SPECIAL SYMPOSIA

CHAIR
CO-CHAIR

Riccardo Gottardi 
Children’s Hospital of Philadelphia
Philadelphia, USA

Annemarie Lang
Charité-Universitätsmedizin Berlin
Berlin, Germany

SPEAKER 1
SPEAKER 2
SPEAKER 3
SPEAKER 4

Martinijn Van Griensven
MERLN Institute
Maastricht, Netherlands

Roberto Di Gesù
Ri.MED Foundation
Palermo, Italy

Nupur Kohli
Imperial College London
London, UK

Annemarie Lang
Charité-Universitätsmedizin Berlin
Berlin, Germany

ABSTRACT

Preclinical studies are highly needed to tackle remaining unmet clinical needs in the musculoskeletal research field, especially with respect to an aging population and the increase of comorbidities. Today’s gold standard of preclinical drug or compound screening and risk assessment is the use of animal models, mainly rodents (mice and rats). The 3R principle (1959; Russel & Burch) serves as a roadmap towards a responsible “humane” use of animals in research including the prioritization of alternative methods (Replace), the optimization of studied individuals (Reduce) and the adjustment of procedures to improve animal welfare (Refine). Although the awareness for the 3R principle has increased in the past few years, its implementation into daily lab routines is still limited. With this symposium, we aim at highlighting current approaches for the active implementation of the 3R principle in musculoskeletal research to stimulate the discussion among scientists and to motivate the development of own solutions. The speakers will illustrate multiple examples that could be implemented in different laboratories, and will elaborate on (i) the simulation of the in-patient situation using novel in vitro or ex vivo approaches to Reduce/Replace lab animal usage and (ii) the optimization of pain management in mouse femoral fracture models as an effective example Refinement that implements the limitations of unnecessary pain and stress.

CHAIR
CO-CHAIR

Francesca Masieri
University of Suffolk
Ipswich, UK

Vanessa Ward
University of Suffolk
Ipswich, UK

SPEAKER 1
SPEAKER 2

Vuk Savkovic
University of Leipzig
Leipzig, Germany

Elena Jones
University of Leeds
Leeds, Germany

ABSTRACT

The proposed symposium aims to present and discuss novel and emerging frontiers in the areas of musculoskeletal (MSK) cell therapies, encompassing in vitro, quasi vivo, and pre-clinical promising models with a chance of being quickly translated into the clinics.

We have managed to secure two invited speakers. The first speaker has extensive expertise into the complexities surrounding Advanced Therapy Medicinal Products (ATMPs) and will also provide an overview of key regulatory aspects in this area. The second speaker has worked extensively in the field of quality-control tools for the therapeutic use of minimally-manipulated, bone-derived MSC for bone repair applications, and joint resident MSCs for cartilage regeneration in osteoarthritis.

CHAIR
CO-CHAIR

Holger Jahr
Maastricht University
Maastricht, Netherlands

Yageng Li
Universityt of Science and Technology
Beijing, China

SPEAKER 1
SPEAKER 2
SPEAKER 3
SPEAKER 4

Holger Jahr
Maastricht University
Maastricht, Netherlands

Yageng Li
Universityt of Science and Technology
Beijing, China

Maximilian Voshage
DAP, RWTH Aachen
Aachen, Germany

Amir Zadpoor
3ME-BME, Delft Technical University
Delft, Netherlands

ABSTRACT

Treating large bone defects is still a major clinical challenge without a perfect solution, mainly due to the unavailability of suitable bone implants. Additively manufactured (AM) porous metals provide unparalleled opportunities to realize the challenging requirements for bone-mimetic implants.

Mechanical meta-biomaterials are architected materials that are designed to exhibit unusual properties and this principle can be applied to AM porous metals implants. Here, we will discuss state-of-the-art topological designs of future Orthopedic implants, the latest insights into their production, and associated technological challenges thereof. The symposium will focus on absorbable metal families and particularly on magnesium and zinc and their alloys. We will further elaborate on their general corrosion behaviour, alloying-dependent insights, the impact of the in vitro test environment on corrosion testing, as well as specific design- and post manufacturing aspects. Current knowledge gaps and the recent status quo of their biocompatibility and clinical application potential will be addressed as well.

CHAIR
CO-CHAIR

Emmanuel Audenaert
Ghent University
Gent, Belgium

Jonas Grammens
University of Antwerp
Antwerp, Belgium

SPEAKER 1
SPEAKER 2
SPEAKER 3
SPEAKER 4

Jonas Grammens
University of Antwerp
Antwerp, Belgium

Emmanuel Audenaert
Ghent University
Gent, Belgium

Tinashe Mutsvangwa
Affiliation University of Cape Town
Cape Town, South Africa

Femke Danckaers
University of Antwerp
Antwerp, Belgium

ABSTRACT

The mini symposium entitled “Shape modelling for routine clinical practice in hip, knee and ankle pathology”, aims to present recent developments in the translational field of computational anatomy (statistical shape and kinematics modelling), its applications in clinical practice and beyond. As these techniques are uttermost fit to model the influence of shape in osteoarthritis, the symposium will focus on hip, knee and ankle joint degeneration from diagnostics and risk assessments to innovative treatment algorithms.

Advanced 3D imaging techniques and shape modelling provide a deeper understanding of the anatomy on a population level by describing morphological variation in a unique way. Furthermore, state-of-the-art techniques powered by artificial intelligence and big data can discover new patterns of diagnostic and prognostic value. Instead of a range of normal values, patient-specific parameters can be inferred as a target for reconstructive surgery. With the emerging techniques of 3D printing for a variety of biocompatible materials, implants can be designed to fit seamlessly, and PSI-aided osteotomies can be executed with high precision.

Contributions to this mini symposium will focus on innovative methodology, validation or application of statistical shape analysis in solving clinical problems.

CHAIR
SPEAKER

Solvig Diederichs
Heidelberg University Hospital
Heidelberg, Germany

Jessica Bertrand
Otto-von-Guericke University Magdeburg
Magdeburg, Germany

CHAIR
SPEAKER

Solvig Diederichs
Heidelberg University Hospital
Heidelberg, Germany

Jessica Bertrand
Otto-von-Guericke University Magdeburg
Magdeburg, Germany

ABSTRACT

Hundreds of millions of people worldwide are suffering from osteoarthritis and there is an urgent need for new therapeutic solutions. Cartilage calcification is commonly observed during osteoarthritis and is directly linked to the disease severity. However, only little knowledge exists about the effects of calcium crystals on chondrocytes and the signalling pathways involved in their generation. Uncovering the mechanisms that drive cartilage calcification will allow to find novel and improved therapeutic approaches for osteoarthritis. Interestingly, in vitro chondrogenesis of mesenchymal stromal/stem cells induces a hypertrophic chondrocyte phenotype which makes cells highly prone to calcification. Much can be learned regarding key drivers of this pathological development from this valuable model of osteoarthritis.

This symposium will bring together experts in cartilage regeneration who have investigated regulation of cartilage calcification from very different angles. The keynote speakers will illuminate how calcium crystals regulate the chondrocyte phenotype, highlight latest advances to suppress chondrocyte hypertrophy/calcification and introduce induced pluripotent stem cells as novel in vitro model.

Moreover, this symposium offers a unique forum for researchers and clinicians from various backgrounds all working toward the treatment, repair and regeneration of cartilage to share their insights into the mechanisms regulating the fatal events leading to cartilage calcification.

CHAIR
SPEAKER
Peter C. Amadio, MD

Peter Amadio
Mayo Clinic

Suzanne Mahe
Hospital for Special Surgery

SPEAKER 1
SPEAKER 2
SPEAKER 3
SPEAKER 4
SPEAKER 5
SPEAKER 6

Jongkil Kim
Cornell University
New York, USA

Lauren Lisiewski
Columbia University
New York, USA

Jason C. Marvin
Cornell University
New York, USA

Michael Hast
University of Pennsylvania
Pennsylvania, USA

Kelsey Collins
ORS Preclinical Models Section
Columbia, USA

Zachary Working
Oregon Health & Science University
ORS International Section of Fracture Repair (ISFR)
Oregon, USA

ABSTRACT

This symposium will highlight the award-winning abstracts as presented by ORS Research Section members on the topics of: meniscus, tendon, spine, implants, fractures, and preclinical models.

CHAIR
CO-CHAIR
Silvia Spriano
Politecnico di Torino
Torino, Italy
Alessandro Bistolfi
Città della Salute di Torino
Torino, Italy
SPEAKER 1
SPEAKER 2
SPEAKER 3
SPEAKER 4
SPEAKER 5
SPEAKER 6
Silvia Spriano
Politecnico di Torino
Torino, Italy
Alessandro Bistolfi
Città della Salute di Torino
Torino, Italy
Paulo Tambasco
Universidade de Sao Paulo
Sao Paulo, Brasil
Anuj Bellare
Polymerix LLC, Boston
Boston, USA
Riccardo Ferracini
Università di Genova
Genova, Italy
Lia Rimondini
Università degli Studi del Piemonte Orientale
Novara, Italy
ABSTRACT

The outcome of a bone implant depends on several issues (surgery procedure, implant design, materials and treatments, patient clinical factors, risk of infection…).

The aim of the symposium is to make a focus on the role of the surface of the implant in its clinical outcome.

Several post-implantation events are related to the surface features and are covered by the symposium:

  • protein adsorption,
  • osseointegration through cell adhesion, proliferation, and differentiation
  • eventual release of ions due to corrosion
  • eventual infection, biofilm formation or release of anti-bacterial agents or drugs
  • early and eventually chronic inflammation
  • eventual fibrotic encapsulation
  • fretting or wear
  • excessive growth of bone on the surface of temporary implants

Researchers, materials scientists, and biologists involved in developing advanced and innovative surfaces for orthopaedic implants and clinicians with experience in failure or positive outcome of bone implants, dealing with any surface feature, are invited to show and discuss their results.

CHAIR

Gabriela Lorite Yrjänä
University of Oulu
Oulu, Finland

SPEAKER 1
SPEAKER 2
SPEAKER 3
SPEAKER 4
SPEAKER 5
SPEAKER 6

Boris Mizaikoff
Ulm University
Ulm, Germany

Harold Brommer
Utrecht University
Utrecht, Netherlands

Ali Mobasheri
University of Oulu
Oulu, Finland

Simo Saarakkala
University of Oulu
Oulu, Finland

Boris Mizaikoff
Ulm University
Ulm, Germany

Harold Brommer
Utrecht University
Utrecht, Netherlands

ABSTRACT

Osteoarthritis constitutes a major challenge for the health systems and affects 242 million people globally. Currently, surgeon’s decision-making during arthroscopy is based on visual inspection and manual probing of the cartilage tissue which is highly subjective and of poor repeatability. Untreated or not-correctly treated joint injury will most likely progress towards osteoarthritis. Hence, the development of advanced cartilage assessment tools is urgently needed.

The MIRACLE team is developing the first mid-infrared attenuated total reflection (MIR-ATR) arthroscopy system for real-time, in-depth, clinical examination and diagnosis of degenerative joint diseases such as osteoarthritis. This device will allow orthopaedic surgeons to obtain real-time information about the biochemical composition of the cartilage tissue, leading to objective intra-operative decision-making on the most adequate treatment course, enhancing patient’s well-being and reducing the need for follow-up surgery.

The MIRACLE symposium will focus on the innovative aspects of the MIRACLE device from a manufacture’s perspective, while case studies will be presented by a surgeon who will share his experience with the device. Lastly, a roundtable will join experts in the field discussing the limitations of conventional arthroscopy and how MIRACLE will circumvent these problems, pushing forward the market of arthroscopy devices and impacting the early diagnosis of osteoarthritis.

CHAIR
CO-CHAIR

Federica Francesca Masieri
University of Suffolk
Ipswich, UK

Elizabeth Rosado-Balmayor
University of Maastricht
Maastricht, Netherlands

SPEAKER 1

Elizaveta Kon
Humanitas University
Milano, Italy

ABSTRACT

This symposium aims at presenting and discussing inspiring, high-quality contributions in orthopaedic and musculoskeletal research made by eminent female scientists. We want to provide a comprehensive discussion platform to emphasise the progresses accomplished and reflect on the work still to be done in a science area often perceived as one of the least open to diversity and inclusion. Relevant topics such as female representation in science, gender equality and the impact of females on scientific work will be discussed. We wish also to provide an allied platform for the LGBTQIA+ community and their intersectionality with women representation. We recognise that gender inequalities, unconscious bias, and associated patterns are transversal instances, often hindering the opportunity for fair representation in academia, industry, and the wider society. These disparities have been unfortunately further enhanced by the ongoing COVID-19 pandemic.

CHAIR
CHAIR 2

Gabriela Graziani
University of Bologna & Istituto Ortopedico Rizzoli
Bologna, Italy

Jeroen Geurts
Lausanne, Switzerland

SPEAKER 1
SPEAKER 2

Riccardo Levato
Utrecht Netherlands

Stijn Bolink
Deventer Netherlands

ABSTRACT

This symposium aims at presenting and discussing inspiring, high-quality contributions in orthopaedic and musculoskeletal research made by eminent female scientists. We want to provide a comprehensive discussion platform to emphasise the progresses accomplished and reflect on the work still to be done in a science area often perceived as one of the least open to diversity and inclusion. Relevant topics such as female representation in science, gender equality and the impact of females on scientific work will be discussed. We wish also to provide an allied platform for the LGBTQIA+ community and their intersectionality with women representation. We recognise that gender inequalities, unconscious bias, and associated patterns are transversal instances, often hindering the opportunity for fair representation in academia, industry, and the wider society. These disparities have been unfortunately further enhanced by the ongoing COVID-19 pandemic.

CHAIR
CO-CHAIR

Peter Pilot
CortoClinics
Schijndel, Netherlands

Walter Van Der Weegen
St. Anna Hospital
Geldrop, Netherlands

SPEAKER 1
SPEAKER 2
SPEAKER 3
SPEAKER 4

Peter Pilot
CortoClinics
Schijndel, Netherlands

Walter Van Der Weegen
St. Anna Hospital
Geldrop, Netherlands

Job Doornberg
Universitair Medisch Centrum
Groningen, Netherlands

Joost Kuipers
ETZ Tilburg
Tilburg, Netherlands

ABSTRACT

Big data, artificial intelligence and machine learning are the current buzz words in health care. But incorporation of these techniques still seems far-fetched in daily orthopedic practice. However, quite rapidly the first practical applications are surfacing, and not only in highly specialized hospitals. In this workshop we demonstrate and discus several practical applications of open-access, user friendly big data systems and machine learning algorithms which will change the way orthopedic care will be delivered, as well as the total patient journey in the near future. This will range from doing your history taking at home with AI diagnostics incorporated, to robotic surgery coupled with Patient Reported Outcomes. Of course automated radiographic image analysis will play a role, not only for fracture or osteoarthritis recognition but also for predicting future pathology.

CHAIR
CO-CHAIR

Lisbet Haglund
McGill University
Montreal, Canada

Karin Wuertz-Kozak
Rochester Institute of Technology
Rochester, USA

SPEAKER 1
SPEAKER 2
SPEAKER 3
SPEAKER 4

Karin Wuertz-Kozak
Rochester Institute of Technology
Rochester, USA

Christine Le Maitre
Sheffield Hallam University
Sheffield, UK

Lisbet Haglund
McGill University
Montreal, Canada

Marianna Tryfonidou
Utrecht University
Utrecht, Netherlands
ABSTRACT

Degenerative disc disease (DDD) is a major contributor to chronic low back pain (cLBP). As existing treatments do not target the molecular mechanisms of the disease, research activities focus on the identification of novel treatments. This includes identification of drug targets, as well as testing of new approaches in-vitro and in-vivo. This symposium will highlight research activities spanning from basic science investigations to preclinical testing:

  • Transient receptor potential (TRP) channels are implicated in inflammation and pain transmission in numerous tissues. Prof. Wuertz-Kozak will highlight recent findings and discuss the potential of TRP channels as therapeutic targets in DDD.
  • Prof Le Maitre will discuss a three prong attack to stimulate tissue regeneration of the disc utilising a novel injectable hydrogel which restores mechanical function, delivers a regenerative cell source and inhibits the catabolic environment of the degenerate disc.
  • There is growing recognition that senescent cells accumulate with ageing and DDD. Prof. Haglund will discuss the potential of senolytics as a treatment option for disc-related cLBP in human and mice.
  • Tryfonidou will discuss a multidisciplinary effort to advance therapies for disc-related cLBP, with a focus on local controlled drug delivery in preclinical and veterinary clinical studies.
CHAIR
CO-CHAIR

Stefano Zaffagnini
IRCCS ISTITUTO ORTOPEDICO RIZZOLI
Bologna, Italy

V. Denaro

Vincenzo Denaro
Biomedical Campus University Foundation
Roma, Italy

SPEAKER 1
SPEAKER 2
SPEAKER 3
SPEAKER 4
SPEAKER 5
SPEAKER 6
V. Denaro

Vincenzo Denaro
Biomedical Campus University Foundation
Roma, Italy

G. Vadala

Gianluca Vadalà
Biomedical Campus University Foundation
Roma, Italy

Stefano Zaffagnini
IRCCS ISTITUTO ORTOPEDICO RIZZOLI
Bologna, Italy

Amedeo Amoresano
INAIL Prosthetic Center
Vigorso di Budrio, Italy

Mario Lando
Polyclinic of Modena
Modena, Italy

Christian Cipriani
Scuola Superiore Sant’Anna
Pisa, Italy

ABSTRACT

Osseointegration represents an alternative method of treatment for amputees with socket-related problems and low quality of life. It consists of attaching an intramedullary stem directly to the amputated skeletal segment that extends out of the residual limb. A prosthesis is then attached to the metal extension.

Osseointegration has many advantages for the patient, including skeletal proprioception, improvement of socket-related skin problems, increased walking speed, improved walking efficiency and better muscle control of the stump. In addition, thanks to the implementation of neural control and sensory feedback,

a bidirectional neuromuscular interfacing can be created between the implanted electrodes and the bone-anchored prosthesis for upper limb amputees, which has proven to be functional in the long term.

However, osseointegration also presents considerable disadvantages, such as possible infections of the skin stoma, which requires daily cleaning. More and more interest has been placed in this method in recent years. With this symposium, we present the experience gained in Italy after the first cases performed.

CHAIR
CO-CHAIR

Paolo Domenico Parchi
University of Pisa
Pisa, Italy

Ferdinando Auricchio
University of Pavia
Pavia, Italy

SPEAKER 1
SPEAKER 2
SPEAKER 3
SPEAKER 4
SPEAKER 5
SPEAKER 6

Sara Condino
ENDOCAS Center University
Pisa, Italy

Lorenzo Andreani
University of Pisa
Pisa, Italy

Stefania Marconi
University of Pavia
Pavia, Italy

Alberto Leardini
Istituto Ortopedico Rizzoli
Bologna, Italy

Carmelo De Maria
Research Center ‘Enrico Piaggio’
Pisa, Italy

Maria Livia Rizzo
Studio Legale Stefanelli & Stefanelli
Bologna, Italy

ABSTRACT

From its first applications in orthopedic surgery in the mid-1980s, 3D Printing is progressively grown and in the last years reached a solid role in preoperative planning especially in a complex case, fabrication of customized implants as in oncologic orthopedic surgery, and education of the new generation of surgeons. The whole process starts from the segmentation patient’s medical image dataset (CT o MRI) to create a 3D virtual model of the patient’s anatomy. This model is then used for the fabrication of the 3D solid model of the patient’s anatomy, through various additive manufacturing techniques, that can be used variously to enhance the anatomy interpretation, (visual and physical evaluation) and to aid in the planning and the execution of the surgical act.

In this symposium will be discuss and analyzed the main applications of 3D printing in orthopedic surgery through a series of literature reviews on a specific topic and a special talk describing the experience of a complete “in-house” hospital 3D lab.   A particular focus will be on bioprinting an innovative sector for the development of patient-specific 3D cellularized scaffolds that is rapidly developing and that will change the future of tissue engineering surgery.

CHAIR
CO-CHAIR

Markus Windolf
AO Research Institute
Davos, Switzerland

Geoff Richards
AO Research Institute
Davos, Switzerland

SPEAKER 1
SPEAKER 2
SPEAKER 3
SPEAKER 4
SPEAKER 5
SPEAKER 6

Peter Varga
AO Research Institute
Davos, Switzerland

Jan Buschbaum
AO Research Institute
Davos, Switzerland

Dominic Mischler
AO Research Institute
Davos, Switzerland

Karen Mys
AO Research Institute
Davos, Switzerland

Markus Windolf
AO Research Institute
Davos, Switzerland

Maximilian Heumann
AO Research Institute
Davos, Switzerland

ABSTRACT

Orthopaedic treatment with the final goal of safe and sound patient outcome starts with training the orthopaedic surgeon for an improved skill set in decision making and execution. The AO Research Institute sees strong potential for digital technologies to significantly enhance the treatment journey. In this symposium various related key projects will be outlined: Virtual training of basic biomechanical understanding and hands-on training of surgical tasks with digital feedback and outcome measurement. Optimized implant designs based on computer simulations and digital aids to improve surgical execution such as simplified fracture reduction. And finally, objective data acquisition during the healing process for evidence based and patient specific rehabilitation. Potentials and hurdles of the proposed concepts will be presented and critically discussed.

CHAIR
CO-CHAIR

Norbert Passuti
ON Foundation
Lucerne, Switzerland

Stefanie Holm
ON Foundation
Lucerne, Switzerland

SPEAKER 1
SPEAKER 2
SPEAKER 3

Elizaveta Kon
Humanitas University
Milano, Italy

Laura de Girolamo
IRCCS Istituto Ortopedico Galeazzi
Milano, Italy

Sylvia Nürnberger
Medical University of Vienna
Vienna, Austria

ABSTRACT

Cartilage regeneration is without doubt one of the hottest topics within the different areas of orthoregeneration. Researchers around the world are working hard to find the holy grail focusing on different approaches in their research. Which strategy will be most successful to regenerate cartilage – PRP, Cells or Scaffolds? In this interactive session, three renowned and eloquent experts will make the case for their personal favourite research area. They will explain current knowledge, share recent findings and point out the future potential. In the interactive battle the audience will decide which of the three research areas is most promising. Directly after the battle the ON Foundation will offer a 10’000 € Kick-starter Grant on the winning topic. All EORS researchers are invited to apply.

CHAIR
CO-CHAIR

Martin Stoddart
AO Research Institute Davos
Davos, Switzerland

Sibylle Grad
AO Research Institute Davos
Davos, Switzerland

SPEAKER 1
SPEAKER 2
SPEAKER 3
SPEAKER 4

Ralph Müller
ETH Zurich
Zurich, Switzerland

Sibylle Grad
AO Research Institute Davos
Davos, Switzerland

Junxuan Ma
AO Research Institute Davos
Davos, Switzerland

Martin Stoddart
AO Research Institute Davos
Davos, Switzerland

ABSTRACT

Optimizing therapies for orthopaedic applications requires a detailed knowledge of the underlying mechanism of action. This has led to the development of more complex systems, both in vitro and in vivo, to allow the regenerative process to be investigated in more detail. This symposium elaborates on models for bone, cartilage and intervertebral disc. Within this symposium we highlight mechanobiology studies performed both high resolution in vivo studies, and ex vivo models using complex bioreactor systems. Additionally, co-culture models aiming to add the interplay of neuronal interactions will be discussed. Once developed, these models not only increase the understanding of the underlying regenerative process, but they also offer more accurate test beds for new therapies.

CHAIR
CO-CHAIR
Feng-Sheng Wang
Kaohsiung Chang Gung Memorial Hospital
Kaohsiung, Taiwan

Holger Jahr
Maastricht University
Maastricht, Netherlands

SPEAKER 1
SPEAKER 2
SPEAKER 3
SPEAKER 4

Feng-Sheng Wang
Kaohsiung Chang Gung Memorial Hospital
Kaohsiung, Taiwan

Holger Jahr
Maastricht University
Maastricht, Netherlands

Wei-Shiung Lian
Kaohsiung Chang Gung Memorial Hospital
Kaohsiung, Taiwan

Bernd Rolauffs
G.E.R.N.
Freiburg, Germany

ABSTRACT

In this symposium, we will give an update on how microenvironmental cues, like mechanobiological triggers, oxidative stress, or bioactive molecules may be used to alter the course of bone regeneration and cartilage deterioration. We will provide latest insights on how epigenetics governs the progression of osteoarthritis. We will show how customized geometrically micro-patterned surfaces may be used to control the phenotype of human chondrocytes for translational cell-based cartilage repair options. Furthermore, the impact of adipomyokine-derived hormone-like soluble factors of the articular cartilage secretome on the chondrocyte metabolism will be reported by using Fndc-5 as an example. Last-not-least, insights on the role of other bioactive molecules as well as data in support of a novel role for the oxidative stress response master regulator Nrf2 in bone fracture healing will be presented.

CHAIR
CO-CHAIR

Nicola Baldini
University of Bologna & Istituto Ortopedico Rizzoli
Bologna, Italy

Gabriela Graziani
University of Bologna & Istituto Ortopedico Rizzoli
Bologna, Italy

SPEAKER 1
SPEAKER 2
SPEAKER 3
SPEAKER 4
Gabriella Graziani
University of Bologna & Istituto Ortopedico Rizzoli
Bologna, Italy
Julietta V. Rau
Istituto di Struttura della Materia, Consiglio Nazionale delle Ricerche
Rome, Italy
Maria Chatzinikolaidou
University of Crete
Crete, Greece
Giovanni Baldi
CERICOL Research Center Colorobbia
Sovigliana-Vinci, Italy
ABSTRACT

Infections are among the most severe complications in surgery, having high societal and economic impact. In spite of the definition of detailed guidelines and procedures for prevention of surgical site infections, their rate is sharply increasing. Metallic-based compounds are promising to tackle this challenge, but they experienced a widespread application, negligent of the characteristics of the device and of bacterial contamination, that are crucial to determine their success in the clinic. In addition, in orthopaedics, implants/bone substitutes must not only fight infections, but also facilitate osseointegration. Avoiding any detrimental interference between these two actions is not trivial, as antibacterial compounds can be toxic to the bone-cells, while all features that promote integration (i.e. porosity, high surface roughness, patterning, etc.) favour bacterial adhesion and proliferation.

The symposium will discuss new strategies to tackle these needs, by merging research and industrial perspectives and by examining the new trends and open challenges in the development of antibacterial and bioactive devices and on new 3D in vitro methods for their validation.

Special attention will be devoted to metal-based biomaterials and nanomaterials, their capability to overcome the progressive development of multi-drug resistant organisms and their industrial scalability, moving towards a personalized medicine in infection.

CHAIR
CO-CHAIR

Heinz Röttinger
Artemed Clinic South Munich
Munich, Germany

Tim C. Lueth
Technical University of Munich
Munich, Germany

SPEAKER 1
SPEAKER 2
SPEAKER 3
SPEAKER 4

Heinz Röttinger
Artemed Clinic South Munich
Munich, Germany

Amir Bigdeli
Artemed Clinic South Munich
Munich, Germany

Alexandra Mercader
Technical University of Munich
Munich, Germany

Timon Röttinger
Artemed Clinic South Munich
Munich, Germany

ABSTRACT

Nowadays, about 20% of patients are dissatisfied after Total Knee Arthroplasty (TKA). This is mainly caused by anterior pain. This pain can be partly explained by a change in the kinematics of the knee after replacing the joint. In order to better visualize this change and to better predict the ideal position of the prosthesis, an innovative 3D model of the patient is presented that reproduces the exact flexion movement of the knee, measured prior to surgery on the patient. The latest technological advances in the field of 3D printing make it possible to quickly reconstruct a model of the patient’s knee. The patient’s knee is printed identically and allows a better visualization of the geometry of the femur, the tibia and the patella. Both the patellofemoral and tibiofemoral joints play an important role in knee replacement surgery. The rollback effect must be taken into account when cutting in order to respect the initial flexion movement of the knee. The surgeon must also ensure that the patella is sufficiently aligned with the forces of the patellar ligament and the quadriceps. This allows for smooth movement of the patella and reduces postoperative problems. In order to control all these parameters and to visualize the influence of the position of the prosthesis on the kinematics of the knee, the 3D model is used for the prosthesis placement. This allows to compare the postoperative result with the preoperative movement. In addition, several prosthesis positions can be tested and used for comparison. The operation on the model allows the surgeon to practice on a copy of the patient and also to understand the influence of different prosthesis configuration modifications on the knee movement.

CHAIR
CO-CHAIR

Chelsea S. Bahney
Steadman Philippon Research Institute/ UCSF
Vail, USA

Elizabeth Rosado Balmayor
University of Maastricht
Maastricht, Netherlands

SPEAKER 1
SPEAKER 2
SPEAKER 3
SPEAKER 4

Chelsea S. Bahney
Steadman Philippon Research Institute/ UCSF
Vail, USA

Elizabeth Rosado Balmayor
University of Maastricht
Maastricht, Netherlands

Fergal O’Brien
RCSI
Dublin, Ireland

Hamish Simpson
University of Edinburgh
Edinburgh, UK

ABSTRACT

Fractures are one of the most common injuries worldwide. While most bone injuries regenerate well, 10-15% of normal fractures demonstrate impaired healing in the for m of delayed- or non-union. Delayed- or non-union rates increase to 50% of fractures when coupled with vascular damage or a high co-morbidity burden. Clinically, these non-unions are difficult and costly to treat as physicians are reluctant to diagnose until 6-9 month without radiographic evidence bone formation. Current standard of care for non-unions is surgical intervention to increase biomechanical stability or promote healing through application of bone graft. As such, there is an unmet clinical need for osteoinductive therapeutics that stimulate fracture healing through a non-surgical delivery platform. Delivery of mRNA is an attractive tool recently popularized by the novel coronavirus vaccine that delivers genetic material without genomic integration. To date, broad application of mRNA-based therapeutic platforms has been limited due to challenges associated with mRNA stability, toxicity of delivery vectors and immunogenicity. Here we discuss how we can harness the latest research advances in mRNA therapeutics.

CHAIR
CO-CHAIR

Leo Massari
University of Ferrara
Ferrara, Italy

Roy K. Aaron
Brown University Medical School
Providence, USA

SPEAKER 1
SPEAKER 2
SPEAKER 3
SPEAKER 4

Roy K. Aaron
Brown University Medical School
Providence, USA

Mauro Alini
AO Foundation-Research Division
Davos, Switzerland

Milena Fini
IRCCS Istituto Ortopedico Rizzoli
Bologna, Italy

Reiner Bader
University of Rostock
Rostock, Germany

ABSTRACT

In recent years, the therapeutic approach for osteoarthritis has focused on nonpharmacologic strategies, owing to the evidence that nonpharmacologic approaches are more likely to relieve symptoms in the long term and to delay or prevent functional decline.

Biophysical stimulation (i.e. the application of non-ionizing physical energies for therapeutic purposes) proved to be an effective chondroprotective treatment. Pulsed Electromagnetic Field (PEMF) increase the anabolic activity of chondrocytes and cartilage explants and antagonize the catabolic effects of inflammation through the agonistic activity on A2A adenosine receptors (A2A ARs). In Dunkin Hartley, PEMFs were able of halting the progression of osteoarthritis, preserving cartilage thickness and preventing sclerosis of the subchondral bone. Similarly, electrical stimulation could lead to improved quality of regenerated cartilage tissue in vitro.

The recent scientific evidence suggesting that cartilage regeneration is now an achievable goal raises new challenges. The modulation of resident stem cells and the control of chondrocyte senescence, oxidative stress and mitochondrial dysfunction play a major role in maintaining and restoring the integrity of articular cartilage. A2A ARs activation has been reported to counteract both cellular senescence and mitochondrial dysfunction, suggesting the opportunity to apply biophysical stimulation not only for chondroprotective purposes but also for cartilage regenerative treatments.

CHAIR
CO-CHAIR

Holger Jahr
Maastricht University
Maastricht, Netherlands

G. Vadala

Gianluca Vadalà
Biomedical Campus University Foundation
Roma, Italy

SPEAKER 1
SPEAKER 2
SPEAKER 3

Holger Jahr
Maastricht University
Maastricht, Netherlands

Feng-Sheng Wang
Kaohsiung Chang Gung Memorial Hospital
Kaohsiung, Taiwan

Wei-Shiung Lian
Kaohsiung Chang Gung Memorial Hospital
Kaohsiung, Taiwan

CHAIR
CO-CHAIR

Arne Burssens
University Hospital of Ghent
Ghent, Brussels

Claudio Belvedere
Rizzoli Orthopaedic Institute
Bologna, Italy

SPEAKER 1
SPEAKER 2
SPEAKER 3
SPEAKER 4

Alberto Leardini
Rizzoli Orthopaedic Institute
Bologna, Italy

Alexej Barg
University Medical Center Hamburg
Hamburg, Germany

Kevin N. Dibbern
University of Iowa
Iowa City, USA

François Lintz
Clinique de l’Union
Toulouse, France

ABSTRACT

Acquired foot and ankle deformities compromise complex 3D modifications of the articulating bones. In this context, medical imaging under weightbearing conditions is fundamental to enhance pre- and post-treatment evaluations. Over the past decades, weightbearing radiographs of the foot and ankle have been performed to meet this requirement. Unfortunately, several important drawbacks of this imaging modality are reported: superimposition of the osseous structures, the radiograph contains a 2D projection of three-dimensional structures, difference in patient positioning relative to radiographic beam resulting in marked alternations in the angular alignment, and general manually-based assessments. The recent advent of weightbearing CT imaging has demonstrated to overcome these limitations. The measurements based on this imaging modality contain a high reliability and have a superior accuracy when compared to 2D weightbearing radiographs. Recent advances are now focussed on using 3D computed measurement that can be performed semi-automatic, implemented in a pre- and post-operative planning and used to generate patient specific assisted instrumentation.

The aim of the present symposium proposal is to offer an overview this imaging modality, including the applications these state-of-the-art devices and related findings in terms of complex foot and ankle pathology.

CHAIR
CO-CHAIR

Sibille Grad
AO Research Institute
Davos, Switzerland

Astrid Soubrier
AO Research Institute
Davos, Switzerland

SPEAKER 1
SPEAKER 2
SPEAKER 3
SPEAKER 4
Frank Schildberg
University Hospital Bonn
Bonn, Germany
Matteo Moretti
EOC Cantonal Hospital
Lugano, Switzerland
Andreas Traweger
Paracelsus Medical University
Salzburg, Austria
Raquel Goncalves
University of Porto
Porto, Portugal
ABSTRACT

Cell based therapies are widely investigated in orthopaedic research. In recent years, the trophic effect of implanted cells has gained increasing attention. With respect to mesenchymal stem cells (MSCs), there is strong evidence that paracrine signals play a major role in their therapeutic effect. The secretome of MSCs has been shown to exhibit significant anti-inflammatory, immune-modulatory, anabolic, and regenerative activity. This effect is based on the release of soluble mediators and extracellular vesicles than contain lipids, hormones, proteins, bioactive small molecules, and nucleotides. Non-coding RNAs such as micro-RNAs that are important transcription regulators are mainly delivered through this mechanism.

For orthopaedic regeneration, formulations based on trophic signals offer several advantages compared to cell transplantation therapies. Certain safety risks such as unwanted differentiation are eliminated, and an off-the-shelf preparation can be foreseen. Local treatments with exosomes or microvesicles are therefore promising for repair and regeneration of traumatic or degenerative musculoskeletal disorders. In this symposium, recent advances in the characterization and application of secretomes and extracellular vesicles will be discussed.

CHAIR
CO-CHAIR

Manuela Gomes
3B’s Research Group, University of Minho
Gumarães, Portugal

Dimitrios Zeugolis
National University of Ireland
Galway, Ireland

SPEAKER 1
SPEAKER 2
SPEAKER 3

Denitsa Docheva
3B’s Research Group, University of Minho
Gumarães, Portugal

Ana Gonçalves
3B’s Research Group, University of Minho
Gumarães, Portugal

Eugenia Pugliese
National University of Ireland
Galway, Ireland

ABSTRACT

Due to accidents and ageing, tendon diseases present major clinical and financial challenges in orthopaedics, accounting for a considerable share of musculoskeletal pathologies. In recent years, a growing interest on tendon biomechanical properties has highlighted potential studies towards improved therapeutic strategies in the orthopedic field. Tissue engineering approaches are being increasingly studied in order to create successful alternatives for tendon repair and regeneration.

Recent advances in tissue engineering and regenerative medicine envision the reconstruction of the tendon microenvironment ensuring appropriate cell and biomaterial interactions, to tackle tendon disease. In turn, this bioengineered environment will trigger key biochemical and biomechanical signals that steer desirable and stable cell behaviour. Therefore, this symposium will address cell-to-matrix and material interactions controlling cell behaviour, 3D niches, tendon engineering strategies, as well as repair/regeneration models.

CHAIR
CO-CHAIR

Thomas M. Grupp
Aesculap AG Research & Development
Tuttlingen, Germany

Luca Cristofolini
Alma Mater Studiorum Università di Bologna
Bologna, Italy

SPEAKER 1
SPEAKER 2
SPEAKER 3
SPEAKER 4

Francesco Traina
Rizzoli Orthopaedic Institute
Bologna, Italy

Luca Cristofolini
Alma Mater Studiorum Università di Bologna
Bologna, Italy

Alexander Giurea
Medical University of Vienna
Vienna, Austria

Thomas M. Grupp
Aesculap AG Research & Development
Tuttlingen, Germany

ABSTRACT

In total hip arthroplasty a major cause of hip revision is aseptic loosening of the acetabular component.  Such failure is typically accompanied with defects in and around the acetabulum that must be restored during revision surgery.  Morselized bone graft represents the golden standard for the reconstruction.  Due to its limited availability, synthetic bone graft substitutes are adopted as an alternative material.

In the treatment of severe contained defects bone graft substitutes were tested in human donor pelvises and bone/implant motions were measured by digital image correlation.

In complex knee revision cases accompagnied by instable ligaments or for patients with severe varus or valgus deformities, a rotating hinge knee prosthesis is a viable clinical option. Hybrid fixation with cementless stems to enable a stem revision without extended bone removal is a method of choice in case of peri-prosthetic joint infection.

End-of-Stem Pain is localized pain in the region around the tip of the stem of a prosthesis after revision total knee arthroplasty. Surface deformations were measured on human femora under dynamic load using digital image correlation. High deformations were detected at the tip of the stem during simulated stair climbing and chair raising activities, which may be relevant for End-of-Stem Pain.

CHAIR
CO-CHAIR

Ali Mobasheri
University of Oulu
Oulu, Finland

Holger Jahr
Maastricht University
Maastricht, Netherlands

SPEAKER 1
SPEAKER 2
SPEAKER 3
SPEAKER 4

Mohit Kapoor
Schroeder Arthritis Institute, University Health Network
Toronto, Canada

Shabana Amanda Ali
Bone and Joint Center, Henry Ford Health System
Detroit, USA

Annemarie Lang
Charité-Universitätsmedizin
Berlin, Germany

Ali Mobasheri
University of Oulu
Oulu, Finland

ABSTRACT

Osteoarthritis (OA) is the most common form of arthritis with significant healthcare costs and unmet needs in terms of early diagnosis and treatment. Many of the drugs that have been developed to treat OA failed in phase 2 and phase 3 clinical trials. High throughput omics technologies are a powerful tool to better understand the mechanisms of the development of OA and other arthritic diseases. In this speakers outline the strategic reasons for increasingly applying deep phenotyping in OA for the benefit of gaining a better understanding of disease mechanisms and developing targeted treatments. High throughput omics technologies are increasingly being applied in mechanistic studies of OA and other arthritic diseases. Applying multi-omics approaches in OA is a high priority and will allow us to gather new information on disease pathogenesis at the cellular level, and integrate data from diverse omics technology platforms to enable deep phenotyping. This symposium is intended to raise further interest and awareness in the application of omics technologies for deep phenotyping in OA. New knowledge in this area will unleash the power of Big Data Analytics and resolve the extremely complex cellular taxonomy of OA and potentially reveal “druggable pathways”, thus facilitating future drug development.

CHAIR
CO-CHAIR

Patrina S.P. Poh
BIH at Charité Universitätsmedizin Berlin, Julius Wolff Institute
Berlin, Germany

Gabriela Russow
BIH at Charité Universitätsmedizin Berlin, Julius Wolff Institute
Berlin, Germany

SPEAKER 1
SPEAKER 2
SPEAKER 3
SPEAKER 4

Sven Maerdian
BIH at Charité Universitätsmedizin Berlin, Julius Wolff Institute
Berlin, Germany

Patrina S.P. Poh
BIH at Charité Universitätsmedizin Berlin, Julius Wolff Institute
Berlin, Germany

Sara Checa
BIH at Charité Universitätsmedizin Berlin, Julius Wolff Institute
Berlin, Germany

Jan Baumbach
University of Hamburg
Hamburg, Germany

ABSTRACT

Fragility fracture is a common ailment affecting people over the age of 50, costing the health care system billions of dollars annually. Although bone has intrinsic healing capability, impaired fracture healing occurred in up to 30% of cases, commonly leading to bone defects. Currently, bone defect therapeutic approaches include grafting, distraction osteogenesis, or “Masquelet” technique with highly variable healing outcomes due to inevitable physiological changes with chronological ageing, environmental influences and disease comorbidity. Coupling with population ageing necessitates advanced bone regenerative therapy and a holistic view of the bone defect. This call for cross-field collaborations to innovate solutions for the realisation of precision regenerative therapy. This symposium aims to bring together expertise from various research fields, i.e., bioinformatics, clinicians, bioengineers, giving an overview of how each of these seemingly disparate fields contributes towards the clinical translation of precision bone regenerative therapy.