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Thomas M Grupp Aesculap AG, Research & Development & Medical Scientific Affairs, Tuttlingen, Germany
Ludwig Maximilians University Munich, Department of Orthopaedic and Trauma Surgery, Musculoskeletal University Center Munich (MUM), Campus Grosshadern, Munich, Germany

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Sabine Rusch Aesculap AG, Research & Development & Medical Scientific Affairs, Tuttlingen, Germany

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Philippe Massin CMC Ambroise-Paré-Hartmann, Neuilly-sur-Seine, France

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Ashley Blom National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
Translational Health Sciences, Bristol Medical School, Musculoskeletal Research Unit, University of Bristol, Southmead Hospital, Bristol, UK

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Eduardo Garcia-Rey Hôpital Universitario La Paz-Idi Paz, Madrid, Spain
Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, CIBER-BBN, Madrid, Spain

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Luca Cristofolini Department of Industrial Engineering, School of Engineering and Architecture, Alma Mater Studiorum - Università di Bologna, Bologna, Italy

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Dennis Janssen Radboud University Medical Center, Radboud Research Institute, Orthopaedic Research Lab, Nijmegen, the Netherlands

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Bernd Grimm Luxembourg Institute of Health, Human Motion, Orthopaedics, Sports Medicine & Digital Methods Group, Transversal Activities, Luxembourg

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Alexander Giurea Department of Orthopaedic Surgery, Medical University of Vienna, Vienna, Austria

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Marcus Jäger Department of Orthopaedics, Trauma & Reconstructive Surgery St. Marien Hospital Mülheim an der Ruhr & Chair of Orthopaedics and Trauma Surgery University of Duisburg–Essen, Essen, Germany

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Francesco Siccardi Medacta International SA, Research & Development & Medical Affairs, Castel San Pietro, Switzerland

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Søren Overgaard Copenhagen University Hospital, Department of Orthopaedic Surgery and Traumatology, Copenhagen, Denmark
Department of Clinical Medicine, Faculty of Health & Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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of the 1 st EFORT European Consensus on ‘Medical and Scientific Research Requirements for the Clinical Introduction of Artificial Joint Arthroplasty Devices’ were foremost to focus on patient safety through performance requirements for medical

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Søren Overgaard Department of Orthopaedic Surgery and Traumatology, Copenhagen University Hospital, Copenhagen, Denmark
Department of Clinical Medicine, Faculty of Health & Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Thomas M Grupp Aesculap AG Research & Development & Medical Scientific Affairs, Tuttlingen, Germany
Department of Orthopaedic and Trauma Surgery, Ludwig Maximilians University Munich, Musculoskeletal University Center Munich (MUM), Campus Grosshadern, Munich, Germany

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Rob GHH Nelissen Department of Orthopaedics, Leiden University Medical Center, Leiden, the Netherlands
Technical University Delft, Delft, the Netherlands

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Luca Cristofolini Department of Industrial Engineering, School of Engineering and Architecture, Alma Mater Studiorum - Università di Bologna, Bologna, Italy

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

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Marcus Jäger Department of Orthopaedics, Trauma & Reconstructive Surgery St. Marien Hospital Mülheim an der Ruhr & Chair of Orthopaedics and Trauma Surgery University of Duisburg–Essen, Essen, Germany

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Matthias Fink TÜV Süd Product Service GmbH, Clinical Centre of Excellence, Munich Germany

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Sabine Rusch Aesculap AG Research & Development & Medical Scientific Affairs, Tuttlingen, Germany

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Hassan Achakri Zimmer Biomet, Clinical, Regulatory & Quality Affairs, Winterthur, Switzerland

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Francesco Benazzo IUSS Pavia, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy

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Dario Bergadano Medacta International SA, Medical Affairs, Castel San Pietro, Switzerland

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Georg N Duda Julius Wolff Institute and Center for Muskuloskeletal Surgery, Berlin Institute of Health at Charité Universitätsmedizin Berlin, Germany

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Christian Kaddick EndoLab Mechanical Engineering GmbH, Riedering, Germany

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Volkmar Jansson Department of Orthopaedic and Trauma Surgery, Ludwig Maximilians University Munich, Musculoskeletal University Center Munich (MUM), Campus Grosshadern, Munich, Germany

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Klaus-Peter Günther University Clinic Carl Gustav Carus, Center for Orthopaedic & Trauma Surgery, Technical University Dresden, Dresden, Germany

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the European Federation of National Associations of Orthopaedics and Traumatology together with a 1st EFORT European consensus initiative on ‘Introduction of Innovations’ ( 1 ). Due to the ubiquitous and increasing need for arthroplasty surgery first

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Theofilos Karachalios Orthopaedic Department, University General Hospital of Larissa, Biopolis, Mezourlo Region, Larissa, Hellenic Republic
School of Health Sciences, Faculty of Medicine, University of Thessaly, Biopolis, Mezourlo Region, Larissa, Hellenic Republic

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Katre Maasalu Clinic of Traumatology and Orthopedics, Tartu University Hospital, Tartu, Estonia
Department of Traumatology and Orthopedics, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia

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Li Felländer-Tsai Division of Orthopaedics and Biotechnology, CLINTEC, Karolinska Institutet, Stockholm, Sweden
Trauma, Emergency Surgery and Orthopaedics, Reconstructive Orthopaedics, Karolinska University Hospital, Stockholm, Sweden

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). We report the results of a survey among European orthopaedic and trauma surgeons, under the auspices of the European Federation of Orthopaedics and Traumatology (EFORT), which assesses the perception, availability, usage, modification, compliance and

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Alan G. Fraser Department of Cardiology, University Hospital of Wales, Cardiff, UK

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

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Per Kjærsgaard-Andersen Department of Orthopaedics, Vejle Hospital, South Danish University, Vejle, Denmark

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Piotr Szymański Centre of Postgraduate Medical Education, MSWiA Central Clinical Hospital, Warsaw, Poland

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Tom Melvin Healthcare Products Regulatory Authority, Earlsfort Terrace, Dublin 2, Ireland

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Paul Piscoi Health Technology Unit B6, Directorate General for Health (DG SANTE), European Commission, Brussels, Belgium

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On behalf of the CORE–MD Investigators (see Appendix) Alan Fraser, Piotr Szymański, Chris Gale, Aldo Maggioni, Elisabetta Zanon, Christina Dimopoulou, Cinzia Ceccarelli, Polyxeni Vairami, Anett Ruszanov, Per Kjærsgaard-Andersen, Rob Nelissen, Adrian Ott, Elizabeth Macintyre, Loredana Simulescu, Marieke Meijer, Berthold Koletzko, Sarah Wieczorek, Adamos Hadjipanayis, Stefano Del Torso, Perla Marang-van de Mheen, Lotje Hoogervorst, Ewout W. Steyerberg, Bas Penning De Vries, Peter McCulloch, Martin Landray, Daniel Prieto Alhambra, James Smith, Anne Lubbeke-Wolf, Stefan James, Sergio Buccheri, Robert Byrne, Laurna McGovern, Stephan Windecker, Andre Frenk, Georgios Siontis, Christoph Stettler, Arjola Bano, Lia Bally, Frank E. Rademakers, Jan D‘hooge, Anton Vedder, Elisabetta Biasin, Erik Kamenjasevic, Petra Schnell-Inderst, Felicitas Kühne, Ola Rolfson, Joel Jakobsson, Amanda Tornsö, Enrico G. Caiani, Lorenzo Gianquintieri, Cinzia Cappiello, Maristella Matera, Tom Melvin, Niall MacAleenan, Ria Mahon, Michèle Meagher, Gearóid McGauran, Thomas Wejs Møller, Ann-Sofie Sonne Holm-Schou, Jan Szulc, Robert E. Geertsma, Jantine W.P.M. van Baal, Joëlle M. Hoebert, Susana L.F. Cabaço, Paola Laricchiuta, Marina Torre, Filippo Boniforti, Eugenio Carrani, Stefania Ceccarelli, Claudia Wild, Sabine Ettinger, Juan Antonio Blasco Amaro, Juan Carlos Rejón Parrilla, Agnieszka Dobrzynska, David Epstein, Valentina Strammiello, Hannes Jarke, Kaisa Immonen, Françoise Schlemmer, Sabina Hoekstra, Marianna Mastroroberto, Christoph Ziskoven, Michael Hahn, Erman Melikyan, Richard Holborow, Suzanne Halliday, Alexey Shiryaev, Gero Viola, Harry van Vugt

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agencies (or ‘competent authorities’). The role of the European Commission is to implement the Medical Device Regulation (MDR) 1 together with the national regulatory agencies. Unlike some other jurisdictions worldwide, however, it lacks its own central

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Pablo Castillón Department of Trauma and Orthopaedic Surgery, Hospital, Universitari Mútua Terrassa, Terrassa, Barcelona, Spain
Universidad Autònoma de Barcelona (UAB), Bellaterra, Barcelona, Spain

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Josep Maria Muñoz Vives Department of Trauma and Orthopaedic Surgery, Hospital Althaia Manresa. Manresa, Barcelona, Spain
Department of Trauma and Orthopaedic Surgery, Hospital Nostra Senyora de Meritxell, Andorra

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Héctor José Aguado Department of Trauma and Orthopaedic Surgery, Hospital Clínico Universitario de Valladolid. Valladolid, Spain
Universidad de Valladolid, Valladolid, Spain

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Arantxa Capel Agundez Department of Trauma and Orthopaedic Surgery, Hospital Universitario 12 de Octubre, Madrid, Spain

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Alina Ortega-Briones Department of Trauma and Orthopaedic Surgery, Hospital Clínico Universitario de Valladolid. Valladolid, Spain

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Jorge Hassan Núñez Department of Trauma and Orthopaedic Surgery, Hospital, Universitari Mútua Terrassa, Terrassa, Barcelona, Spain
Universidad Autònoma de Barcelona (UAB), Bellaterra, Barcelona, Spain

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the PISCO Investigators †
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the PISCO Investigators

consensus spanned over 13 months and five specific steps were followed. Step 1 (October 2021): Selection of delegates. The lead author (Dr Castillón) selected a consensus group of 22 expert orthopaedic trauma surgeons, from 15 hospitals in 7 autonomous

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Mattia Loppini Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
Fondazione Livio Sciutto Onlus, Campus Savona – Università degli Studi di Genova, Savona, Italy

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Francesco Manlio Gambaro Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy

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Rob G H H Nelissen Landelijke Registratie Orthopedische Implantaten (Dutch Arthroplasty Register), ’s Hertogenbosch, The Netherlands
Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands

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Guido Grappiolo IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
Fondazione Livio Sciutto Onlus, Campus Savona – Università degli Studi di Genova, Savona, Italy

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Introduction Total hip arthroplasty (THA) is one of the most frequent and successful surgeries performed in the orthopedic field, nevertheless, a clear consensus on post-surgical management still lacks ( 1 ). The need to define a clear

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Fabian Tobias Spindler Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Munich, Germany

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Wolfgang Böcker Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Munich, Germany

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Hans Polzer Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Munich, Germany

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Sebastian Felix Baumbach Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Munich, Germany

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applied for acute, isolated syndesmotic injuries. Figure 3 combines the clinically applied classification systems identified in the systematic literature review ( 1 , 19 , 29 ), reported in the ESSKA-AFAS expert panel consensus guideline ( 14 ), and a

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Xiang-Dong Wu Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, China

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Yixin Zhou Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, China

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Hongyi Shao Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, China

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Dejin Yang Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, China

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Sheng-Jie Guo Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, China

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Wei Huang Department of Orthopaedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

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review of the evolution, application and evidence base . EFORT Open Reviews 2020 5 866 – 873 . ( https://doi.org/10.1302/2058-5241.5.200037 ) 12. St Mart JP Goh EL . The current state of robotics in total knee arthroplasty . EFORT Open Reviews

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Cristina Alves Department of Pediatric Orthopaedics, Hospital Pediátrico – CHUC, EPE, Portugal

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Europe, as it may allow local research projects to grow into larger programmes through collaborations funded via the European Union. 4 The European Federation of National Associations of Orthopaedics and Traumatology (EFORT) Foundation also funds

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Geovanny Ruiz Ponce Health Sciences University, School of Medicine, Ponce, Puerto Rico

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Norberto J Torres-Lugo Department of Orthopaedic Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico

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Pablo Marrero-Ortiz Department of Orthopaedic Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico

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Humberto Guzmán Department of Orthopaedic Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico

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Gerardo Olivella Department of Orthopaedic Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico

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Norman Ramírez Department of Orthopaedic Surgery, Mayagüez Medical Center, Mayagüez, Puerto Rico

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comprehensive definition that brings consensus in diagnosis and management. Initially, the term EOS was used by Ponseti and Friedman in 1950 to describe idiopathic scoliosis in patients less than 10 years old ( 1 ). They determined that those patients carried a

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