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Xun Wang Department of Orthopedics, Center for Plastic & Reconstructive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China

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Aiqi Zhang Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China

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Wenchao Yao Department of Orthopaedics, the First People's Hospital of Chun'an County, Hangzhou, Zhejiang, China

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Haiyan Qiu Department of Endocrinology, Afliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China

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Fabo Feng Department of Orthopedics, Center for Plastic & Reconstructive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China

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patients with long-term follow-up 251 Wong et al. ( 52 ) 2008 Neurologic impairment from ectopic bone in the lumbar canal: a potential complication of off-label PLIF/TLIF use of bone morphogenetic protein-2 (BMP-2) 242 Parker et al

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Bart G. Pijls Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands

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Jennifer M. T. A. Meessen Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands

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Keith Tucker Implant Performance Committee, England and Wales National Joint Registry, ODEP, Beyond Compliance and MHRA Expert Advisory Group for MoM Prostheses, London, UK

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Susanna Stea Istituto Ortopedico Rizzoli, Bologna, Italy

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Liza Steenbergen Dutch Arthroplasty Register (Landelijke Registratie Orthopedische Implantaten, LROI), 's- Hertogenbosch, The Netherlands

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Anne Marie Fenstad The Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway

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Keijo Mäkelä Department of Orthopedics and Traumatology, Turku University Hospital, Turku, Finland

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Ioan Cristian Stoica Foisor Orthopaedics Clinical Hospital, Bucharest, Romania

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Maxim Goncharov VJRR, Russian Scientific Research Institute of Traumatology and Orthopedics, St Petersburg, Russia

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Søren Overgaard Department of Orthopedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark

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Jorge Arias de la Torre Departament de Salut, Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, Spain
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
Instituto de Biomedicina (IBIOMED). Universidad de León, León, Spain

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Anne Lübbeke Division of Orthopaedic Surgery and Traumatology, Geneva University Hospitals, Geneva, Switzerland
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK

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Ola Rolfson Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

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Rob G. H. H. Nelissen Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands

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expect surgeons to use all components of the same manufacturer, almost all included registries report off-label mix-and-match prostheses, except for the GAR. The NAR and RAR reported that these mix-and-match prostheses consist of the use of BHR acetabular

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Razvan Ene Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
Bucharest Emergency Clinical Hospital, Romania

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Mihai Nica Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
University Emergency Hospital Bucharest, Romania

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Dragos Ene Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
Bucharest Emergency Clinical Hospital, Romania

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Adrian Cursaru Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
University Emergency Hospital Bucharest, Romania

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Catalin Cirstoiu Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
University Emergency Hospital Bucharest, Romania

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antibiotic delivery system based on bioactive glass. Until solid data are provided by research into this synthetic biomaterial as an antibiotic delivery system its use for this purpose remains experimental and off-label. 31 – 34 Calcium phosphate

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Marcel Niemann Charité – Universitätsmedizin Berlin, Center for Musculoskeletal Surgery, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany

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Ellen Otto Charité – Universitätsmedizin Berlin, Center for Musculoskeletal Surgery, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany

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Christian Eder Charité – Universitätsmedizin Berlin, Center for Musculoskeletal Surgery, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

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Yasmin Youssef Department of Orthopaedics, Trauma Surgery and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany

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Lutz Kaufner Charité – Universitätsmedizin Berlin, Department of Anesthesiology and Intensive Care Medicine, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

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Sven Märdian Charité – Universitätsmedizin Berlin, Center for Musculoskeletal Surgery, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

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( 1 ) We do not recommend the use of recombinant- activated coagulation factor VII ( rFVIIa ) as first-line treatment . We suggest that the off-label use of rFVIIa be considered only if major bleeding and traumatic coagulopathy persist despite

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Pelle V Wall University of California San Diego School of Medicine, Gilman Drive, La Jolla, California, United States of America

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Brendon C Mitchell Department of Orthopaedic Surgery, University of California San Diego, West Arbor Drive, California, United States of America

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Canhnghi N Ta Department of Orthopaedic Surgery, University of California San Diego, West Arbor Drive, California, United States of America

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William T Kent Department of Orthopaedic Surgery, University of California San Diego, West Arbor Drive, California, United States of America

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, and risk of thrombosis may complicate their use. Further, these reversal agents are not approved for all DOACs ( 48 ). Prothrombin complex concentrate (PCC) and activated prothrombin complex concentrate (APCC) have also been used off-label for DOAC

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Marilena Giannoudi Department of Cardiology, Bradford Teaching Hospitals NHS Trust, Bradford, UK
Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK

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Peter V Giannoudis Academic Department of Trauma and Orthopaedics, Floor D, Clarendon Wing, LGI, University of Leeds, Leeds, UK
NIHR Leeds Biomedical Research Centre, Chapel Allerton Hospital, Leeds, UK

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, there have been no studies directly comparing the use of DOAC antidotes to PCC and APCC ( 55 ). Such agents have therefore been typically used in an off-label fashion prior to the invention of the direct antidotes and currently when such antidotes are

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Paul L Rodham Academic Department of Trauma & Orthopaedics, Leeds General Infirmary, Leeds, United Kingdom of Great Britain and Northern Ireland

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Vasileios P Giannoudis Academic Department of Trauma & Orthopaedics, Leeds General Infirmary, Leeds, United Kingdom of Great Britain and Northern Ireland

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Nikolaos K Kanakaris Academic Department of Trauma & Orthopaedics, Leeds General Infirmary, Leeds, United Kingdom of Great Britain and Northern Ireland
Department of Trauma & Orthopaedics, University of Leeds, Leeds, United Kingdom of Great Britain and Northern Ireland

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Peter V Giannoudis Academic Department of Trauma & Orthopaedics, Leeds General Infirmary, Leeds, United Kingdom of Great Britain and Northern Ireland

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off-label, BMPs have also been investigated in the management of critical bone defects. In a canine ulna model, Salkeld et al. were able to demonstrate that the combination of Rh-BMP 7 with either autograft or allograft lead to faster times to union

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Victor Lu School of Clinical Medicine, University of Cambridge, Cambridge, UK

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Maria Tennyson Department of Trauma and Orthopaedics, Addenbrooke’s Hospital, Cambridge, UK

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Andrew Zhou School of Clinical Medicine, University of Cambridge, Cambridge, UK

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Ravi Patel Department of Trauma and Orthopaedics, Shrewsbury and Telford Hospital NHS Trust, UK

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Mary D Fortune Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK

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Azeem Thahir Department of Trauma and Orthopaedics, Addenbrooke’s Hospital, Cambridge, UK

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Matija Krkovic Department of Trauma and Orthopaedics, Addenbrooke’s Hospital, Cambridge, UK

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( 45 ). A higher proportion of ankles treated with a non-ankle fusion nail used ‘off-label’ have implant failure than those that used nails specific for hindfoot stabilisation. Furthermore, short nails that do not cross the tibial isthmus were assumed

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