eCM XII Implant Infection conference
The eCM XII Implant Infection conference was held at the Congress Center in Davos, Switzerland, from June 22–24, 2011.
22 July 2011
Michael Raschke makes a presentation during the eCM XII conference. (Photo: AO Foundation/Communications & Events)
eCM XII Conference
The eCM XII Implant Infection conference was held at the Congress Center in Davos, Switzerland, from June 22-24, 2011. Approximately 160 participants, one third of whom were clinicians along with biologists, engineers and material scientists, attended the meeting, encouraging multidisciplinary discussion and networking. Attendees came from as far away as New Zealand, Australia, Malaysia, India, Columbia, USA, Middle East and many from Europe. The organization of the conference into single sessions with one third of the time for discussion promoted optimum exchange of expert knowledge in basic, translational, and clinical research in the field of orthopedic infection. This was the first eCM meeting to focus on infection, which was prompted by the decision by the AO Trauma research commission (AOTRC) to set up a new clinical priority program (CPP) on bone infection. The bone infection CPP is due to begin activities in early 2012.
The scientific program was arranged by the conference organizers Dr Fintan Moriarty, Dr Martin Stoddart, and Prof Geoff Richards from the AO Research Institute Davos (ARI). Specific topics included clinical aspects of Infection, anti-infective strategies and bacterial pathogenicity. Each session contained two keynote lectures by recognized experts in their fields followed by presentations of cutting edge infection research. At the conference opening the attendees were introduced to Davos in all its guises as a congress, science, sports, holiday, and health center by Dr Sibylle Grad from AO Research Institute Davos. After a presentation on the mission, programs, and activities of AO Research Institute Davos by its Director Prof Geoff Richards, the president elect of the AO Foundation, Prof Jaime Quintero from Bogota, Columbia, gave a brief introduction to the AO Foundation and fundamental principles of Infection treatment to improve patient care.
Prof Charalampos Zalavras from Los Angeles, USA, Past-President of the Musculoskeletal Infection Society of North America opened proceedings with an excellent clinical overview of the surgical treatment of infection in the presence of fracture fixation implants emphasising good debridement as the key to a successful outcome. To counterbalance this clinical presentation, Prof Henk Busscher from University Medical Center Groningen in The Netherlands, gave a research based talk titled: Biomaterials-related infection-the race for the surface and beyond and reminded all that there will never be one surface to solve all implant related infection problems, many modalities have to be used in the constant battle against infection. In the mid-morning session we had the first of two anti-infective strategies sessions. In the first, we heard about the selection of appropriate antibiotics from Christoph Berberich from Wehrheim in Germany and the clinical and preclinical performance of a new gentamicin coated tibial nail was presented by Prof Michael Raschke from Münster, Germany. The second session on this topic, with keynotes by Dr Klaus Dieter Kühn from Wehrheim, Germany and Dr Noam Emanuel from Ness Ziona Israel, continued the theme with presentations of novel local antibiotic delivery methods.
Pathogenicity and immunological aspects
Bacterial pathogenicity and immunological response to infection was covered in three separate sessions over the first two days. Keynote presentations by experts in this field, included presentations on Staphylococcal MSCRAMMS by Prof. Magnus Höök from Texas, USA, S. epidermis biofilm formation by Prof. Dietrich Mack from Swansea in Wales and complement evasion by staphylococci from Prof. Jos van Strijp from Utrecht in The Netherlands. Vaccination studies and immune response to implanted biomaterials and developments in diagnostics were the focus of very interesting keynote presentations by Prof Mark Shirtliff from Baltimore, USA, Dr Sebastian Zaat from Amsterdam in The Netherlands and Prof Mark Smeltzer from Arkansas, USA.
A return to a clinical focus on the final day saw a discussion on diagnostic imaging given by Prof Alberto Signore from Rome, Italy. Dr Vincent Stadelmann from AO Research Institute Davos gave an interesting insight into the potential of high resolution CT in monitoring bone adjacent to implants and revealed the potential of this technique for osteomyelitis diagnosis. In the closing session, Dr Nicolaus Renner current chair of AO Trauma research commission chaired a session with keynotes by Prof Irving Shapiro from Philadelphia, USA on vancomycin functionalised titanium and the final keynote of the meeting was given by Prof Werner Zimmerli one of the most well-known infectious disease specialists in the world, from Liestal, Switzerland (where AO was founded) who presented some of the research highlights from his laboratory on the most appropriate antibiotics and treatment regimens for orthopaedic implant related infection.
eCM XII Implant Infection was the first joint meeting with the Asia Pacific Orthopaedic Association Infection Section (APOA) with a dedicated session on Friday morning. The APOA session opened with an introduction to APOA by Dr Sureshan Sivananthan , Vice Chairman of the APOA Infection Section. Dr Sivananthan gave an introduction to the APOA, its history and invited attendees to join the APOA annual conference in New Delhi, India in 2012, where one full day will be dedicated to infection research. The opening keynote of the APOA session was by Dr Said Saghieh from Beirut, Lebanon who gave an overview of antibiotic impregnated calcium sulphate and was followed by a very probing introduction into the myths and facts of cleanliness in the surgical operating room by Prof. John Fairclough from Cardiff Centre of Excellence for Orthopaedic Care, Wales (who also has been surgeon to the Welsh International Football team, Cardiff Rugby Club, Glamorgan Cricket, the Welsh Rugby Union and more). The APOA also hosted their Muculoskeletal Infection prize competition at eCM. Over the three days, four pre-selected entrants were invited from a large number of applicants to present their work and compete for the USD 10,000 APOA-Pfizer award for best paper. On Friday evening at the conference dinner the four prize entrants, Prof Britt Wildemann from Berlin, Germany, Dr Jason Cheung from Hong Kong, Josh Kempthorne from Christchurch, New Zealand and Steffen Rosslenbroich from Münster in Germany were all in attendance. The travel to eCM of the four preselected prize entrants was subsidized by APOA. After much deliberation (based upon the actual manuscript scientific quality, podium presentation, and handling of questions) by the judges, the winner was announced to be Prof Wildemann for her work on Sequential release kinetics of two (Gentamicin and BMP-2) or three (Gentamicin, IGF-1 and BMP-2) substances from one-component polymeric coating on implants. However, the work was not awarded the full APOA- Pfizer Award Medal for best paper, but it was agreed that a USD 5,000 prize be given to the team to improve the work for publication as it was by far the best all round paper submitted for the APOA Infection award in 2011. Anyone can apply for this award in future years and Dr Sivananthan encouraged all eCM XII attendees to apply.
The next award presentations are planned to be held in New Delhi from 3–6 October, 2012 followed by Kuching in Borneo, Malaysia from 29–31 August 2013.
Finally, the organizers awarded student prizes to Justyna Nowakowska from the Department of Biomedicine, University Hospital of Basel, for her oral presentation "Serrulatane EN4, a New Antimicrobial Compound Exerts Potent Acitvity against Adherent Biofilm-Forming Bacteria In Vitro", and the best poster award went to Christopher Henkenbehrens from Hannover, Germany for his poster A new animal model for implant-associated infected non-unions of the tibia and bacteria detection with fluorescence in situ hybridization.
In a summary statement at the conclusion of the meeting, Geoff Richards made us aware that we still have many of the same challenges in the prevention, treatment and diagnosis of infection that we have faced for the past fifteen years since the first AO Injury supplement on Infection (and its follow on supplement in 2006). He reminded us that with increasing antibiotic resistance, this problem may become an even greater challenge to researchers and practicing clinicians in the future and that rapid progress requires the interaction between clinicians and scientists as was enjoyed during the previous three days.
The summary and all the abstracts will be published as a supplement of eCM journal. We look forward to the next eCM in 2012 eCM XIII: Bone Fixation, Repair & Regeneration (Focus CMF, Spine, Trauma) from 25th–28th June 2012, Davos Congress Centre.
eCM Journal has yet again surpassed all expectations with its new impact factor of 9.650.
APOA winner Britt Wildemann and conference speaker Bill Costerton. (Photo: AO Foundation/Communications & Events)
Keynote speaker Henk Busscher leads a discussion. (Photo: AO Foundation/Communications & Events)
Audience participation during conference discussion. (Photo: AO Foundation/Communications & Events)
Geoff Richards along with Sureshan Sivananthan and John Fairclough announcing the APOA prize winner.
(Photo: AO Foundation/Communications & Events)
Jaime Quintero and Geoff Richards at the conference.
(Photo: AO Foundation/Communications & Events)