The historic city of Istanbul hosted this year’s EFORT Congress. A great deal of preparation had gone into planning Europe’s largest orthopaedic meeting, and a programme spanning the breadth of orthopaedic surgery had been organised. How were the organisers to know that their congress would be overshadowed by civil unrest that started only days before the congress would begin? International news reports described riots and violence in Istanbul, with the epicentre of this unrest unfortunately less than a mile away from the congress site. With local colleagues dropping like flies, deciding it was not safe to travel, it was with some trepidation that we decided to make the trip. Very little public information had been published on the EFORT website in advance to inform us of the safety situation. Driven by a burning desire to boost CVs, a few brave souls stepped onto planes bound for Turkey, armed only with our poster rolls. In fact, the protest reminded me more of a scene at Glastonbury rather than a riot. The atmosphere was calm, and while there were reported pockets of violence during the night, the area felt relatively safe during the day. Visiting the protest site became another sight to see on the tourist trail.
The congress venue was a large site in wall-to-wall marble that was more than large enough to host the delegates and industry sponsors. The site was well organised, and the congress ran smoothly. Catering was not provided for the delegates, and even water had to be paid for. The conference was opened by the EFORT president Professor Hoffmeyer and Professor Hakki Sur, Chairman of the Congress. Dr Sur's speech shed light on the politics behind the Taksim Square demonstration, explaining that the protestations were in defence of the values of Ataturk's modern secular society. The guest lecture, ‘The Science of Ionia’ by Professor Celal Sengor, was entertaining, passionately delivered and provided a fascinating insight into the ancient history of the region. The ceremony was brought to a close by the Shaman dance group before a pleasant drinks reception for a thirsty audience.
The congress offered a large array of research from the European orthopaedic community. Twelve rooms ran simultaneously, delivering numerous free-paper sessions, symposia and instructional courses. We heard an excellent lecture from Dr C. Garnavos of Greece, regarding management of fractures of the proximal tibia. One of the techniques discussed was the combined use of percutaneous open reduction internal fixation of the articular surface and an intramedullary device for the diaphyseal component of Schatzker 5 and 6 fractures. A fascinating lecture by Dr J. Lindahl from Finland discussed the surgical management of pelvic ring injuries. Of particular interest was his description of open reduction for sacral fracture dislocations through a mini longitudinal posterior approach prior to percutaneous or internal fixation.
Dr A. Eklund from Sweden presented a stimulating historical journey from the first described shoulder replacement by Neer in the 1970s to current innovations and possibilities for future management. One of the ideas discussed was the use of overlapping 3D reconstructions to help delineate bone loss in the shoulder. The increasing use of reverse shoulder arthroplasty for three- and four-part proximal humeral fractures in the elderly was mentioned, as was the use of platform systems to try and ease the technical difficulties encountered when removing a well cemented stem in revision surgery. New materials such as a spherical pyrocarbon implant for use as an interposition arthroplasty were introduced, although clearly these ideas remain unproven at present.
Friday began with a number of interesting papers on how best to align total knee replacements (and the debate still continues) and there still appears to be little consensus of opinion. The Japanese keynote speaker, Dr Tomita, discussed tackling difficult spinal tumours. This was followed by sessions on how best to repair or replace the knee meniscus (the overriding message was that the meniscus should be preserved whenever possible), and then a refreshing personal view by Dr Overgaard from Denmark who still strongly supports the use of cemented femoral stems in total hip replacement.
Istanbul seemed largely unaffected by the troubles, and many at the congress spent time enjoying the historical architectural wonders that the city has to offer. In spite of the civil unrest, over 7500 delegates still attended. Many extra sessions were provided (at a cost). The uniting language of English suited certain individuals but we found that occasionally the nuances are lost when it was not the speaker’s first language. Despite this, the congress still delivered a platform that was able to bring together orthopaedic surgeons from all over the European Union and further afield. Plans are already afoot for the next EFORT Congress, which will be in London next year; this year was a resounding success and we would thoroughly recommend attendance at the next.
