the National Representative of the EHS for the Netherlands, at the Reinier de Graaff Hospital in Delft. This day was especially dedicated to the anterior approach and to “one day” primary hip surgery. Dr Vehmeijer shared his knowledge and experience, and we had a very inspiring and educational discussion on the philosophy of fast-track in total hip arthroplasty.

On Tuesday, we went to Amphia Hospital in Breda to visit Dr van Houten and Dr Bolder. They showed us the direct superior approach and made a very nice presentation with its results compared with the standard posterior approach.

On the next two days, we visited Dr René H.M. ten Broeke and Dr Jan A.P. Geurts in Maastricht Medical Centre. It is a large academic orthopaedic centre with an extensive experience in revision surgery and periprosthetic joint infections. Here, we had the opportunity to participate in complex acetabular revisions (Paprosky tipe III) managed with bone impaction grafting and femoral revisions. On Thursday, we visited the research laboratories of the orthopaedic department and had a nice presentation about their main research lines. Dr ten Broeke was very kind with us arranging for the evening a very nice visit to Maastricht, one of the oldest cities of The Netherlands, and a superb dinner with him and Dr Geurts in a fabulous Italian restaurant.

On the last day of the fellowship, 19^th October, we came back to the starting point – the Radboud UMC in Nijmegen.  Prof Schreurs was once again fantastic with us, constantly sharing and teaching. Prof Schreurs is a great man, a great “pair of hands”, for us a great example to follow. Thank you!

In these two busy weeks, we met excellent surgeons and wonderful people. We would like to thank all the professors and their colleagues for their hospitality, they really took care of us. This fellowship allowed us to increase our knowledge in hip surgery, exploring different philosophies and techniques. We will bring with us all the useful things we learnt to improve our daily practice.Read the EHS Visiting Fellowship 2017 ReportRead the EHS Visiting Fellowship 2016 Report

EHS Travelling Fellowship 2018 Report by George Grammatopoulos and Christian Merle

The destination of the European Hip Society’s 2018 Travelling Fellowship was Turkey and the venues were split between the two largest cities (Ankara and Istanbul). We were extremely fortunate to have fantastic hosts. Professor Mazhar Tokgözoglu and Professor Bülent Atilla are two of the most renowned hip surgeons both nationally and internationally; they had prepared an exciting, well-balanced and broad agenda covering all aspects of hip surgery for our time spent in Turkey; their hospitality was second to none; their entire team gave us a very warm welcome from the moment we landed at Ankara Esenboga International Airport until the last moments of our stay.

Our experience started with an extremely busy outpatient clinic at the Hacettepe University Hospital in Ankara. The medical school of Hacettepe University was founded in 1963 and is internationally recognised as one of the top medical schools in Turkey. Our introduction with the team took place over a glass of Cay, which was in true tradition served with every opportunity. In the outpatient clinics we reviewed and intensely discussed about the diagnosis, clinical examination and treatment options for patients with complex hip pathologies. Those included Crowe 2 – 4 neglected DDH cases, post-traumatic hip deformities, aseptic loosening around 20-25 year old THAs and lastly THAs in spastic paraplegia and paediatric neurologic conditions. Following a stimulating clinic session, we were cordially invited to join the team for an authentic Turkish lunch at the University’s terrace restaurant. Whilst enjoying the panoramic views of the city and getting to know each other, a 4-course meal of excellent quality (…and quantity) was lightening our spirits. In the afternoon we learned about the team’s experience with complex THAs in DDH of variable severity including their experience with acetabular and femoral reconstructions using femoral autograft for the acetabulum and a plate to augment the femoral shortening osteotomy, whilst using a standard primary uncemented stem and cup.

Our second day was Labour Day (1^st of May) and hence no clinical duties were undertaken. Professor Atilla showed us the Anatolian Civilisations Museum, one of the most impressive museums we have ever been to. The region’s rich cultural heritage was beautifully and elegantly displayed, spanning a period of over 11,500 years. We were amused to see transcripts crafted in stone from 1300 BC, illustrating that not much has changed in human behaviour, dealing with aspects of human life, friendship, marriage, taxes, war, divorce and wills. Following a visit to the castle, Professor Atilla and his wife invited us to their beautiful home, where we enjoyed a delicious Turkish feast. They both made us feel most welcome, reflecting Turkish hospitality at its best. (Continues…)Our 3^rd to 5^th days were full of lectures and operating theatre experience. We visited Cankaya private hospital on Wednesday, an excellent and well-organised orthopaedic clinic. We spent time with Professor Tandogan and Dr. Kayaalp discussing indications, surgical techniques and outcomes in hip arthroscopy. We had the opportunity to observe 2 FAI cases elegantly and effectively treated arthroscopically. Thursday and Friday of week 1 were again spent at Hacettepe University Hospital joining Professor Tokgözoglu and his team for a THA in a Crowe 4 DDH case with subtrochanteric shortening osteotomy, impressively demonstrating all aspects we had covered in lectures earlier in the week. Thereafter, we participated in an open dislocation of the hip for the treatment of FAI, with a very effective restoration of functional, impingement-free range of movement after re-shaping of the femoral head-neck junction. On Friday, following talks on hip preservation by Drs. Yilmaz and Aksoy (Paediatric Orthopaedic Team), we joined Professor Atilla for a nicely executed anterior approach for open FAI treatment. This was followed by a complex revision of a loose stem in a previously 4-times revised THA. Albeit the difficulties associated with the case, surgery was performed effectively and very well controlled with a great post-operative outcome.

Following the day’s work, our weekend started by renting a car and driving to Cappadocia in central Turkey, providing us with a unique insight in the regions rich cultural heritage. We visited Christian churches and underground cities carved into the region’s unique volcanic soft rocks (‘Fairy Chimneys’), the Ihlara valley/canyon, Göreme’s UNESCO world heritage open air museum and a pottery museum with ancient and contemporary art. All this was accompanied by an outstanding and broad experience in Turkish cuisine.

The second week started with lectures at Hacettepe by Professor Yazici and invited Professor Ömeroglu discussing about cerebral palsy, neuromuscular hip problems, the hip-spine syndrome in young patients, neglected DDH cases and its differentiated surgical treatment with various concepts of acetabular and femoral reconstruction. Thereafter, on Tuesday we joined Professor Tokgözoglu in the operating room for a complex 3^rd time revision with an extended trochanteric osteotomy of a 24-year old in situ revision THA with femoral allograft that was aseptically loose. Following a beautiful execution of the revision, we were again invited by Professor Tokgözoglu for lunch at the University’s restaurant and realised the both professional and social purpose of such a wonderful venue. During lunch colleagues of various disciplines (genetics and physiology) joined our table allowing for inter-disciplinary discussions and potential collaborations over great food.  In the afternoon, we joined Dr. Ömür Caglar performing a complex primary THA for a Crowe 3 DDH with acetabular roof reconstruction using femoral head autograft.

The last day at Ankara started with our presentations during the morning conference prior to the trauma meeting. Christian talked about the variability of native anatomy in primary hip osteoarthritis and its implications for pre-operative templating, implant choice and subsequent patient reported outcome. George talked about hip-spine syndrome and outcome post-THA. Both presentations stimulated lively discussions. Thereafter, we made our way to the Department of Orthopaedics and Trauma Surgery at University of Ankara Hospital, which is the largest University Hospital at Ankara. Our host was Professor Kinik, an experienced and internationally renowned trauma surgeon who lead discussions on the treatment of hip and peri-prosthetic fractures. This was followed by observation of a very elegant surgery performed for the treatment of extra-capsular hip and peri-prosthetic distal femoral fractures respectively. We were also able to join Dr. Basarir performing a 2-stage THA procedure associated with significant proximal femoral bone loss for PJI. The OR set-up and team collaboration was very impressive at the hospital as 5 OR rooms used by the team are all joined by an open corridor, allowing for excellent inter-collegiate discussion and support.

We flew to Istanbul on Thursday and after checking in and settling in our nice hotel, we set out to explore the city’s Asian and European parts by taking the ferry from Kadiköy to Besiktas with fantastic views of the Bosporus during sunset. The last two days of our fellowship were committed to a primary and revision hip arthroplasty course chaired by Professor Atilla and organised on behalf of the Turkish Hip Society at Acibadem University. Acibadem University is a state of the art private university with world-renowned educational facilities. During the course, we were shown around the educational centre and had the opportunity to explore contemporary teaching tools such as virtual reality CPR training, virtual ultrasound, simulated OR rooms, delivery rooms, paediatric ICU, ER and pre-clinical rescue simulation. The unique surgical wet training lab has separate large rooms for laparoscopic, endoscopic, robotic and cadaveric training. The course was very well-organised with a good balance between lectures and cadaveric sessions. The lectures were held in Turkish with simultaneous translation to English, for which we were most grateful and which reflected the attention to detail and care our hosts provided us with during the entire visit. The course covered a wide spectrum of primary and revision topics and complex cases that were actively discussed within the small group of delegates and faculty. During the cadaver sessions we were able to perform primary and revision THA using various approaches, implants and restoration techniques. We were invited to join the faculty dinner at a fish restaurant on Bosporus with magnificent views of the Bosporus traffic and the European side. On our last meal in Turkey, we were fortunate to have our Turkish coffee cups read by a local lady, who provided interesting insight into our future and what it holds; this almost completed the full cultural experience we had on our to-do list.

We are grateful to our chiefs and departments (Prof. Ewerbeck, Department of Orthopadic and Trauma Surgery, Heidelberg University Hospital, Germany and Prof. Haddad, University College Hospital, London, England) for supporting our application and providing us with the time off in order to enjoy and learn from such a unique experience. Christian would like to thank Professor Murray and Professor Aldinger and George would like to thank Professor Beaule and Mr Andrade for their great support in the application process. We feel extremely honoured having been selected for this travelling fellowship. We would like to express our gratitude to the European Hip Society for the unique opportunity in making this happen. Mrs. Samantha Stokes deserves our special thanks for the excellent communication and organisation of the entire endeavour. We would like to say “çok teşekkür ederim” to Samet, Saygin and Ömür from Haceteppe for making us feel most welcome, showing us the city and providing us with tips on how to enjoy Ankara as locals. Finally, we will be forever grateful to Professor Tokgözoglu and Professor Atilla for their outstanding hospitality, perfect organisation, great attention to detail, and their care and humour. We leave Turkey with unique impressions and lots of new friends and look forward to coming back (Professor Atilla has promised to organise a traditional Turkish Hamam session, which is still on our to-do-list…).

THE END

To see the itinerary in detail, click here

Read the EHS Travelling Fellowship 2017 ReportRead the EHS Visiting Fellowship 2017 Report

Report from EHS Visiting Fellows 2017

We would like to begin by expressing our gratitude to the ExCom of The European Hip Society (EHS), the President of the EHS B Willem Schreurs for selecting us for this excellent opportunity for our careers and Prof Thorey (pictured left) for organising this busy fellowship. We understand that it was not an easy task.  Dr Jesús Moreta (pictured left) would like to thank the Spanish Representative Prof José Cordero-Ampuero, and Dr Oliver Marín-Peña and Dr Jenaro Fernandez-Valencia for their support during the application process. Dr Antonios Koutalos (pictured right) would like to thank the Greek representative Prof George Machairas, Prof Eleftherios Tsiridis, the Secretary General of EHS and Prof Karachalios for his guidance all these years. Last, but not least we would like to thank Mrs Samantha Stokes, for her help and support before, during and after the fellowship.

In September 2017, Dr Antonios Koutalos (University Hospital of Larissa, Greece) and myself Dr Jesús Moreta (Hospital Galdakao, Spain) were honored to perform The European Hip Society Traveling Fellowship 2017. In creating this program, The European Hip Society was driven by a goal to foster the talents of young hip surgeons by providing them with an inspiring and educational two-week tour of outstanding centers for hip surgery in Germany.We observed cases of primary hip arthroplasty through MIS Hardinge approach, MIS Watson Jones approach and periprosthetic hip infections. The highlight was observing a complex revision hip arthroplasty in a patient with severe acetabular bone defectOur tour started in Heidelberg, at the prestigious ATOS Klinik with Prof Fritz Thorey, the German National Representive for EHS, who is a highly recognised hip specialist. Located in Germany’s most romantic city, Heidelberg, ATOS Klinik offers high level medical services within their 20 specialized centres and five operating rooms. Prof Thorey has specialised in hip arthroscopy, hip primary arthroplasty and revision hip arthroplasty. During two days in the operating theatre we observed a variety of procedures, including primary hip arthroplasty through minimally invasive Watson Jones approach with short and conventional stems and complex revision hip arthroplasty. Prof Thorey showed us some tips and tricks for supine position-anterolateral approach and how to perform an adequate surgical exposure with this approach.

Our next stop was at Herzogin Elisabeth Hospital in Braunschweig with Prof Karl-Dieter Heller. The Orthopaedic Hospital Braunschweig is one of the largest orthopaedic institutes in Germany and the only orthopaedic specialty hospital in the Braunschweig area. Prof Karl-Dieter Heller, chief of staff of the Orthopedic Hospital, is a specialist in hip and knee surgery and has a huge experience in primary and revision hip arthroplasty and arthroscopy. He was very kind and arranged many interesting topics for us. We observed several cases of primary hip arthroplasty through MIS Hardinge approach, MIS Watson Jones approach and periprosthetic hip infections. The highlight in the operating room was observing a complex revision hip arthroplasty in a patient with severe acetabular bone defect.

In addition, we received clinical and basic science lectures regarding the principles of the Metha short stem, management of periprosthetic hip infection and custom implants for complex acetabular revision. We also had the opportunity to give a talk to the whole team about our interests we could discuss the differences among the joint replacement procedures in the German, Greek and Spanish Health Systems. After this meeting, Prof Heller and the staff arranged for a nice dinner in the Hospital.

Friday afternoon we had a chance to visit some historical places in Braunschweig with a guided tour arranged by Prof Heller, and we also had a nice dinner with him.Prof Thorey showed us some tips and tricks for supine position-anterolateral approach and how to perform an adequate surgical exposure with this approachOur second week started with sightseeing in the beautiful city of Dresden. We visited the Dresden Frauenkirche church, the Zwinger palace and the world famous Sember Opera House. On Sunday, Prof Gunther invited us to his house for brunch and then a walk along the Elbe river ending the astonishing garden of Pillnitz Castle. A great place to discuss about hip preservation surgery, about the health systems of Germany, Greece and Spain and the future of orthopaedics. It was a perfect finish for the weekend ahead of a busy week.

On Monday we met with Prof Gunther at the University Hospital of Dresden. University Hospital of Dresden is a public hospital taking care of patients with multiple comorbidities, complex cases and infections. It is a referral centre for hip preserving surgery.

Every day we joined Prof Gunther in his office just before the morning meeting and we went through the cases of the day. He made to us short presentations about minimal invasive anterolateral approach to the hip and he showed us cases of hip preserving surgery. We scrubbed every day and we saw an acetabular fracture with posterior wall and column fracture, three complex revision surgeries and two cases of hip preservation surgery. Professor Gunther showed us his technique with minimally invasive anterior approach to the hip to treat a patient with femoroacetabular impingement (arthroscopically assisted mini open surgery).

On Wednesday, we saw a really complex cam deformity with ischiofemoral impingement and a labral tear. A surgical hip dislocation was performed in order to achieve a labral repair, femoral neck osteoplasty and an osteotomy with neck lengthening. On the social part, we had dinner with the clinic staff on Tuesday evening enjoying traditional food and local beer. On Wednesday, we also took part in a seminar about fast track surgery.

On Wednesday evening we flew to Munich, a true European, busy city. The next day, we visited the University hospital (Rechts der Isar Hospital of the University of Technology Munich) and saw three cases of hip arthroscopy, a revision total hip arthroplasty and a total hip arthroplasty with minimally invasive anterior approach. Saturday was sunny and was the perfect day for sightseeing and walking in the English Garden. We spent the evening in Oktoberfest. We could not think of a better end for this fellowship.

During our fellowship, we visited beautiful places, we met wonderful people and we enjoyed complex surgeries. We would like to thank all the professors and their colleagues for their excellent hospitality. This “diamond” fellowship did increase our knowledge in hip surgery and we learnt useful things to take back in our countries and incorporate in our daily practice.

Apply NOW to the EHS Travelling Fellowship 2018Read about the EHS Travelling Fellowship 2017Read about the EHS Guest Society Visiting Fellowship 2017 with AAHKSRead about the EHS Visiting Fellowship 2016

EHS Travelling Fellows Goksel Dikmen (Turkey) and Oleksii Tankut (Ukraine)

Dr Goksel Dikmen writes…

First of all, I would like to state my deep gratitude to the ExCom of EHS, and the Chairman of the EHS EduCom, Prof Ullmark for selecting me and giving me the opportunity to be a part of highly valuable clinical fellowship. Also, I would like to thank my chief Prof Remzi Tözün & National Representative of our country Prof Mazhar Tokgözoĝlu for their great care and support. In addition, I’d like to thank the European Hip Society for funding this Fellowship and last but not least, I’d like to thanks Mrs Samantha Stokes for her great help.
Planning started immediately after receiving the good news that I had been selected to participate in this great fellowship. We made some arrangement for work and travel to France; before the travelling, host clinics made some recommendations for local stay and travel within France between centers. The fellowship was shared by the three centers depending on the availability. We started the fellowship in Marseille, then passed to St Étienne in the second week and we finished the fellowship in Quimper (Brittany) at the North Pole of France.

1st Week-May 29th to June 3rd: Marseille
Prof J N ARGENSON Hospital Sainte
Marguerite, Marseille Cedex
During the first week in Marseille, we had a chance to see the working style of Prof J N Argenson and his team in the Hospital Sainte Marguerite. Prof Argenson is a very busy surgeon, chief of the clinic, who spends most of his time on hip and knee arthroplasty, some trauma cases and also the set-up of the 2nd World Arthroplasty Congress, which is organized by EKS, EHS & ICJR in 2018. Prof Argenson and his team have, for over the years, experienced the patient specific implants for total hip arthroplasty. We had theatre sessions with Prof Argenson on one day. We learned some tips and tricks for supine position-anterolateral approach and how to prepare the femoral canal for a custom made femoral stem.

We had a scientific meeting and staff meeting prepared by Sainte Marguerite resident team (the youngest resident and a last year resident gave us lectures about femoral and acetabuler defect in revision total hip arthroplasty) at the end of the first day of the fellowship.

We had a chance to watch direct anterior approach with Prof Pinelli in the other two days of theatre session. The teamwork the surgical team exhibited was very evident in OR.

We ended the second surgery day with a very special lunch with Prof Argenson and Dr Parette at La Villa restaurant in Prado. We also witnessed some hip revision cases and primary hip & knee prosthesis, high tibia osteotomy with patient specific cutting blocs by Dr Sebastien Parette and Dr Xavier Fletcher. In addition, Dr Xavier showed us some hip arthroscopy cases for FAI patients in the Hospital Nord, which is the north part of Marseille.

On the last day of the first week we visited the biomechanical laboratory of Sainte Marguerite and learned of the upcoming research activities, we also observed the design of custom made prosthesis for scheduled patients with PhD students.

Friday afternoon and Saturday, we had a chance to visit some historical places in Marseille and the most beautiful cities of Provence – Nice & Cannes, and also Monte Carlo and Monaco with Oleksii.

2nd Week-June 5th to June 10th: St Etienne
Dr F FARIZON (Dual mobility cups)
Hospital Nord du CHU, Saint-Priest-en-Jarez
On the 2nd week of the Fellowship, we arrived at St Etienne by train on Sunday afternoon. The first day of the week was the national celebration day of France (5th of June), because of that we meet some residents in the Hospital Nord orthopedics service and learned the weekly OR program, and visited the historical places of St Etienne.

On the second day, early morning, we met Prof Frederic Farizon and his team in the staff meeting. Prof Farizon is an accomplished surgeon; an excellent chief and shows great care for all residents and all cases of the operating room, he is also a key researcher for the dual mobility concept. Prof Gilles Bousquet -the surgeon who first entered research and development phases, and worked on dual mobility design – was the chief of Prof Farizon.

We had a chance to see some primary and revision cases of dual mobility cup. I’d like to say a special thanks to Prof Farizon for letting us scrub for all procedures with him during our two days. He shared his knowledge very carefully and explained, at every stage, precisely how he was acting. The positive attitude and teamwork of Hospital
Nord was a delight to watch. Posterior approach was the main approach; we learned some tips and tricks from Prof Farizon about how to apply dual mobility systems. We also had the chance to see an old Bousquet cup (tripod revision (18 years)) this was very interesting, because we did not observe linear wear in the old polyethylene with a 22.2 mm metal head -the revision reason was femoral neck & head material mismatch, not the poly wear (Taper corrosion).

The next day in OR, we assisted Prof Remi Philippot with primary and revision hip arthroplasty. The last evening, we had a scientific meeting; Prof Farizon’s team and other orthopedic surgeons from the different hospitals of St Etienne made some presentations about knee osteotomies and unicompartmental knee arthroplasty in the physical therapy department of Saint-Priest-en-Jarez, after which an official dinner followed with traditional St Etienne kitchen foods.

The following day, in the morning, we left this lovely city with lots more knowledge and friends.

3rd Week-June 12th to June 17th: Quimper
Dr F GAUCHER (DDH sequelae)
Centre Hospitalier B.P. 67, Lannec Hospital
From St Etienne I travelled by train with Oleksii to Quimper where Prof François Gaucher was our host. Quimper is the capital of the “department” of Finistère and is known as the French Conrnwall (“Cornouaille”) – it is the northwest part of France that is the called Brittany region. Also, Quimper is a well known area for congenital hip disease between French orthopedics surgeons.

On the first day of the week, we met Prof Gaucher in the orthopedic service of Hospital Lannec; Prof Gaucher planned two separate video presentations about femoral shortening osteotomy, cemented fixation techniques with and without trochanteric osteotomy in high hip dislocated patients. Also, he gave us a lecture about the French classification of DDH (Cochin) and we discussed the other classification systems and techniques after presentation.

On the second day of Quimper, we scrubbed up with Dr Philippe Brunet; we learned some tips about anterior and posterior approaches from him, and learned some new
knowledge about anatomical dual mobile cups, which are designed to decrease iliopsoas impingement of large poly heads.

On the third day of week, there was no operation; Prof Gaucher arranged a small trip around Brittany, and took us for a delightful tour with his car. We saw the famous Pointe du Raz, which is one of Brittany’s most popular natural sites. We climbed and walked this intriguing island with Prof Gaucher and then lunched in Hôtel Restaurant de la Baie des Trépassés, with the beautiful view of the Atlantic Ocean and Pointe du Raz.

Thursday, we scrubbed up with Dr Yann Cotonea for knee osteotomy and knee revision case for combined ligament insufficiency after cementless CR total knee arthroplasty.

On the last day of the Quimper and also our fellowship, we had two operations with Prof Gaucher. I had a chance to see direct lateral trans-trochanteric chevron osteotomy for acetabuler reconstruction with femoral head autograft and cemented femoral stem application in dysplasia sequel; it was a very nice experience to see such a difficult case for reconstruction.

Prof Gaucher is also interested in pediatric hip surgery, and in the second case, we made a cannulated screw for a slipped capitis femoris in young male patients. I’d like to give special thanks to Prof Gaucher for letting us scrub for all procedures with him and for sharing his experience with us, and thanks for the hospitality of the Lannec orthopedic service during five days.

 

In summary, what can I say?
One of the special aspects of a Travelling Fellowship ino France is that every city is entirely unique and offers a completely different experience. The Travelling Fellowship was a once in a lifetime experience. I want to thank again EHS and the ExCom of EHS, EduCom of EHS, and all our hosts and for organizing everything so very well.Read about the EHS Visiting Fellowship 2016

Greece 20th November -4th December 2016

Report by Dr Olga Pidgaiska & Mr Sujith Konan

The European hip society has grown in strength over the last few years and as a part of educational developments developments, advertised an excellent educational opportunity; the European Hip Society Travelling fellowship. The candidates chosen for the year 2016 were announced earlier during the year. We (Dr Olga Pidgaiska, Orthopaedic Surgeon from Ukarine and Mr. Sujith Konan, Orthopaedic surgeon from UK) were honored to take part in the first visiting fellowship program. The country of visit chosen was Greece. Three orthopaedic centers were selected for the visit namely Athens, Larissa and Thessaloniki. The fellowship was for a total duration of two weeks.

Following the announcements, we made arrangements at work and to travel to Greece; while the host surgeons made arrangements for local stay and travel within Greece.

The fellowship was split between the three centers depending on the host availability and clinical commitments. The first week was to be spent between Athens and Larissa and the second week at Thessaloniki.

During our first three days in Athens, we had the pleasure of shadowing Prof. George Macheras and his team in the KAT Hospital in Athens. Incidentally, this is the same city where Prof Hartofilakidis worked and published his seminal work on dysplasia. Prof Macheras is a busy surgeon who also spends considerable amount of his time in administrative and leadership activities of EHS & EFORT as well as administration at the KAT hospital in Athens. He has over the years mastered the direct anterior approach using a traction table. We had theatre sessions with Prof. Macheras on 3 days and took turns to scrub for procedures with him. We were filled in on tips and nuances of the direct anterior approach in cases of primary hip arthroplasty. We also witnessed some revision cases with the traditional posterior approach. It was clear from the start that Prof Macheras had streamlined his theatre activities and trained up an excellent group of theatre personnel who brilliantly demonstrated their skills. There was minimal verbal communication between cases; with members of the team easing into the ‘roles’ at various stages of the procedure. The positive attitude and teamwork was a delight to watch. When we were not in theatre we also accompanied Prof Macheras and his team on a ward round, a presentation of departmental research activities, a visit to an upcoming research facility, and some excellent case discussions. During the ward round we observed post-operative patients who were mobilized early after DAA. Prof Macheras is a visiting surgeon in countries outside Greece where he takes on challenging arthroplasty cases and uses his expertise to reconstruct failed and neglected hip and knee cases. We had the opportunity to see some of the radiographs and intra-operative pictures of these cases during our discussions.

While in Athens we experienced the “Greek Hospitality” first hand, and were kindly invited to organized visits of the old city, the Acropolis and some excellent lunch and dinner outings. The fresh tasty food with historic backdrops and some stimulating orthopaedic (and non orthopedic) discussions was a perfect start to the visit.

From Athens we travelled with Prof Macheras to Larissa where Prof. Theofilos Karachalios was our host. Prof Karachalios is an accomplished surgeon, an excellent researcher and above all well read in history, music and politics. He had arranged an excellent flavor of cases he deals with on a regular basis. Greece is known to be part of the ‘European dysplasia belt’ and it was no surprise that the hip replacements were all for high dislocations and neglected dysplasias. We had the opportunity to observe shortening osteotomies at sub trochanteric as well as distal femur levels. Two separate educational events had been planned to coincide with our visit. An evening of presentations by the Orthopaedic Surgeons in Larissa and us fellows saw a fine exchange of research information. A separate two day “suprapath concept” course with lectures and cadaveric demonstrations was also organized. It was clear that a lot of planning and organization had gone into our visits. Once again the evenings were filled with visits to historic locations such as the open theatre and the ancient city as well as dinner discussions over several relevant topics. Our visit to the holy Meteora Monastery was an unparalleled experience and deserves a special mention.We believe this fellowship has given us a unique opportunity to visit leading surgeons and observe different teams at work. We picked up several surgical, leadership and managerial tips that will stay in our minds forever

In the second week of the fellowship Prof. Eleftherios Tsiridis in Thessaloniki hosted us. In anticipation of our visit, a schedule had been planned and included clinical activities, visits to historic locations and educational meetings. We spent time in two hospitals, the Papa Georgiou Hospital, the public facility for patients and St Lukes Hospital, an independent facility. We were to observe surgery in both places and the case mix included hip replacements for dysplasia, and complex revisions.  We had the opportunity to observe the technique of figure “7- autografting in a case of dysplastic acetabulum; Hartofilakidis method for controlled acetabulum-plasty with medial wall displacement; usage of TM for acetabulum augmentation and impaction grafting. Prof Tsiridis takes great pride in his work and spent time explaining every surgical step; followed by demonstration. His reconstruction of choice was a hybrid system (Exeter stems with uncemented acetabulum) . We were given a tour of the Papa Georgiou hospital highlighting all the latest facilities in diagnostics and treatment that was being used. We also visited Core-Kedek Research center; an impressive industry/ research collaboration with several ongoing research and innovation activities.

Prof. Tsiridis has a strong research background and all of the residents, consultant surgeons are involved in ongoing research activities, papers for presentation, and publication with a number of then even preparing for post-graduate dissertations. During the scientific meeting we shared our experience of our units’ work. It was useful to engage in direct interaction with the researchers and to get acquainted. It was very interesting that young students, surgeons and researchers were presenting alike with the same zest. The last two days of the fellowship included the annual MAST course chaired by Prof Tsiridis. It had national and international speakers providing relevant lectures and surgical demonstrations.

Thessaloniki, located by the sea, was a beautiful location and visits to historic cites, museums in city and the Virginia, were mind-blowing experiences for us.

We believe this fellowship has given us a unique opportunity to visit leading surgeons and observe different teams at work. We picked up several surgical, leadership and managerial tips that will stay in our minds forever. We also hope to establish strong research and educational links with the host centres for future endeavors. We would like to thank European Hip Society for giving us the opportunity to undertake the fellowship, and extend our sincerest gratitude to all the EHS team for making our visit a truly fantastic experience, in particular prof. G. Macheras, prof. T. Karachalios, prof. E.Tsiridis, and Mrs. Samantha Stokes.Read about the EHS Travelling Fellowship 2017