Dr. Ma­xi­mi­lian Kas­pa­rek as Sci­en­ti­fic Di­rec­tor of Congress

2nd Or­tho Trauma Bad Hof­gas­tein 2024

Fol­lo­wing the suc­cess of the first Or­tho-Trauma Con­gress in 2023 in Bad Hof­gas­tein, the se­cond edi­tion took place this year from April 10 to 12, 2024. Un­der the sci­en­ti­fic di­rec­tion of Prim. Univ.-Doz. Dr. Tho­mas Müll­ner, PhD and Priv.-Doz. DDr. Ma­xi­mi­lian Kas­pa­rek, MSc from the Evan­ge­li­cal Hos­pi­tal Vi­enna, the aim was to pro­vide an up-to-date and in­te­res­t­ing up­date on the most mo­dern and la­test tre­at­ment tech­ni­ques. This ye­ar’s fo­cus was on the lower ex­tre­mity, with a broad sci­en­ti­fic pro­gram on hip, knee and ankle surgery.

The con­gress star­ted on Wed­nes­day, April 10, with the first-ever “Roo­kie­day”, which was or­ga­ni­zed in co­ope­ra­tion with the Young Fo­rum of the ÖGOuT. The aim of this new trai­ning for­mat is to of­fer stu­dents and as­sistant doc­tors a plat­form to ex­pand their know­ledge and ex­ch­ange ideas with ex­pe­ri­en­ced spe­cia­lists. This ye­ar’s to­pic was the tre­at­ment of pro­xi­mal ti­bia frac­tures and knee ar­thro­plasty in post-trau­ma­tic gonar­thro­sis. Fol­lo­wing the sci­en­ti­fic pre­sen­ta­ti­ons of the day, the young ge­ne­ra­tion was also able to get hands-on ex­pe­ri­ence. In a saw­bone work­shop, par­ti­ci­pants were able to treat frac­tures in the fe­mur and ti­bia, and in the en­do­pro­sthe­tic work­shop, they were able to im­plant a ro­bot-as­sis­ted to­tal knee ar­thro­plasty. The Roo­kie­day was very well re­cei­ved and will once again be a fi­xed date for the next ge­ne­ra­tion of or­tho­pe­dics and trau­ma­to­logy next year. 

The in­tro­duc­tion to the sci­en­ti­fic pro­gram on Thurs­day, April 11, 2024, was the tre­at­ment of me­nis­cus in­ju­ries and car­ti­lage da­mage. A high-qua­lity ses­sion be­gan with the ques­tion of what func­tional me­nis­cus loss me­ans for the knee joint. Other to­pics in­cluded the tre­at­ment of me­nis­cus root and ramp le­si­ons, as well as pro­phyl­ac­tic me­nis­cus al­lo­graft trans­plan­ta­tion. Sub­se­quently, the tre­at­ment of trau­ma­tic car­ti­lage da­mage in cru­ciate li­ga­ment rup­ture and the cur­rent evi­dence on the ques­tion of whe­ther mi­cro­frac­tu­ring or car­ti­lage trans­plan­ta­tion should be per­for­med for lo­cal car­ti­lage de­fects were dis­cus­sed in­ten­si­vely. The first sci­en­ti­fic to­pic block en­ded with ort­ho­bio­lo­gi­cal the­rapy to­day and its fu­ture prospects. 

The se­cond to­pic block dealt with the tre­at­ment of pa­tell­ofe­mo­ral pa­tho­lo­gies. The cau­ses and dia­gno­stic al­go­rithm of pa­tel­lar dis­lo­ca­tion as well as the sur­gi­cal tre­at­ment of this pa­tho­logy were dis­cus­sed. Tips and tricks for MPFL plasty, the in­di­ca­ti­ons and sur­gi­cal tech­ni­que of troch­leo­plasty and os­teo­to­mies for pa­tel­lar dis­lo­ca­tion were dis­cus­sed in­ten­si­vely. Fur­ther to­pics were the tre­at­ment op­ti­ons for fe­moropa­tel­lar joint ar­thro­sis and the tre­at­ment op­ti­ons for the pa­tella in knee arthroplasty. 

To con­clude the mor­ning blocks, Bern­hard Gru­ber, a for­mer Aus­trian Nor­dic com­bi­ned skier, gave a key­note lec­ture on his im­pres­sive career. With his home­town of Bad Hof­gas­tein in the Gas­tein Val­ley as a start­ing point, Gru­ber has had an im­pres­sive career. He gai­ned in­ter­na­tio­nal re­co­gni­tion th­rough his out­stan­ding achie­ve­ments, in­clu­ding win­ning the gold me­dal at the 2010 Olym­pic Games in Van­cou­ver as part of the team and the bronze me­dal in the in­di­vi­dual com­pe­ti­tion from the large hill. At the 2011 World Cham­pi­on­ships in Oslo, Nor­way, he won the world title with both Aus­trian re­lay teams (nor­mal and large hill). In ad­di­tion, he crow­ned his career with the title of in­di­vi­dual world cham­pion from the large hill in 2015. 

Af­ter the key­note lec­ture and lunch break, du­ring which a lunch sym­po­sium was also of­fe­red this year, with the op­por­tu­nity to test an sur­gi­cal ro­bot, the af­ter­noon ses­sion began.

In the af­ter­noon of the first day, hip joint di­se­a­ses and pri­mary hip ar­thro­plasty were trea­ted. Start­ing with the to­pic of un­clear hip pain and fe­moro-ace­tabu­lar im­pinge­ment, la­brum and car­ti­lage da­mage as well as the ques­tion of what needs to be ope­ra­ted on, ex­ci­ting dis­cus­sions de­ve­lo­ped. This was fol­lo­wed the­ma­ti­cally by the tre­at­ment of hip joint frac­tures in win­ter sports. Fur­ther to­pics were pe­ri­ace­tabu­lar os­teo­tomy (PAO) and its cur­rent sta­tus, dys­pla­sia cox­ar­thro­sis as well as com­plex de­for­mi­ties of the ace­tabu­lum and fe­mur and the­rapy sug­ges­ti­ons for the tre­at­ment of the same. This ex­ci­ting to­pic block en­ded with the to­pic of de­bon­ding in hip and knee arthroplasty. 

The first day con­cluded with the to­pic block on cur­rent con­cepts in knee ar­thro­plasty. Both the in­di­ca­tion for the me­dial par­tial sled and the suc­cess fac­tors for this were dis­cus­sed. In the fur­ther course, the first cli­ni­cal re­sults of the ori­gi­nal knee tech­ni­que, which was de­ve­lo­ped at the Evan­ge­li­cal Hos­pi­tal, were pre­sen­ted. The to­pic mo­ved on to soft tis­sue re­leases and the im­portance of these to­day. The first day and thus one of the high­lights of the sci­en­ti­fic ses­sion en­ded with a sci­en­ti­fic battle pro and con­tra ro­bo­tics in knee ar­thro­plasty. To round off the in­ten­sive con­gress day, an evening event took place in the Weit­mo­ser­schlössl, a beau­tiful, his­to­ri­cal lo­ca­tion in the Gas­tein Valley. 

The third day of the con­gress on Fri­day, April 12, 2024, star­ted with the to­pic of os­teo­po­ro­sis. This was fol­lo­wed by dis­cus­sions on spi­no­pel­vic ali­gnment in hip ar­thro­plasty and ili­ops­oas im­pinge­ment af­ter hip re­pla­ce­ment. In the area of com­plex ca­ses, the ap­pli­ca­tion of pro­xi­mal fe­mur re­pla­ce­ment in re­vi­sion ar­thro­plasty and the op­ti­ons for an unsta­ble hip pro­sthe­sis were dis­cus­sed. Nerve pa­tho­lo­gies af­ter hip and knee joint re­pla­ce­ment as well as the com­plex dif­fe­ren­tia­tion of adi­pose tis­sue tu­mors were also the­ma­ti­cally treated. 

The fol­lo­wing ses­sion dealt with trau­ma­tic knee in­ju­ries. Ques­ti­ons such as “What to do if my graft is too thin du­ring ACL plasty?” and in­tra­ope­ra­tive so­lu­ti­ons were pre­sen­ted. The ses­sion con­tin­ued with the tre­at­ment of me­dial and la­te­ral in­sta­bi­li­ties of the knee joint. So­lu­ti­ons for com­mon com­pli­ca­ti­ons in an­te­rior cru­ciate li­ga­men­to­pla­sties and re-rup­tures were also dis­cus­sed. The ses­sion con­cluded with news from the field of allografts. 

In the key­note lec­ture of the se­cond day, Mi­chael Strauss, an Aus­trian freeri­der, gave the par­ti­ci­pants an in­sight into his ever­y­day life as a ski freeri­der. His ta­lent and pas­sion led him to num­e­rous po­dium fi­nis­hes at va­rious con­tests. His grea­test suc­cess to date was win­ning the X‑O­ver-Ride 2019 on the Kitz­stein­horn in Zell am See-Ka­prun. With his ex­tra­or­di­nary choice of li­nes and his crea­tive “Strauss-Line”, which in­cluded a back­flip, a 360 and a huge dou­ble drop over the rock faces, he im­pres­sed the jury and pr­e­vai­led against a strong field of competitors. 

Af­ter the lunch break and a lunch sym­po­sium on the up­date of knee sur­gery, the ses­sion con­tin­ued with cur­rent tre­at­ment op­ti­ons for Achil­les ten­don pa­tho­lo­gies, ankle in­ju­ries and ankle arthrosis.

At the same time, there was a block on pre- and post­ope­ra­tive re­ha­bi­li­ta­tion and con­ser­va­tive the­ra­pies, in which cur­rent pos­si­bi­li­ties and fu­ture trends in phy­si­cal me­di­cine, “Back to Sports” af­ter an­te­rior cru­ciate li­ga­ment in­ju­ries, post­ope­ra­tive mo­bi­liza­tion af­ter hip and knee re­pla­ce­ment and an up­date on shock wave the­rapy were discussed.

In the fi­nal block, cur­rent trends in knee ar­thro­plasty were dis­cus­sed and cur­rent gui­de­lines and fu­ture per­spec­ti­ves of throm­bo­sis pro­phy­la­xis were dis­cus­sed. Fur­ther to­pics were the im­portance of os­teo­tomy no­wa­days, ali­gnment stra­te­gies in val­gus gonar­thro­sis and the first re­sults of a pa­ti­ent-spe­ci­fic knee pro­sthe­sis. To con­clude, an over­view of the cur­rent li­te­ra­ture com­pa­ring me­dial and la­te­ral par­tial sleds and to­tal knee ar­thro­plasty was shown and an at­tempt was made to ans­wer the ques­tion of whe­ther 20% of TKA pa­ti­ents are still re­ally dis­sa­tis­fied to­day. To round off the in­ten­sive con­gress, there was a joint din­ner in beau­tiful Bad Hof­gas­tein.
In sum­mary, these were th­ree sci­en­ti­fi­cally highly in­te­res­t­ing and in­for­ma­tive days with many ex­ci­ting, high-qua­lity dis­cus­sions. Due to the great feed­back, the third Or­tho-Trauma Con­gress is plan­ned for next year from April 2 to 4, 2025 in Bad Hofgastein.