Congress Theme: Harmonisation and Diversity

The major themes of the Virtual EFORT Congress (VEC) 2020 are harmonisation and diversity.

Orthopedics as a specialty has a long way to go before the desired goals of diversity are to be reached. The International Orthopaedic Diversity Alliance, in their exhaustive paper in this issue, ¹ paint a portrait of the current global situation. Women make up roughly between 5% and 10% of the orthopaedic workforce in most countries. This state of affairs represents, possibly, the boomer mentalities of the past century. Millennials, in our perhaps biased and lopsided opinion, see the world differently and we are of the expert opinion that things are changing radically. Courses, hands-on exercises and other instructional activities are increasingly attended by women of the younger generation. This represents a strong trend that shows no tendency to abate. Also, orthopaedic societies around the world have set up committees and task forces to tackle the gender issues of our times. To establish sustainable changes, new approaches will have to be found. Innovative solutions including distribution of the workload, flexible schedules and in-house organization must be developed so as to allow women to not only practice efficiently, but also to participate actively in time-consuming activities such as sitting on various professional committees and thus taking on a leadership role in our profession.

Harmonisation is the other major theme of the VEC. Orthopaedic affections whether degenerative, traumatic or other are the same the world over. The pathophysiology of these musculoskeletal disorders is alike in all areas. Some regions will have more specific types of injuries such as ski-related trauma in the alpine regions or gunshot wounds in warzones. But even though these injuries are different, they still ensue as a result of the same basic disease processes. Harmonisation is a multifaceted proposition that includes clinical knowledge, research results, pre and post-graduate education, diagnostic methods, treatment modalities, operative techniques and, more broadly, delivery and financing of healthcare. All these issues are found at very different levels, spanning from the governmental to the individual, from the macroeconomic to the singular. The papers of Senköylu et al. ² and Kärrholm et al. ³ address specific entities, scoliosis and hip prosthetics respectively. They illustrate the varied solutions and provide insight into possible harmonisation applied to these conditions and techniques. A major effort will be necessary to adapt national, regional and local habits and customs so that all our patients, regardless of geographic location, creed or ethnicity receive the best possible care based on the best available evidence. However, to obtain harmonisation of practices, the most credible evidence is that which is acquired through strong scientific research in the local context. Therefore, high-quality innovative research must be encouraged by EFORT. At the VEC symposium on Evidence Based Medicine (EBM), Overgaard in his ‘Eye Opener’ stresses the overriding importance of applying principles of EBM to our practices to succeed in our common determination to introduce harmonisation throughout all the member national society constituents of EFORT.