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Keith Tucker Orthopaedic Data Evaluation Panel (ODEP), Norwich, UK

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Klaus-Peter Günther University Centre of Orthopedics, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany

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

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Jörg Lützner University Centre of Orthopedics, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany

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Jan Philippe Kretzer Laboratory of Biomechanics and Implant Research, Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany

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

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Toni Lange Center for Evidence-based Healthcare, University Hospital Carl Gustav Carus and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Germany

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Luigi Zagra IRCCS Istituto Ortopedico Galeazzi, Hip Department, Milan, Italy

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aspects of these practices and to produce guidance for the benefit of patients, surgeons, manufacturers and regulators. In this article we will attempt to clarify and suggest recommendations around the issues of off-label, including discussing the mixing

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Peter van Schie Department of Orthopaedics, Leiden University Medical Centre, Leiden, The Netherlands
Department of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands

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Shaho Hasan Department of Orthopaedics, Leiden University Medical Centre, Leiden, The Netherlands

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Leti van Bodegom-Vos Department of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands

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Jan W Schoones Walaeus Library, Leiden University Medical Centre, Leiden, The Netherlands

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

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Perla J Marang-van de Mheen Department of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands

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example, a previous study showed that a change in definition within the same surgical context increased the occurrence of adverse outcomes from 7 to 27% ( 20 ). Similarly, data from one study where the complication rate is defined as the case-mix

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James R Satalich VCU Health Department of Orthopaedic Surgery, Richmond, Virginia, USA

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Daniel J Lombardo VCU Health Department of Orthopaedic Surgery, Richmond, Virginia, USA

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Simon Newman Nuffield Orthopaedic Center, University of Oxford, Oxford, UK

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Gregory J Golladay VCU Health Department of Orthopaedic Surgery, Richmond, Virginia, USA

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Nirav K Patel VCU Health Department of Orthopaedic Surgery, Richmond, Virginia, USA

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insertion has evolved significantly since its inception. ‘First-generation’ technique included simple hand mixing, finger packing, and hand insertion of cement. Early basic and clinical studies showed significant improvements in the fixation strength of

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Pierre J Hoffmeyer Editor-in-Chief, EFORT Open Reviews

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sessions, discussions and controversies presented to an attentive audience. Lately, hybrid meetings have come in fashion created with a mix of in-person and virtual and lately in-person meetings have come back. What a relief it is to hear a ‘real’ speaker

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Pierre J. Hoffmeyer Editor-in-Chief, EFORT Open Reviews

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and traumatology journal with a mix of original articles, reviews and sounding boards. It was a print publication distributed widely to all members of the societies participating in EFORT, representing more than 40 000 potential readers throughout

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Prashant Singh London North West University Healthcare NHS Trust, UK

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Suroosh Madanipour Barts Health NHS Trust, UK

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Andreas Fontalis St. George’s Hospital NHS Trust, UK

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Jagmeet Singh Bhamra Guy’s and St. Thomas’s NHS Trust, UK

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Hani B. Abdul-Jabar London North West University Healthcare NHS Trust, UK

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significantly higher rate of one or more complications and major systemic complications for operations involving a trainee compared with ones with no involvement. 5 However, the cohorts in each group were subject to unknown case-mix and unknown levels of

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Hua Luo Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China

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Chaojun Shen Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China

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Tongyou Qu Department of Pharmacy, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang China

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Lin Chen Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China

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Yue Sun Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China

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Yu Ren Department of Pharmacy, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang China

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4 92 – 94 . ( https://doi.org/10.1016/j.jacme.2014.02.004 ) 18. Grissinger M . Key vulnerabilities in the surgical environment: container Mix-ups and syringe swaps . P and T 2018 43 129 – 167 . 19. Harby SA & Kohaf NA . Accidental

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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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Geke A. W. Denissen Landelijke Registratie Orthopedische Implantaten (Dutch Arthroplasty Register), ’s Hertogenbosch, The Netherlands

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Liza N. van Steenbergen Landelijke Registratie Orthopedische Implantaten (Dutch Arthroplasty Register), ’s Hertogenbosch, The Netherlands

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Wouter T. Lollinga Landelijke Registratie Orthopedische Implantaten (Dutch Arthroplasty Register), ’s Hertogenbosch, The Netherlands

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Nico J. J. Verdonschot Dept. of Biomechanics, Radboud University Medical Center, Nijmegen, The Netherlands
Department of Biomechanical Engineering, University of Twente, Enschede, The Netherlands

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Berend W. Schreurs Landelijke Registratie Orthopedische Implantaten (Dutch Arthroplasty Register), ’s Hertogenbosch, The Netherlands
Dept. of Orthopaedics, Radboud University Medical Center, Nijmegen, The Netherlands

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

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components) ( Table 1 ). For bone cement, the name of bone cement, the manufacturer, type of cement, viscosity, whether the cement contains any antibiotics and use of a vacuum cement mixing system are collected ( Table 2 ). In 2014, the process described

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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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Available configuration Preloaded antibiotic Approved antibiotics for mixing Suggested optimal elution time (> MIC) Stimulan® calcium sulphate hemihydrate beads (3 mm, 4.8 mm, 6 mm); paste; bullets (7 mm; 9 mm) – Vancomycin

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