annual report 2010

Annual Report 2010Transforming Surgery−Changing Lives

Exploratory Research Feature StoryFulfilling unmet research needs 2Collaboration drives research results 4Securing the AO‘s future beyond tomorrow 6Expanding the platform 8

Education Feature Story AO Surgery Reference goes mobile 10Harnessing technology to teach 12Lifelong learning 16

StrategyA talk with the President and the Chairman of the AO Foundation 18Continued growth of clinical relevance and guidance 22

AO SpecialtiesAOTrauma—delivers the best patient care in musculoskeletal trauma 24AOSEC—2010 was a watershed year 30AOSpine—the global leader in cutting-edge education and research 32AOCMF—a global driving force in innovative education and research 36AOVET—education leads the way 38

AO Service UnitsResearch and Development—the future of trauma research 41Exploratory Research—where science meets clinics 44Clinical Investigation—a leader in evidence-based clinical trials 45TK System—a year of planned change 46Education—major new education initiatives 47

GovernanceGovernance—enhancing the clinical guidance of the AO Foundation 48Finance—financial reporting aligned with new organizational structure 50 Governing bodies of the AO Foundation 52Addresses 54

Table of contentsOur vision is excellence in the surgical

management of trauma and disorders

of the musculoskeletal system.

Our mission is to foster and expand

our network of health care professionals

in education, research, development,

and clinical investigation to achieve more

effective patient care worldwide.

Steve Buchmann, courtesy of the University of Michigan Health System

tissue engineering to better understand the successful, predictable and durable regenera-tion of human tissue and to exploit those discoveries in innovative ways to expand our capabilities to heal the sick and reconstruct the disfigured,” he explained. As a researcher and full-time clinician in a teaching hospital, Buchman sees the LBDH CRP from two perspectives. “From the research and clinical perspectives, I am excited about what can come out of this program,” he said.

“The outcomes that lead to improved patient care come from the researchers’ labs.” The collaborative approach of the LBDH CRP positions the AO Research Institute Davos (ARI) to do what it does best and leverage the competencies of some of the world’s foremost research institutes to answer clinicians’ ques-tions and—ultimately—improve patient care. “AO Exploratory Research fulfills an unmet need for translational research, which is not only basic science, but coming up with solu-tions that surgeons can use,” Buchman said.

Developing solutions for critical size bone defects is just one part of the bone repair and regeneration work under way as part of AO Exploratory Research’s Large Bone Defect Healing Collaborative Research Program (LBDH CRP). Prof Steven Buchman, AO Cra-niomaxillofacial representative to the AO Exploratory Research Board (AOERB) and “godfather” to the LBDH CRP, said the pro-gram is transforming the way research is done. “The LBDH CRP has high relevance for both craniomaxillofacial and orthopedic trauma surgeons because both Specialties encounter

large bone defects that will not heal on their own or are not amenable to bone grafting,” said Buchman, Director of the Craniofacial Anomalies Program at the University of Mich-igan Medical Center. “But there is more to this CRP than just doing the research; sharing ideas and resources can help move the re-search to the next level.” Buchman said applied tissue engineering is one area where the LBDH CRP, now in its fourth year of funding, contributes to better understanding of large bone defects. “Our challenge is to refine the techniques of

Fulfilling unmet research needsLBDH CRP expands understanding of large bone defects

“AO Exploratory Research fulfills an unmet need for translational research, which is not only basic science, but coming up with solutions that surgeons can use.” Prof Steven Buchman, AOCMF representative to the AOERB

Annual Report 2010 Exploratory Research Feature Story

22


Patients

SpecialtiesSurgeons

Exploratory Research

Collaborative Research Programs

Research Network

AOER Collaborative Research Pro-grams (CRPs) address problems rel-evant to two AOER focus fields: bone repair and regeneration (mecha-nisms, bone induction/repair, bone substitute, implant design) and cartilage-disc repair/regeneration (mechanisms, inflammation, re-placement, implant design). Three such CRPs under way today are Large Bone Defect Healing, Annulus Fibrosus Rupture, and Acute Carti-lage Injury.

Outcomes of AOER CRPs are ex-pected to be relevant to at least two of the four AO Specialties. At the conclusion of a CRP, a Specialty may choose to fund and further develop protocols, approaches and tech-niques advanced by the program. Within the appropriate Specialty, this would take the form of a Clini-cal Priority Program (CPP) aimed at developing clinically viable and usable solutions to specified clinical problems, within a defined time frame.

The AO Research Institute has a Pri-mus inter Pares, “first among equals,” role as coordinator of the network of researchers involved in a working on a CRP. Each network is composed of

both ARI scientists and researchers from institutes around the world collaborating across disciplines to exchange insights, foster innovation and meet clinical challenges.

As the health care experts closest to patients, the AO’s global network of surgeons specialized in the treat-ment of trauma and disorders of the musculoskeletal system fuel the exploratory research process by putting forward the clinical chal-lenges they face. Surgeons guide exploratory research funding and have key stewardship roles in all Collaborative Research Programs.

Improved patient care is at the heart of the AO mission. The AOER provides an expert, collaborative framework for working toward in-novative solutions to patient care problems. Patients are the ultimate beneficiaries of the AO research out-comes and the contributions of the research network, which is working toward cutting edge solutions to clinical problems.

As a link between the patient’s bedside and the researcher’s labora-tory bench, AO Exploratory Re-search (AOER) funds high potential research projects which are the most likely to lead to next-generation musculoskeletal therapies to im-prove patient care. By fostering a

global network of science profes-sionals focused on truly novel ap-proaches and theories in bone repair and regeneration and in cartilage and disc repair and regeneration, AOER harnesses internal and exter-nal research expertise to benefit the AO mission.

Collaboration drives research results Central role of Exploratory Research explained

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Matthias Laschke, Sophie Verrier and David Eglin discuss the LBDH CRP in the ARI lab in Davos

LBDH CRP meeting in Boston with the research network consortia representatives

Musculoskeletal Regeneration, is part of theLong Bone Defect Healing CRP (LBDH CRP).

“My work is focused on critical size bone de-fects and tissue engineering approaches mim-icking original bone to treat them. These are based on the combination of biomaterials with stem and progenitor cells that stimulate the formation of new bone and promote neovas-cularization, crucial for the transport of oxy-gene and nutrients,” Verrier said, adding that collaborations offer exchanges of ideas, tech-nologies and valuable feedback.

Matthias W Laschke, Deputy Director of the Institute for Clinical and Experimental Surgery, University of Saarland, Homburg, Germany, is part of the network of research institutes that collaborate with ARI on the LBDH CRP.

“This program appeals to me because I have a medical background but am not as familiar with materials science as our colleagues at ARI,” he said. “ARI and our institute bring out the best in one another.”

This kind of teamwork has the power to secure the AO’s position in the scientific community and expand the research to solve problems that impede patient care, according to Schütz.

Prof Michael Schütz knows first hand the value of AO research. As a junior resident, he worked part-time for the AO Foundation setting up clinical studies. Today, as Chair of the AO Ex-ploratory Research Board (AOERB), Schütz is convinced that AO Exploratory Research (AOER) is key to securing the future of the AO.

“Exploratory research is an investment in the development of next-generation knowledge. For the AO to secure its future, we must be on the cutting-edge of everything we deliver,” he said.AOER is distinguished by its ability to success-

fully span the interests of AO Specialties and pair the expertise of the AO Research Institute Davos (ARI) with complimentary research institutes worldwide. Having surgeons in key decision-making and advisory roles ensures clinical relevance, and ARI has a “first among equals” position in all AOER collaborations.

“The multidisciplinary landscape of research today demands that groups team up for impact. The Collaborative Research Program (CRP)strategy of funding research consortia instead of stand-alone projects is novel in the AO Foundation,” says Sandra Steiner, Head of AOER.

ARI’s Sophie Verrier, Principal Investigator,

Securing the AO’s future Teamwork solves research problems


“The multidisciplinary landscape of research today demands that groups team up for impact.” Sandra Steiner, Head of AO Exploratory Research

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Keita Ito setting up experiments at the invertebral disc bioreactor in Davos

Section of a bovine disc, with annular fibrosis rupture, where the nucleus has naturally protruded (arrow)


the disc with bone fusion or implant. “Each of these treatments has its own problems. It is obvious that researchers need to tackle this issue.”

Now, Ito said, is the right time for the AFR CRP, which is relevant to both AOSpine and AOVET.

“Right now, work is under way on biological solutions, including novel biomaterials. With the right team, we have a very good chance of finding the right solution,” he said. “I believe the AFR CRP could produce good outcomes and potential solutions in the next five years.”

Sibylle Grad, ARI’s Principal Investigator, Mus-culoskeletal Regeneration, said her interest in AFR research goes beyond the laboratory.

“I know people who have AFR; they suffer severe pain for which medication and therapy often prove ineffective,” she said. “I am ex-cited about every small step we collaborators make toward a treatment.”

AO Exploratory Research will host a sympo-sium, “Where Science Meets Clinics,” in Da-vos in 2011. The event will address the repair of bone, cartilage and intervertebral disc from the perspective of clinicians and scientists.

An AO Collaborative Research Program (CRP) focused on treating Annulus Fibrosus Rupture (AFR) could bring relief to patients suffering from AFR-related disc degeneration and low back pain, according to Prof Keita Ito, who teaches biomedical engineering at Eindhoven University in the Netherlands and is an AOSpine International Board member.

The new AFR and Acute Cartilage Injury (ACI) CRPs, both within the focus field of Cartilage and Disc Repair and Regeneration, join Large Bone Defect Healing (LBDH CRP) to total three programs aimed at resolving clinical problems faced by AO surgeons.

Rupture of the annulus fibrosus—the strong wrapping that constitutes the outer portion of the intervertebral disc—typically leads to disc generation and low back pain. “When a disc herniates, the jelly-like nucleus pulposus at the center of the disc comes out through the tear. If it pushes up against the nerve root, it can cause a lot of pain. The nu-cleus pulposus isn’t meant to be exposed to the rest of the body and has an inflammatory effect,” said Ito, “godfather” to the new AFR CRP. He said past treatments have included pain medication, snipping away exposed nu-cleus pulposus, or in drastic cases replacing

Expanding the platformTwo new collaborative programs launched

“Now is the right time for the AFR CRP, which is relevant to both AOSpine and AOVET.” Prof Keita Ito, AOSpine International Board Member

98

An editorial meeting to discuss the AO Surgery Reference iPhone app development

Screen from the Müller AO Classification of Fractures—Long Bones iPhone app

ubiquitously available,” said Trafton, who worked with AO Education’s Michael Redies to develop AO Surgery Reference. “In some countries, lack of computer access is filled by mobile phones and third-generation wireless internet connections. The mobile app is a just-in-time educational tool that meets the needs of surgeons worldwide.”

AO Education’s Surgery Reference Manager Tobias Hövekamp said AO Surgery Reference, which meets the needs of both AOTrauma and AOCMF and soon also AOVET, in mobile format is a direct response to clinicians’ needs.

“The surgeons and their needs really drive the continued development of the AO Surgery Reference,” Hövekamp said. “The Müller AO Classification of Fractures—Long Bones (the standard classification used by trauma surgeons and physicians dealing with skeletal trauma worldwide) app was released in early November 2010, and AO Surgery Reference mobile app was launched shortly after. In just five months, AO Surgery Reference mobile app has been downloaded 26,088 times.”

The acclaimed AO Surgery Reference—containing 16,000 medical illustrations and more than 8,000 pages outlining hundreds of surgical procedures across 20 anatomical areas—is now available in mobile format allowing surgeons instant access to the information they need, when they need it.

“I use AO Surgery Reference for iPhone as I prepare for surgery, to understand the character of a fracture and the find suggested treatments,” said Markus Loibl, former AO research fellow and a third-year resident at Spital Davos. “It is priceless; many books worth of information in a mobile format.”

AO Surgery Reference has been online since 2005, and the release of the application for iPhone and other smart phones in November 2010 was a natural next step, said Prof Peter Trafton, one of four executive editors responsible for AO Surgery Reference content.

“AO Surgery Reference in both its online and mobile forms is a living document that is constantly updated as new knowledge becomes available. The advantages of the mobile app are that it is portable and almost

“In just five months, the AO Surgery Reference mobile app has been downloaded 26,088 times.” Tobias Hövekamp, Manager AO Surgery Reference

AO Surgery Reference goes mobileJust-in-time educational tool a hit with surgeons

Annual Report 2010 Education Feature Story

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Prof Rick Buckley delivering the AOTrauma webcast, “Surgery for Displaced Intraaricular Calcaneal Fractures”

Checking sound levels during the “Surgery for Displaced Intraaricular Calcaneal Fractures” webcast


Schelkun said the AO is uniquely positioned to provide the highest quality educational op-portunities for surgeons, and webcast technol-ogy offers an exciting platform to do just that.

“We have the best network of expert surgeon faculty in the world. Our information is well organized, evidence-based, presented in a pro-fessional manner and backed by the latest in adult learning methodology,” Schelkun explained. Pre- and post-course assessments determine practice gaps and participant knowledge levels before and after courses.

Webcast topics are determined by the AOTEC based on input from the surgical community and guidance from AO educationalists, and webcasts are produced with the support of AO Education’s Video Services team. Prof Rick Buckley, head of Orthopedic Trauma at the University of Calgary in Alberta, Canada, delivered the 2010 AOTrauma webcast which included course objectives, a preoperative plan, an overview of soft tissue issues, instru-ments, implants, the surgical procedure with participants’ questions answered throughout and a review of all course elements at the end.

For Prof Thomas Sough, faculty member and consultant orthopedic surgeon at the Univer-sity of Abuja Teaching Hospital in Abuja, Nigeria, traveling 4,000 kilometers to Davos for an hour-long course with an expert AO surgeon was just not an option. But thanks to AOTrauma’s groundbreaking use of live webcast technology—made possible with the support of AO Education—Sough and 174 other surgeons in a similar position were able to participate in the 2010 Davos webcast, “Sur-gery for Displaced Intraarticular Calcaneal Fractures,” without needing to leave home.

Steven Schelkun, Chair AOTrauma Education Commission (AOTEC), said the live webcast of this AOTrauma Davos course was a direct response to surgeons’ needs and represented a new twist on distance learning.

“Surgeons tell us they want short courses fo-cused on topics relevant to their practices. For many, it’s not possible to attend five days of courses, but by offering short, interactive edu-cational encounters, we can give them what they need, when they need it,” Schelkun said. “AO webcasts and webinars are another link in our continual professional development.”

Harnessing technology to teachWebcasts now part of the AO Education continuum

“AO webcasts are another link in our continual professional development.” Steven Schelkun, AOTEC Chair

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“By having rehearsed the surgery with the whole team of operating room personnel and the video production crew, we could offer a seamless, engaging and inclusive educational experience,” Buckley said. “If a webcast par-ticipant garners two or three useful points in a one-hour course, that’s a positive learning experience that will bring participants back for other courses. Continuing professional education is a bit-by-bit climb that occurs over a lifetime, and our webcasts contribute to surgeons’ expanding bases of knowledge.”

In preparing to deliver the live webcast course, Buckley said he had received valuable support from the AO Foundation Video Services team—particularly Video Services Manager Robin Greene.

“Backward planning was an important part of preparing for this webcast because it allowed us to plan everything around what Prof Buckley needed to demonstrate and to ensure that neither he nor the participants were ever distracted by the technical aspects of the webcast delivey during the course,” Greene said. “AO Foundation Video Services is there to be of service to the surgeon while he delivers the course and this, in turn, supports the participants’ learning experience.”

Rudolf Elmer, AO Education Project Manager e-Learning and Visual Media, said a live

“If, by participating in a webcast, I improve my skills just one percent, my patients will benefit greatly.” Prof Thomas Sough, University of Abuja Teaching Hospital

As a member of AOTrauma, Prof Thomas Sough can easily access webcasts from the Specialty website

Surgeons and ORP assisting Prof Rick Buckley during the AOTrauma webcast

story continued...webcast requires up to two months of preparation and on the day of broadcast can involve as many as 15 people—surgeons, Operating Room Personnel (ORP), moderators, camera operators, editors, technicians, and information technology experts—being present in the operating room. “The interactive element, giving participants the opportunity to ask questions about the surgery by using text chat, means participants learn from both the faculty member and from

one another’s questions,” he said. “Webcasts are an increasingly important educational tool because we can reach people all over the world and offer them a valuable, interactive learning opportunity.”

For the 175 surgeons who participated in AOTrauma’s live webcast, “Surgery for Displaced Intraarticular Calcaneal Fractures,” during the 2010 Davos Courses, the new learning platform offers direct benefits.

“I have never performed surgery for displaced intraarticular calcaneal fracture, but at some point I will have patients who need that sur-gery,” Sough said. “If, by participating in a webcast, I improve my skills just one percent, my patients will benefit greatly. I also value the fact that the webcast is available on the AOTrauma website for future reference.”

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Germán Ochoa and Bryan Ashman discuss the AOSpine Curriculum during a planning meeting

Backward planning begins with a spine surgeon in his clinic diagnosing a patient problem


These competencies are used to align four key components (educational plan, faculty develop-ment, resources, and assessment) to ensure that spine specialists’ educational needs are ad-dressed. “Underpinning Curriculum design and delivery are the four AOSpine Principles considered to be the foundation for proper spine management: stability, alignment, biol-ogy, and function.” said AOSpine Asia Pacific Chair Bryan Ashman.

“Since AOSpine is working with AOE, shared approaches are being leveraged and best prac-tices in curriculum development customized to the Specialties’ specific needs,” said Urs Rüetschi, Director of AOE, adding that “the

high-level framework of the Curriculum makes it adaptable to all Specialties.” AOE continues to provide support as implementa-tion gets under way, producing outcome metrics, delivering and supporting online components (eg, assessments and forums), and evaluating data and feedback. Ashman and newly appointed AOSEC Chair Germán Ochoa are leading a dedicated Curriculum group and will work closely with Chairs, Education Directors, and Faculty during pi-lot course implementation in 2011. The data gathered will help finalize the Curriculum for broader dissemination.

Developed over several years and geared to provide spine surgeons with new skills and knowledge throughout their professional lives, the new AOSpine Curriculum for Lifelong Learning is a structured, consistent framework for delivering educational activities based on agreed competencies. The Curriculum kicks off with a slate of twelve pilot events in 2011.

“The Curriculum is the culmination of many years of work and describes what we believe should be delivered based on patient problems, learner needs, and our mission and vision,” said AOSpine International Chair Luiz Vialle and AOSpine Education Commission (AOSEC) Chair (2008–2010) Jeff Wang.

“The basis of our approach to developing the AOSpine Curriculum was the involvement of expert surgeons, educationalists, and target learners,” says AO Education (AOE) Program Developer Mike Cunningham. “By using backward planning, we ensured that all Cur-riculum content is based on the patient prob-lems that spine surgeons must diagnose and manage.”

Competencies identified for each area of pathol-ogy (spinal trauma, degeneration, tumor, de-formity, infection, and metabolic/inflamma-tory/genetic) are the bedrock of the Curriculum.

Lifelong learningAOSpine Curriculum implementation underway

“Underpinning Curriculum design and delivery are the four AOSpine Principles.” Bryan Ashman, AOSpine Asia Pacific Chair

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Markus Rauh, Chairman of the Board of Directors

A talk with Norbert Haas, President of the AO Foundation, and Markus Rauh, Chairman of the AO Board of Directors (AOVA) and CEO

What strategic milestones shaped the de-velopment of the AO Foundation in 2010? Rauh In 2010, we forged ahead with the re-structuring process of our clinical divisions, the Specialties, at the same time as securing core funding and a promising future for our Service Units. We also established a professional Re-search Review Board, and allocated the funding from the previous Research Fund to the clinical divisions and the Academic Council.Haas In developing the Specialties we acted too quickly at times and some fine-tuning is now required, as we have already achieved in the area of research; increasing interdisciplinar-ity means that Specialties cannot be active in research on an individual basis. Clinical divi-sions now formulate common proposals for cen-tral research topics that we focus on and work through in conjunction with external research associations. This process of concentration is providing a significant boost to our efficiency. Start-up grants are being used as a means of attracting younger people to work with the AO Foundation.

Education is an important pillar of the AO Foundation. What recent progress do you see in further education and training? Rauh Education influences the reputation of the entire AO Foundation and we introduced innovative new education projects in 2010. We know very well that the medical education mar-ket has become considerably more competitive over the past few years. Our strategic project “AO Connect,” for instance, will bundle all our further educational activities on a single standardized platform and make them available online. We are pooling our strengths, and mak-ing it possible to significantly improve our task planning and implement the necessary checks of our results. I believe we are becoming even more competitive.

Haas Our major aim is to map the whole clinical system as a series of process flows. While we can already offer this for the operative part, we are working together with partners in the fields of diagnostics, analysis, follow-up examinations and monitoring.Rauh The development of new curricula has always played a fundamental role. Nowadays, it is a question of using modern technology and providing the various elements of the cur-ricula in formats such as blended learning and e-learning, giving learners a broad range of options from which to select the right package to suit their individual circumstances.

Have classical educational formats lost some of their significance? Haas Not at all. We regard the element of per-sonal contact and the furthering of skills that courses bring as highly valuable. Reducing the working hours of junior surgeons also reduces the amount of practical activity they do. One way in which we make up for this is with the “PlayGround,” a sort of fitness trail to improve and train manual dexterity. However, it’s important that we complement our range of courses with lifelong learning elements, and that surgeons are always involved in continu-ing education via the Internet. This adds to the experience they gain through the courses. Our Education Platform plays a key role here; it guarantees that education techniques and services are developed centrally, and ultimately benefit all the Specialties.Rauh Although people wrote textbooks off a long time ago, the demand for them continues to rise and we have once again published a number of volumes. On the other hand, inter-est in videos, which become obsolete relatively quickly, has fallen. These formats are being replaced by services such as webcasts, which move with the times.

“We forged ahead with the restructuring process of our clinical divisions”

Annual Report 2010 Strategy

“Clinical evidence” is a buzzword in the health sector. What is the AO Foundation’s position on this? Rauh Evidence-based research is becoming ever more important and I believe that, with the Clinical Investigation and Documentation Center (AOCID), we have been able to posi-tion ourselves successfully with respect to the competition in this field.

Haas In the future, no new technologies or implants will be licensed or paid for by health insurance funds without the necessary evi-dence. We have the great advantage that new developments, which are initiated by our physicians and worked on in collaboration with our partners in industry, are always accompanied by evidence-based research and clinical documentation right from the start.

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Norbert Haas, President of the AO Foundation

Mr Rauh, what changes or challenges will arise when you transfer your current responsibilities to Rolf Jeker in the new role of Vice-Chairperson?Rauh By combining the role of Vice-Chairperson with the responsibilities of CEO of the orga-nization, we expect to simplify our structures considerably, and to improve cooperation and the information-sharing process between Ex-ecutive Management and the Board of Direc-tors (AOVA). I have had the privilege of serving under five Presidents of this Foundation, and it has always worked well. Now, the system must be further developed and the President who takes over leadership of AOVA must endeavor to structure this heterogeneous group in a clear and forward-looking manner.

To what extent have the clinical divisions succeeded in meeting the requirements of their communities?Haas The efforts that were made to fulfill the needs of their communities may have brought about too much decentralization. As mentioned earlier, we are in the process of remedying this. After all, this is also what the individual employees want—to have the “AO family,” the Foundation, as the overarching unit. Rauh Yes, by depicting ourselves once again as a unit, we have made significant progress in this regard. I believe that the clinical divi-sions AOCMF and AOVET understand their communities’ needs very well. At AOSpine, the involvement of neurosurgeons, a process which has recently proved very successful, has brought about a certain shift in priorities. At AOTrauma, we are only just discovering what exactly the needs of that community are and how we can respond to them.

What are the next steps in the reorganiza-tion announced last year, that sees the Re-gions finding their new Specialties’ home?

Rauh There has been a vast amount of progress and, generally speaking, things have worked well. However, we have been forced to ac-knowledge that, in the case of the very highly developed Regions or Sections such as AO North America and AO Germany, the time is not right for integration into the Specialties, and that key questions still need to be answered before new discussions are held. Haas It was important for us to clarify the role and function of the Foundation. Without a doubt, a lot of work remains to be done in the regional units and in the Specialties. This is an ongoing process, which requires fine-tuning.Rauh Of course, it’s not a case of just fine-tuning everywhere. For example in Europe, where new countries from Eastern Europe have joined us, integrating them into a unit, so that they can have access to appropriate funding and can develop activities, is a major project that we still need to tackle.Haas Cohesion is very important to me—and it is something that is very clear in the Specialties, too—in identifying the AO Foundation as the “parent company” of the Specialties.

Do you think members of AOVA should be independent physicians who do not repre-sent a particular clinical division? Rauh That is a large-scale project that is on our agenda. I am assuming that it will be at least two years before the bylaws are amended. Haas Yes, there will be a retreat in 2011 to dis-cuss the restructuring of AOVA so that a solu-tion can be found for this issue too. As chairman of AOVA and President, I would very much like to take this opportunity to sincerely thank Markus Rauh, not just officially but person-ally, too, for everything he has done for the AO Foundation. He was always available—24 hours a day, 365 days a year—and the AO Foundation owes him a great debt of gratitude. Rauh Thank you very much.

“Cohesion is very important to the AO”Annual Report 2010 Strategy

Rauh There’s also the fact that we have made fundamental changes to our TK System—the Technical Commission. This development and licensing commission was removed from the authority of the Specialties and combined into a service-type unit. Thus we have a clearer leader-ship structure and greater financial transparency.

The new bylaws were approved at the Trustees Meeting. How have these been operating to date?

Rauh Two issues must be emphasized: Firstly, we realized that we might have to make a subsequent amendment to modify slightly the process of directly electing the next President as defined in the bylaws. The second issue con-cerns bolstering the AO Foundation’s clinical leadership. We have taken the first important steps toward meeting this requirement by trans-ferring chairmanship of the Board of Directors (AOVA) to the President and by defining the new role of Vice-Chairperson.

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Your AOSpine Curriculum for Lifelong Learning 9

AOSpine learning activities for spinal trauma focus on

addressing common and critical patient problems. The

competencies below are a guiding framework for the design

and delivery of all our learning activities. Specific learning

outcomes for each activity must be defined according to the

needs of the participants.

CompetenciesKey learning outcomes

1. Resuscitatethepatientaccordingto

ATLS®guidelines

• Maintain the patient’s oxygenation level

• Administer IV fluids to the patient

• Maintain normotension in the patient

• Identify all other injuries

• Prioritize the patient’s injuries

2. Immobilizethespineinapatientwitha

suspectedspinalinjurybeginningatthescene

ofinjuryandduringtheassessmentprocess

• Identify potentially unstable spinal injuries

• Recognize that the unconscious patient may have a spinal cord injury

• Recognize that any movement of the patient can result in neurological injury

• Perform spinal immobilization

• Maintain immobilization during imaging procedures and until stability is proven

3. Examinethepatient• Assess the patient’s motor score

• Assess the patient’s ASIA/Frankel score

• Perform a complete neurological assessment

• Assess the patient for secondary injury

• Identify spinal cord shock

• Consider the prognostic importance of sacral sparing

• Serially re-examine the patient for evolving injury

4. Orderappropriateimaging• Order x-rays, CT, MRI, and other imaging modalities based on indications, limitations, timing,

and availability

• Recognize the radiographic features of spinal instability

• Recognize spinal cord edema and hematoma

5. Classifytheinjuryaccordingtofracture

morphology,instability,andneurologicalstatus• Identify the history and, where possible, the mechanism of injury

• Describe the injury based on an image-based morphological classification

• Recognize spinal instability

• Assess the neurological status and identify neural compression/compromise

• Assess the patient using the injury severity score

6. Applyevidence-baseddecisionmakingtothe

managementofthepatient

• Choose the best operative and nonoperative treatment option for each patient

• Select the treatment based on the available evidence

• Consider the prognosis for neurological deficit

• Recognize limitations of surgery skills and hospital resources

• Refer the patient to another center when appropriate to improve care

7. Reduce/decompress/stabilizeappropriately • Consider and apply strategies to minimize soft-tissue disruption

• Perform reduction techniques

• Perform decompression techniques

• Perform stabilization techniques

• Decide the optimal timing for the intervention

• Recognize regional/junctional differences

• Recognize spinal osteoporosis, if present

• Seek to preserve function at uninjured levels

8. Collaborateintherehabilitationplanforthepatient • Prevent and manage the consequences of neurological deficits

• Recognize the importance of preserving proximal cervical levels in the quadriplegic patient

• Implement a plan aimed at early mobilization

• Collaborate with rehabilitation physicians

• Recognize and address psychosocial issues

• Recognize and address work and family issues

9. Identifyandmanagepostinjuryand

postoperativecomplications

• Consider the potential risks of operative and nonoperative treatment

• Recognize complications as early as possible

• Treat complications promptly

• Correct deformity

• Seek to preserve motion and spinal alignment

AOSpine Curriculum—Spinal trauma

The AOSpine Principles

for Spinal trauma

Stability—Apply biomechanical principles of internal fixation Alignment—Restore normal alignment

Biology—Protect the neural elements and enhance bone healing Function—Preserve motion segments

Your AOSpine Curriculum for Lifelong Learning 11

AOSpine Curriculum—Tumor

All AOSpine learning activities for spinal tumor focus on

addressing common and critical patient problems. The




needs of the participants.

Competencies

Key learning outcomes

1. Recognize the possibility of spinal

tumor in a patient presenting with

common symptoms of spinal pathology

• Recognize that symptoms may be nonspecific but check for localizing signs

• Recognize that a neurological emergency presentation may be the first sign of a spinal tumor

• Identify patients who are at risk for spinal tumor

• Investigate spinal symptoms in cancer patients as early as possible

2. Establish a diagnosis based on

histological verification and plan

appropriate treatment

• Order and interpret blood tests and imaging studies to confirm spinal tumor

• Order or perform a biopsy to obtain a tissue diagnosis

• Recognize that histological findings determine the treatment plan

• Perform local and systemic staging

• Collaborate with medical and radiation oncologists

3. Optimize the physical condition of

the patient before treatment

• Identify and address medical comorbidities, nutritional status, hematological status,

coagulation profile, and prior treatment

4. Recognize the presence or possibility

of spinal instability

• Identify spinal instability from symptoms and imaging

• Anticipate instability following treatment

• Address instability as part of the treatment plan

5. Recommend treatment based on

consideration of benefit vs risk

• Weigh the benefits, risks, and availability of each treatment option

• Consider the impact of each treatment on the timing of others

• Recognize the goals of treatment for primary and metastatic tumors

6. Perform specific surgical interventions • Perform appropriate preoperative planning and interventions

• Anticipate potential intraoperative complications

• Involve other surgical specialists as required

• Plan and implement a reconstruction and stabilization technique based on the

chosen resection method

7. Anticipate and manage postoperative

complications

• Recognize increased risk of wound problems with prior surgery or radiation and with patients

in poor physical condition

• Recognize increased risk of complications during resection and reconstruction

• Address postoperative complications early

• Recognize recurrent disease


for Tumor

Stability—Stabilize pathological instability

Alignment—Restore balance in pathological deformity

Biology—Determine prognosis; collaborate with oncologists Function—Preserve quality of life

10 Your AOSpine Curriculum for Lifelong Learning

AOSpine Curriculum—Degeneration

All AOSpine learning activities for spinal degeneration focus

on addressing common and critical patient problems. The




needs of the participants

Competencies

Key learning outcomes

1. Analyze the patient history and physical

examination findings

• Assess the patient’s pain

• Assess the patient’s disability and quality of life

• Assess the patient’s psychosocial situation and its relevance

• Assess relevant comorbidities

• Recognize abnormal findings in the history, including ‘red flags’

• Perform a comprehensive clinical examination

• Exclude non-spine pathologies

2. Use appropriate diagnostic tools• Order appropriate imaging studies based on the history and physical examination findings

• Use additional diagnostic tools if indicated

• Critically evaluate the use of invasive tests

• Recognize the limitations of each diagnostic tool

• Correlate the diagnostic test results with the clinical findings

3. Use evidence-based decision making

when recommending operative and

nonoperative interventions

• Critically review the benefits and risks of each operative and nonoperative intervention

• Select operative and nonoperative interventions based on the best available evidence and

on the natural history

• Consider the patient’s treatment preferences and expectations

• Consider the psychosocial, cultural, and ethical implications of the recommended treatment

4. Use appropriate nonoperative

treatments

• Initiate appropriate medical and physical treatment, based on available evidence

• Know when to refer – recognize your own limitations

• Recognize the importance of a multidisciplinary approach

5. Select and perform appropriate surgical

procedures for specific indications

• Select the most appropriate surgical procedure for each patient based on the

best available evidence

• Recognize the optimal timing for each surgical procedure

• Select the most appropriate surgical approach

• Ensure an adequate technique is completed for each procedure

• Apply sound biological and biomechanical principles to each procedure

• Consider spinal alignment and spinopelvic parameters

6. Prevent/manage operative and

postoperative complications

• Use measures to avoid preventable complications

• Recognize and manage intraoperative complications

• Identify early postoperative complications and treat promptly

• Identify and treat late-presenting postoperative complications

7. Use outcome measures to assess the

effectiveness of each intervention

• Use validated assessment tools before and after intervention

• Enroll patients in a database and maintain follow up

• Measure and report outcomes as a quality assurance activity

• Continuously assess your clinical judgment and performance


for Degeneration

Stability—Protect adjacent segments

Alignment—Restore balance in degenerative deformity

Biology—Explain the pathogenesis of degeneration Function—Measure outcomes of interventions

the value propositions for the Specialties and the Foundation.

The newly formed AO Research Review Com-mission (AORRC) launches its operations on January 1, 2011, with the primary aim of en-suring the highest possible quality of research supported by the AO Foundation. In order to remain at the cutting-edge of education and to extend the AO Foundation’s competitive-ness, the AO Education Platform was further developed as a body for strategic direction setting in educational initiatives. Operation-ally, AO Education delivered a series of key services and projects, especially in e-learning and blended learning environments.

Strategic projectsThe strategic project to plan, design and implement a single technological platform, which connects all AO stakeholders and employees to both the aggregated knowledge and business processes and applications of the Foundation, progressed significantly in 2010 with the involvement of key contributors

and users. Using a modular approach, building blocks in the areas of membership, education and research will be made available online, starting with a step-by-step rollout mid-2011. The involvement of both the AO Foundation’s Clinical Divisions and Service Units ensures the platform’s clinical relevance and attractiveness to the surgical community, guaranteeing further improvement in the global competitiveness of the AO.

Personnel newsDuring the Lisbon Trustees Meeting in July 2010, Norbert Haas was elected President of the AO Foundation and took over office from Paul Manson. In addition to the Chairman-ship of the Academic Council and the Presi-dential Team, the new President—based on the Bylaws—assumed Chairmanship of the Board of Directors (AOVA) as well, a move which will foster the clinical guidance of the Foundation. Claude Martin Jr joined the AO Executive Management (AOEM) as the new Executive Director of AOTrauma in the last quarter of 2010.

Following on from the strategic initiatives pursued in 2009, in 2010 the AO Foundation has further strengthened its clinical guidance and the relevance of its offerings to and ser-vices for the surgical community. The changes in the Bylaws, which were approved by the Board of Trustees in July 2010, put the clinical leadership on a firm footing (see Governance on pages 48 and 49).

Clinical DivisionsThe 2009 strategic initiative to establish an AOTrauma Specialty—with its full comple-ment of Education, Research and Commu-nity Development commissions—became a restructuring process in 2010, delivering a consistent structure within the international and regional operations. The transition pe-riod for AOTrauma comes to an end at the Board of Trustees meeting in July 2011. Since membership programs are a strategic asset

in understanding and serving the surgical communities’ needs, all of the AO Special-ties bolstered their competitive advantage during the past twelve months: the AOTrau-ma membership program went live, AOSpine simplified existing membership levels while the development of the AOCMF membership network far exceeded expectations and a new AOVET community was officially inaugu-rated.

Service UnitsProgress was made in providing core funding to the AO Foundation’s Service Units in order to secure their role as collaboration partners for the clinical divisions. The strategic goal behind this initiative is to foster an interdis-ciplinary and cross-Specialty approach in education, research and innovation. Across the Service Units, further attention was paid to internal customer focus and to determining

Continued growth of clinical relevance and guidance

Clinical divisions meet stakeholders’ needs through membership programs and collaboration with Service Units

Annual Report 2010 Strategy

1 Norbert Haas takes over the presidency from Paul Manson

2 AOSpine Curriculum for Lifelong Learning

1 2

1 Adrian Sugar hands over the AORRC chair to Mark Markel

2 Chair Education Program (CEP) in Cairo, Egypt

1 2

22 23

AOTrauma Community Development Commission (AOTCDC)

Community Development Manager: Christoph Volz

Chairperson AOTAPCommunity Development Committee

ChairpersonAOTNACommunity Development Committee

Chairperson AOTMECommunity Development Committee

Kamel Afifi

Miles de la Rosa

Cliff Turen

Chairperson AOTEUCommunity Development Committee

Matej Cimerman

ChairpersonAOTLACommunity Development Committee

Juan M Concha

Chairperson: Klaus Dresing

AOTrauma Education Commission (AOTEC)

Chairperson AOTEUEducationCommittee

Chairperson AOTAPEducationCommittee

Representative ORPCommittee

ChairpersonAOTNAEducationCommittee

ChairpersonAOTMEEducationCommittee

ChairpersonAOTLAEducationCommittee

Chairperson: Steve Schelkun

Kodi Kojima

Emanuel Gautier

Bruce Twaddle

Wa’el Taha

Michael Baumgaertner

Martin van Dijen

Education Manager: Clint Miner

AOTrauma International Board (AOTIB)

Regional Chairperson

AOTAP

3 Commission Chairpersons

Chairperson: Michael Wagner

Regional Representatives

AOTNA


AOTME


AOTLA

Regional Representatives

AOTEU

Rami MosheiffHans-Jörg Oestern

Sergio Fernandez Mamoun Kremli Jack WilberPeter Trafton

AOTrauma Transition Research Commission Nikolaus Renner

AOTrauma TransitionEducation Commission Steve Schelkun

AOTrauma Transition Community Development Commission Klaus Dresing

Tadashi Tanaka

Executive Director: Claude Martin

Chairperson AOTEUResearchCommittee

Chairperson AOTAPResearchCommittee

Representatives:

Representative AOTK

ChairpersonAOTNAResearchCommittee

ChairpersonAOTMEResearchCommittee

ChairpersonAOTLAResearchCommittee

Hazem Abdel Azeem

Mauricio Kfuri

Michael Stover

David Helfet

Michael Blauth

Frankie Leung

Chairperson: Nikolaus Renner

AOTrauma Research Commission (AOTRC)

David StephenMark Vrahas

Rodrigo Pesantez Peter Messmer

Research Manager: Philipp Büscher

A year of leadership transformations The year 2010 was a challenging and exciting year for AOTrauma, its regional and international boards and global commissions. Several factors—including the decentralization of key operational decisions and budgets to the five Regions—heightened adjustments, improvements and adaptations for the newly created clinical Specialty, AOTrauma. There was demand to be accountable for the efforts and money spent in areas where the AO Foundation and AOTrauma excel: medical education, research, clinical investigation and documentation. In October 2010, AOTrauma consolidated its management team with Claude Martin Jr, an AO fellowship trained hand surgeon, joining as Executive Director and Christoph Volz as the Community Development Manager. Michael Wagner, Chairperson of the AOTrauma International Board, as well

as its members, regional representatives and commissions continued to provide excellent leadership and steady operational expertise. The AOTrauma Transition Board became the AOTrauma International Board, having established a fully functional clinical Specialty. Nikolaus Renner was nominated by the AOTIB as Chairperson-Elect, and then approved by the Board of Directors (AOVA) in Davos in December 2010.

A stronger presenceAOTrauma is committed to empowering the next generation of trauma and orthopedic surgeons and related health care profession-als, and to driving its academic excellence and community spirit. AOTrauma defines how musculoskeletal trauma professionals can join a distinguished international orga-nization with distinct benefits for potential members and, most importantly, the patients they treat. In fulfilling its mandate, AOTrau-ma integrates its activities very closely with all AO stakeholders. Prudent economic poli-cies, attainable budgets, and member-focused orientation allow it to carry out its principal duties: providing state-of-the-art musculo-skeletal and trauma education, research, and community development.

Building a strong network in Community Development Creating an interactive network that adds value to a community is an important and challenging task. In a year marked by change,

AOTrauma took a bold step and launched its global membership scheme designed to create a stronger and more present network of trauma specialists and collaborators. On September 1, 2010, the membership program went live, introducing valuable and tangible benefits for AOTrauma members. Legacy memberships, including AO Alumni Association with its worldwide Country Chapters, Country Sec-tions, Trustees and others, were incorporated into the AOTrauma membership. Within months of its launch, the community attracted nearly 1,000 new members who were proud to belong to, share and commit to advancing the ideals of AOTrauma and the Foundation.

At the AO Foundation Davos Courses 2010, the impact of change was evident in the lat-est technical developments and innovations showcased by AOTrauma. The year 2011 will be a stimulating year for the AOTrauma mem-bership and community development program as it endeavors to continuously improve— integrating established members into the new program and creating a cross-cultural mix that moves forward to be an active community of excellence.

Making a rapid transition in Education As the new AOTrauma Specialty was matur-ing in 2010, surgeons and ORPs indicated that AOTrauma Education (AOTE) should be: fo-cused on clinical problems; practice relevant; evidence-based; driven by surgeons; adapted to regional content needs; able to leverage

technology; just-in-time; versatile; and taught by the best faculty. In order to deliver these requirements, teams of surgeons and educa-tionalists used the best educational practices in backward planning (beginning with patient problems from expert surgeons as the central method of defining curriculum content) to develop solutions. A new Faculty Develop-ment Program, integrating online activities and discussions, face-to-face microteaching and exercises, and coaching and mentorship, was developed. AOTE accommodated regional differences, addressed time specific needs and global access by way of:

1. E-learning modules: in imaging, radiation hazards, bone healing, and reduction

2. Mobile apps: Müller AO Classification of Fractures and AOTrauma Surgery Refer-ence

3. Educational gaming: Müller AO Classification of Fractures methodology

4. Interactive video: as an educational tool in collaboration with AO Education

5. Webcasts/webinars: for active, live participa-tion of registered participants

6. AOTrauma video library: expansion and con-versions to podcast and download formats

7. Online forums and communities of practice: for registered participants to share cases, clinical problems, and meet experts online

8. Blended courses: offering online modules prior to courses so as to increase hands-on practice and interaction with peers and experts at the course.

AOTrauma—delivers the best patient care in musculoskeletal traumaAnnual Report 2010 AOTrauma

AOTrauma creates a dynamic environment fostering change through its state-of-the-art education and research, and a global interactive community

2524

The next “big ticket item” in ResearchThe goal of AOTrauma Research is to define and implement evidence-based guidelines and to find and introduce new treatment meth-ods. To reach that goal, the Specialty aligns resources and focuses on select research topics.

As efforts continue to be directed towards addressing fragility fractures and fracture fixation in osteoporotic bone, trauma and or-thopedic surgeons are universally concerned about postoperative infections. Despite best practices in antibiotic therapy, pre-operative planning, careful technique, meticulous tis-sue manipulation and wound management, competent fracture fixation can be severely undermined by such an infection. A clinical priority project (CPP) began in 2010 to shed some light on this devastating clinical problem with an expert meeting to corroborate key re-search questions and encourage experienced researchers to propose quality projects. It will take the better part of 2011 to get this CPP—planned for 2012—off the ground.

To gain exposure to clinical problems which may require a dedicated research focus, AO-Trauma organized several regional research forums in 2010. Participating clinicians, re-searchers and other health care profession-

als discussed and identified specific topics for further research studies. This allows AOTrauma Research to be more clinically rel-evant and to bring greater value back to the AOTrauma Specialty and ultimately to patients and surgeons.

Innovative solutions to clinical problems in the TK System In 2010, the TK System concentrated on the thorough definition of clinical problems as compared to technical modifications. Trans-specialty task forces were implemented in biomaterials, thorax/sternum, and cables/cerclage wires. This new approach—screen-ing of ideas for potential application in corre-sponding clinical areas—has made innovation open to unexpected solutions. A prioritization process was set up for optimal use of engineer-ing resources to accelerate development and throughput time. The goal remains to develop universal solutions suitable for relevant clini-cal situations.

TK System highlightsThe 2.4 mm Variable Angle Locking Intercar-pal Fusion Set for posttraumatic medio-carpal collapse after various carpal injuries was in-troduced in 2010. The 2.4/2.7 mm Variable Angle LCP Forefoot/Midfoot System is intend-

Annual Report 2010 AOTrauma

Creating a global interactive network

1 AOTrauma partner, Human Anatomy, shows a 3D model at the Davos Courses

2 Müller AO Classification of Fractures iPhone app

1 2

1

ed for a wide range of trauma and reconstruc-tive indications. The Slipped Capital Femoral Epiphysis Screw Set allows standardized treat-ment options for rare, but significant pediatric problems. The Proximal Femoral Nail Antiro-tation (PFNA) can now be used in conjunction with augmentation using Traumacem V+, a Polymethylmethacrylate(PMMA)-based ce-ment with improved biocompatibility and higher stability compared to standard PMMA. The Expert Tibia Nail is now available in a gentamicin-coated version to reduce the risk of infections. This new concept required an extended approval process with the regula-tory authorities. Existing sets have been en-hanced: the Variable Angle Locking Clavicle Set by medial and lateral plates, the Philos by suture hole options, the LCP Paediatric Hip Set by 130º and 140º plates, and the 3.5 mm LCP Proximal Tibia Set by low bend and high bend versions. In computer-assisted surgery, the Trauma Module 3.0 for 2D fluoroscopy image-based navigation has been completed.

Moving forward with Operating Room Personnel (ORP) AOTrauma ORP held 99 courses in 2010 with 5,555 participants learning AO Principles. In Tunisia, Oman and Kuwait, this was a first-time occurrence. Another twelve ORP events, with

576 attendees, were held in AO Socio Eco-nomic Committee (AOSEC) countries while eight ORP were awarded fellowships of vary-ing durations in Europe.

July 2010 saw the release of the enthusiastically received “Techniques and Principles for the Operating Room” by Matthew Porteous and Susanne Bäuerle. This book was welcomed as a valuable tool for all ORP as well as residents starting careers in orthopedic trauma care. In September 2010, the international AOT ORP task force met for the first time to create a new global AOT ORP curriculum. A first draft of the program focusing on face-to-face teaching, including pre- and post-course assessments, is under development. New teaching methods, including e-learning modules, will be implemented. The entire program will allow ORP interested in trauma to pursue self-directed learning at their convenience.

Twenty-five ORP from 22 different countries were invited to be trained as course faculty. Due to the newly established AO activities for ORP in certain countries, many ORP have only recently become involved with the AO. This education program has been specifically designed to support competent ORP in becom-ing better adult educators.

Evidence-based research

1 Expert meeting on bone infection in Chicago

2 Intercarpal Fusion System

3 AOTrauma ORP interna-tional program editors

2

3

2726

Home to Trauma & Orthopaedics

Final Program

AOTrauma Clinical Priority Program (CPP) workshop

Bone InfectionJuly 23, 2010 Boston, USA

financing its own re-search fellows at the AO Research Institute Davos. During 2010, a fellow who had gained valuable international experience returned home to Latin America to take on a clinical fac-ulty position in Brazil.

Europe: moving forward AOTrauma Europe (AO-TEU) continued to grow in 2010 with further integration of legacy members and alumni. The membership launch was well received by the 2,000 existing members from European countries. At the AOTEU Country General Council Assembly in London in August 2010, a largely decentralized governance structure was recommended as being the best way to proceed and progress. Community Develop-ment, Education and Research officers were nominated and the regional committees of Education and Community Development have been very active throughout 2010.

Europe continued to account for nearly 45% of all AOTrauma course participants, globally. The highlight education events included suc-cessful regional AOTrauma courses in Malta, and a European faculty retreat that provided knowledge exchange and opportunities for collaboration among the faculty and surgeon

communities. Five semi-nars and five cadaveric workshops are planned as special education events in 2011.

Middle East: a cohesive emerging group AOTrauma’s newest re-gion, AOTrauma Middle East (AOTME) became more cohesive and as-sumed a prominent po-sition within AOTrauma International. With Ma-moun Kremli as Chair-person of the Middle East Regional Board, the

first AOTME country chair council convened in Dubai in October 2010 with 13 countries represented. The chairpersons discussed requirements at the country level, how to align the needs and share resources, as well as how to grow the AOTrauma community in the Middle East.

Educational events were held in two new locations, Iraq and Kuwait. The annual regional courses in Dubai received great praise for the quality of the faculty and the best-practices of the educational content. Challenges for the region in 2011 will be demand outstripping supply of educational capacity. Enthusiasm and awareness remain strong in this emerging region for AOTrauma International.

Asia Pacific: good to great! Over 60 AOTrauma Principles, Advances and Specialty courses, including ORP courses, were conducted in the Asia Pacific region (AOTAP) in 2010. Given the growing demand for courses, faculty development is a major focus of AOTAP education development with three education programs for faculty organized last year in Chi-na and South Korea. Varying from four to eight weeks of both face-to-face and asynchronous learning, these programs provided surgeons with opportunities to enhance their knowledge and skills as educators. Additionally during 2010, seven starter fellowships and 21 regional and international fellowships were awarded.

The AOTAP Clinical Research Forum was held in Hong Kong in September 2010 bringing together the region’s research expertise to demonstrate and showcase research work and achievements within the region. Six one-year stand-alone research grants were awarded to support projects dealing with trauma, surgery of the musculoskeletal system and related basic and clinical research.

North America: strong debut for cross-discipline meetings The new multi-specialty meeting, “The Power of Synergy—Working Together for a Stronger Tomorrow,” made a strong debut in Phoenix, Arizona in November 2010. Over 200 surgeons, fellows, residents and exhibi-tors came from all over the world to make contacts and explore the latest approaches from renowned thought leaders and AO North America (AONA) faculty.

Cliff Turen, Chairperson, 2010 AONA meet-ing, said, “Our goal is to bring the Specialties into one cohesive group and to reinforce the unity of purpose within AONA. The inter-active discussions and featured networking opportunities capitalized on the strength of each specialty and encouraged ample discus-sion, thought-provoking ideas and solutions for attendees to apply to their practice.” The exhibit floor hosted participants eager to see the newest products and solutions from top vendors in the industry. “The Magic of Synergy: Challenges in Fracture Care across Disciplines” has already been scheduled for early 2012 in Florida.

Latin America: a stronger presence AOTrauma Latin America (AOTLA) increased its focus on faculty development by intro-ducing three Faculty Education Programs in Mexico, Brazil, and Argentina attended by 45 faculty members and future course chair-persons in the regions. On the organizational side, a new AOTLA chairperson and three members of the AOTLA Regional Board will commence their terms in 2011.

AOTLA supported over 70 educational activi-ties, including courses and conferences (with a budget allocation similar to that of 2009) through careful definition of faculty and efficient operating cost control. Countries like Brazil, Argentina, Mexico, Colombia, Peru, and Chile continued their leadership in edu-cational events, while Columbia and Brazil saw a rise in the number of new AOTrauma members. In recent years, AOTLA began

Regional activities

Annual Report 2010 AOTrauma

1 AOTAP Clinical Research Forum participants in Hong Kong

2 AOTAP Faculty Training Course in South Korea

1 AOTME Chairman Mamoun Kremli presenting at the Lisbon Trustees Meeting

2 AOTEU Cadaver Lab in AMTS, Lucerne, Switzerland

2 2 1 1

28 29

there was overlap between these two parts of the AO Foundation. In particular I would like to mention the debt of gratitude we owe Susanne Bäuerle. Susanne is an incredibly effective liason between AOSEC and AOT and is central to our development of ORP in de-veloping countries. She brings her experience of staff development in AOTrauma to AOSEC, from which we benefit greatly. We are very grateful that AOTrauma recognizes our need and continues to provide support.

What have been the big success stories for AOSEC in the past twelve months?We are now seeing locally recruited and trained medical practitioners in Africa orga-nizing and becoming educators on courses at a local level. This process is also taking place in the same way throughout the Indian subcon-tinent. It is our mission for this evolutionary process to happen in all our Regions, until such time as the AOSEC can withdraw and future training devolves to AOTrauma.

I would like to make a special mention of an event that took place at the 2010 Trust-ees Meeting whereby a large number of the Trustees donated their per diems to AOSEC and in particular to the Malawi fund under the auspices of Jim Harrison. These generous donations made a significant difference and were used to very good effect. Such contribu-tions are always appreciated and provide great benefits in the countries in which AOSEC is

Tell me about your strategic priorities in 2010?This was a watershed year for AOSEC as it saw the end of Paul Demmer’s tenure as Chairper-son, a position that he made his own over his nine years in office. The challenge for AOSEC was to manage this transition, particularly in Africa where Paul had also held the role of Africa representative, and his contacts within the medical and orthopedic communities were invaluable to us. Fortunately we were able to negotiate a transition to this role by Jim Harrison who already has an excellent track record in Malawi, especially in the field of education, while I took over the Chairperson position with a less hands-on role. The orga-nization is also fortunate in gaining Joachin Prein as a member of the AOSEC Committee, thus recognizing the value of his contributions and contacts in his previous capacity as an ex-officio advisor.

Another priority has been to look at where we’ve been, where we are and where we are going. We are considering the winding down of activities where we have been able to hand over financial support and management to or-ganizations such as the East-Central-Southern African Orthopaedic Association (ECSAOA), and this will be an ongoing process. I can also report that we have developed a good working relationship with AOTrauma (AOT) in 2010, particularly with respect to AOTrauma Asia Pacific (AOTAP), resolving situations where

active. We would love to see this noble gesture become an annual occurrence.

Have there been any major disappoint-ments this year?Integrating our activities into the overall AO Foundation financial model is always a challenge. In African countries, for example, it happens that courses get moved from one quarter to another for a variety of reasons. When this happens, particularly toward the end of the financial year, the courses then run the risk of losing their funding. Unfortunately this occurred with three courses last year that were moved to the following year. Obviously we continue to have problems with unstable political situations in Africa and a number of countries in the Asia Pacific Region and it’s not safe for us to bring faculty and equip-ment into these countries in order to deliver courses. As we expand into Francophone West Africa this issue has to be factored in to our planning.

How is the expansion of your mission into West Africa going?Sylvain Turner, a French surgeon, was elected to AOSEC in 2010 to help develop our expan-sion into the Francophone Region of Africa. Sylvain has already done a lot of the ground-work by identifying the key people in the rel-evant countries and putting forward proposals for courses. In the next phase these key people will need to be brought up to speed by attend-

ing courses in Central Africa. They will then be able to go back and plan and deliver courses in their own countries. Developing AOSEC’s operations in West Africa continues to be a strategic priority for us in 2011.

What are your other big plans for 2011?In addition to continuing to provide courses in Central Africa and South East Asia, we are undertaking to finish the AOSEC Manual. Planning for this publication began a num-ber of years ago but changing needs and a requirement to focus on different regions have resulted in an amended plan. We now have new funding and AOSEC is planning to bring this project to fruition. Paul Demmer and I will act as editors and the textbook will focus on delivering good trauma care with limited facilities in developing countries, covering non-operative techniques which are not in-cluded in the existing AO Manual. We will be referencing the operative resources of the online AO Surgery Reference.

What is your message for the network of AO Foundation surgeons?We are grateful for the continuing support of the AO network. We are always eager to know about new projects that surgeons establish in countries in which we operate. We want to ensure that we do not overlap; we are all working for the same cause and with transpar-ency we should be able to avoid duplication and wasting of resources.

Annual Report 2010 AOSEC

AOSEC—2010 was a watershed yearInterview with AO Socio Economic Committee (AOSEC) Chairperson John Croser

1 John Croser, new AOSEC Chairperson

2 AOSEC Chairmanship handover from Paul Demmer to John Croser

21

1 Jim Harrison, new Africa Representative for AOSEC

2 AOSEC ORP Course held in Zambia

Projects AO Asia Pacific

East TimorFijiPapa New GuineaSolomon Islands

Projects Indian and Asian Subcontinent

BangladeshIndiaNepalPakistan

Projects Africa

CameroonEthiopiaGhanaKenya Malawi TanzaniaUgandaZambia

Projects AO Latin America

BrazilMexico

21

30 31

Education—major steps forward A strategic education workshop with repre-sentatives of all key stakeholder groups was held in Rio de Janeiro, Brazil. The goal of the workshop was to set the long-term strategic direction of AOSpine’s educational programs by achieving the following key strategic objec-tives:

• Creating a strategic vision for education• Identifying key factors of change• Developing innovative educational tools

and formats• Working toward positive cultural change,

becoming an even stronger learning organization

• Building stronger learning communities and communities of practice

• Supporting creative, visionary leaders in education

AOSpine CurriculumDevelopment of the AOSpine Curriculum for Lifelong Learning, a significant step for AOSpine, began in 2010. This innovative and sustainable competency-based model puts AOSpine in a position to plan, implement, and measure quality education. Under the guid-ance of Jeffrey Wang and Bryan Ashman, the AOSpine Education Commission drove this project by developing essential competencies for each of the six spinal pathologies—what surgeons need to effectively perform in their practice settings and meet the standards of the profession. This is what drives our edu-cational programs and forms the framework for all educational activities—face-to-face courses, e-learning modules, videos. Work on the Curriculum culminated in December

with a pilot module element included in the Davos Advances Course, featuring pre- and post-course assessments and a faculty support package. The next crucial step will be to roll out the Curriculum globally and gradually integrate all our educational activities. The AOSpine Education Commission (AOSEC), led by recently elected Chairperson Germán Ochoa, will drive this process, integrating input and direction from the regions based on local needs and implementing several curriculum-aligned courses worldwide dur-ing 2011.

Continued growth in AOSpine Community DevelopmentAOSpine’s Community Development mis-sion is to attract spine care professionals to advance AOSpine’s mission. Accomplishments such as the simplification of the Membership Program, the rollout of a more effective com-munications strategy, and the introduction of the Evidence-Based Spine-Care Journal (EBSJ), a new journal with a directive to enhance the quality of evidence in spine; and Scolisoft, an interactive library of adolescent idiopathic scoliosis cases, were instrumental in achieving a 23 percent increase in AOSpine Membership in 2010. In 2011 AOSpine plans to enhance its website—www.aospine.org—in order to provide a valuable and persistent connec-tion for members. The aim is to quickly and smoothly connect members with knowledge that is organized and managed to be used effectively, and to connect them with each other. The community epitomizes the essence of AOSpine, where members can improve pa-tient outcomes through knowledge sharing, collaboration and communication.

Significant accomplishments in 2010The launch of the AOSpine Knowledge Forums, the development of the AOSpine Curriculum and the continuous growth of the community further established AOSpine’s position as the leading global academic community for inno-vative education and research in spine care. In 2011, AOSpine’s innovative drive in educa-tion, research and community development will be reflected at the Global Spine Congress and events worldwide.

Breaking new ground in ResearchAOSpine successfully launched the Knowl-edge Forum concept where working groups lead by key opinion leaders in specific spine pathologies aim to generate and disseminate knowledge by publishing evidence-based recommendations, developing and updating clinical practice guidelines, and performing clinical studies, which will assist all AOSpine members in clinical decision-making. The first Knowledge Forum on tumor was launched in Davos in 2010 focusing on a clinical study to determine predictors of local recurrence and survival in the surgical management of primary tumors of the spine. Moving forward, AOSpine is evaluating the needs and options for the remaining pathologies.

Research—experimentalUp until the end of 2010, more than 30 peer-reviewed papers have been published, and more than 90 articles presented from the Spine Research Network. The Research

Commission decided to continue the success of this Clinical Priority Program with its focus remaining on Intervertebral Disc Degenera-tion and Regeneration.

Research—clinicalScoliosis Research Society (SRS) cooperation project AOSpine initiated a clinical project in conjunc-tion with the Scoliosis Research Society. The goals of this prospective, multi-center study will be to establish the risk of neurological injury related to surgical correction of adult spinal deformity and to identify characteristics associated with increased risk of neurological complications related to the surgery.

Cervical Spondylotic Myelopathy—International Study (CSM-I)The CSM-I study reached a critical milestone: the end of the patient recruitment period. With almost 500 patients, this project is one of the most extensive prospective clinical studies in the field of spine.

World Forum for Spine ResearchThe World Forum for Spine Research (WFSR) was held in Canada in July 2010. This event focusing on intervertebral disc was a signifi-cant success for AOSpine with more than 175 participants who benefitted from the exper-tise shared. Based on the positive feedback and experience of the Montreal WFSR, the AOSpine Research Commission decided to organize another in 2012 in Helsinki, Finland.

AOSpine is composed of surgeons, researchers, ORP, and health care professionals from all continents providing educational, research, consulting, and networking opportunities

AOSpine—the global leader in cutting-edge education and researchAnnual Report 2010 AOSpine

1 Discussions during the World Forum for Spine Research 2010

2 AOSpine Membership

1 The AOSpine International Board

2 AOSpine Curriculum competency-based model

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Ziya Gokaslan

Member No. 10203 Valid to 04/11

A member of AOSpine in North America

Neurosurgeon

EXELLENCE IN SPINE

The AOSpine community—together we lead the improvement in the outcome and cost effectiveness of spine surgery.

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the ongoing development of a successful fellowship program. Continuing into 2011 and with changing political situations in the Region, we will embed the AOSpine brand by rais-ing education standards through widespread ap-plication of the AOSpine Curriculum, expanding the reach of local educational activities and identifying new markets.

North America: raising our profilesAOSpine North America (AOSNA) investiga-tors completed the two year follow-up of 278 patients with cervical spondylotic myelopa-thy (CSM). The comprehensive study, which has garnered several prestigious awards, has contributed key knowledge with impor-tant implications for everyday practice and health policies. A leading academic journal, Spine, published two AOSpine Focus Issues on “Complications” and “Trauma” in 2010. The “Complications” issue outlined major patient safety issues combining formal evidence-based review methods and clinical experi-ences. The “Trauma” issue represented the collective efforts of the Spine Trauma Study Group, summarizing and critically evaluat-ing many of the key controversies related to the management of spinal trauma and cord injury. The revised course curriculum for the Principles of Spine Surgery for Residents will be introduced in 2011. AOSNA will be offer-ing help with the mandatory Maintenance of

Certification required for practicing spine surgeons.

Latin America: a remarkable yearThis year saw the mile-stone of 1,000 members in AOSpine Latin America (AOSLA) reached and a notable increase in educa-tional activities (15 courses and 32 seminars with 1,830 participants). An additional highlight was the gather-ing of 40 delegates from across the region at the Latin American Educa-

tion Meeting where the main objective was to strengthen and improve Faculty teaching skills and to enhance the quality of AOSpine educational activities. Some Regional Officers reached the end of their term giv-ing Osmar Moraes (Chairperson), Ro-berto Postigo (Education Ortho), Marcelo Valacco (Community Development) and Andrés Rodríguez (Spine Centers and Fellows) the opportunity to lead the Re-gion. Looking forward to 2011, AOSLA will implement the AOSpine Curriculum and the AOSpine Principles in a comprehensive program combining an innovative online platform with traditional education activities. In addition the Region will establish faculty and event organizer guidelines to streamline the delivery of educational courses and en-sure roles are clarified. Furthermore, a new Observership Program will be designed to encourage greater collaboration and the ex-change of experience across the Region.

Regional activities

New approved products from the TK SystemIn 2010 the Spine TK introduced several new products, some of which are detailed here. The Matrix System is a non-cervical spinal fixation device intended for use as posterior pedicle screw fixation system (T1-S2/ilium), a posterior hook fixation system (T1-L5), or as an anterolateral fixation system (T8-L5). The new Matrix 5.5 MIS allows placement of can-nulated pedicle screws and the Matrix MIS rod in a mini-open non-visual or percutaneous approach. This system will complement the existing interbody fusion systems as supple-mental fixation for lateral, anterior, posterior or posterior transforaminal fusions using a minimal incision and preserve the soft tissue. The new Prodisc-C Nova is intended to replace a diseased and/or degenerated intervertebral disc of the cervical spine in patients with symptomatic cervical disc disease (SCDD) allowing for the removal of the diseased disc while restoring biomechanical stability and disc height, and providing the potential for motion at the affected vertebral segment. It offers improved MRI and multi-level capabil-ity as well as simple one-step keel cutting. The vertebral body stent (VBS) system is an ex-pandable metal scaffolding that can be inflated from inside a vertebral body, thus addressing the procedural drawbacks of common treat-ment options like vertebro- and kyphoplasty.

Regional activities

Asia Pacific: a year of growth and progressAOSpine Asia Pacific (AOSAP) achieved a membership growth of 40% mainly driven through the Neurosurgeon Engagement Pro-

gram for China and Korea. The region also saw an increase in the number of education events (from 26 to 36) and the number of participants (from 1,780 to 1,860). The East Asia Council and the Regional Board elected new officers, with Bryan Ashman leading the regional board for the next three years. All new officers were inducted, resulting in better succession continuity and program strategies that are better aligned and implemented be-tween region and country councils.

Europe: recognizing diversityWhile building on past successes, by working to ensure strength in each country, the follow-ing highlights in AOSpine Europe (AOSEU)were noted in 2010:• 25 educational events in 18 countries, with

flagship courses in Palermo and Strasbourg• A community of nearly 1,500 members,

guided by a new regional board• The relaunch of a region-wide spine

center network and development of a new research strategy

In 2011, we will leverage deep local relation-ships while developing faculty to ensure con-sistently high quality education; lead the way in implementing the AOSpine Curriculum, innovative e-learning tools and expanded use of wet labs; and ensure our network is a genu-ine community enabling all to get involved.

Middle East and North Africa: achieving critical massThe strategic focus of AOSpine Middle East (AOSME) in 2010 included: planning future ex-pansion from three educational events in 2010 to six in 2011, country chapter regeneration and expansion across the region, while ensuring

Leading the wayAnnual Report 2010 AOSpine

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1 Prodisc-C Nova implant lateral x-ray

2 AOSME Regional Meeting

3 AOSAP Course in Beijing, China

1 AOSAP Chairmenship handover

2 AOSME Course

3 AOSLA Education Meeting in Rio de Janeiro, Brazil

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database containing summary information on published clinical CMF trauma evidence is currently under development and will be offered to members in 2011. The CDC’s first election cycle was in November 2010 and it was determined that, in August 2011, Gregorio Sanchez-Aniceto will succeed Nils-Claudius Gellrich, who has chaired the Commission since its inception in mid-2007.

Fruitful collaborations continueAfter the successful launch of the Clinical Pri-ority Program (CPP) “Imaging and Planning of Surgery” the decision was made to continue the program in 2010 by granting support to seven additional grant applications (out of 13 full grant applications submitted to AOCMF). Overall there are 19 studies in nine countries in both the “Imaging and Planning of Sur-gery” and “Large Bone Defects in Relation to CranioMaxilloFacial Surgery” supported by AOCMF. The AOCMF R&D Commission and the CPP Committee members monitor the ongoing studies on a regular basis and offer advice when necessary. The first publica-tions resulting from supported projects have either been accepted or are being prepared. The planned workshop to be held in 2011 in “Imaging and Planning of Surgery” will pres-ent an ideal opportunity for researchers to share their outcomes with others working in the same or similar fields of interest.

AO Clinical Investigation and Documentation and the AO Research Institute Davos (ARI) continued their AOCMF supported studies. The clinical study on orbital fractures was suc-cessfully launched and patient recruitment continues. In cooperation with ARI, a new call for projects in the area of “Bisphosphonate-

Related Osteonecrosis of the Jaw” is in prepa-ration and will be launched in 2011.

New TK approved productsIn 2010 the CMF TK completed the family of previously developed craniomaxillofacial Ma-trix Systems which are available for midface and neuro procedures with the finalization of the new Matrix Mandible System. The plates in the system have rounded profiles and edges and an improved “angle plate” designed to reduce stress in critical areas. In keeping with previously released Matrix Systems, all screw diameters in the set can be used with all the plates in the system. The Matrix Mandible System will also provide the basis for future developments to continuously ensure state-of-the-art patient care, ie, a preformed (anatomi-cal) reconstruction plate.

Just like its sibling for trauma indications, the new Norian Reinforced Fast Set Putty is a moldable, biocompatible, calcium-phosphate bone cement, with added reinforced fibers, that sets at body temperature. It is indicated for repairing or filling craniofacial defects and craniotomy or augmentation of bony contours of the craniofacial skeleton. To avoid crack-ing during the setting phase caused by dural pulsations, reinforcing fibers were added to the formula of the existing Norian.

Furthermore the new Curvilinear Distraction System is an internal distraction osteogenesis device that gradually advances mandibular fragments along a curved trajectory of dis-traction. It addresses the clinical need for an internal mandible distractor that lengthens the mandible in both vertical and horizontal planes.

Building on last year’s successesDespite the impact of natural disasters and unstable political situations in some parts of the world, the scope of AOCMF educational activities has broadened for the fifth consecu-tive year and major progress has been made on the implementation of a three-year Mid-Term Course Planning process. The development of the AOCMF membership network far ex-ceeded expectations while the AOCMF Clini-cal Priority Program created a high level of awareness and participation within the CMF network with peer reviewed projects of the highest scientific quality well under way.

Defining the best way forward in AOCMF EducationFor the AOCMF Specialty Board, defining the Global Education Strategy during the Miami Education Retreat was a major milestone. Strategic decisions were taken to ensure the quality and relevance of educational offerings by revisiting content offerings; evaluating educational quality on a regional level and conducting pre- and post-course assessment (a pilot was launched by AOCMF North America). AOCMF Education will use new promotional channels (the AOCMF journal, website and associated events) to market their courses. It was further agreed that Operating Room Personnel courses are of high impor-tance to the Specialty and will continue to be offered as part of the education portfolio. Innovation was high on the agenda with the integration of new communication and information technologies seen to be key. A

task force has been mandated to evaluate the integration of e-learning content into AOCMF Principles Courses.

At the AOCMF European Faculty Retreat, faculty development and the implementation of the strategic education priorities within Eu-rope was discussed by 70 European faculty members. A major 2010 landmark achieve-ment was the first AOCMF Neurotrauma course in Davos attended by 33 participants from 16 countries. AOCMF courses worldwide reported another successful year delivering 72 courses for surgeons, ten for ORP and four symposia at national or international congresses, while the number of fellowships remained stable at 29.

Milestone year for the AOCMF membership communityBy April, the community had already exceed-ed its year-end goal of 900 paying members. One month later, we welcomed our 1,000th member. AOCMF also reached the milestone of having its first round of membership re-newals in 2010. Overall, AOCMF achieved a healthy member retention rate of 67% and the year ended with a final tally of 1,333 paying members worldwide.

The successful growth of the AOCMF member network enabled the Community Develop-ment Commission (CDC) to negotiate addi-tional benefits to our members. In July 2010, access to five new scientific journal subscrip-tions was made available. In addition, a new

AOCMF uses modern techniques to achieve successful patient rehabilitation. In 2010, education flourished and membership grew to unexpected levels

AOCMF—a global driving force in innovative education and researchAnnual Report 2010 AOCMF

1 AOCMF Principles Course, Tehran, Iran

2 AOCMF Strategy Retreat, Miami, USA

3 Orbital Course & AOCMF Symposium, Mallorca, Spain

1 The Matrix Mandible System

2 The Curvilinear Distractor

3 AOCMF Faculty Retreat, Montereggione, Italy

4 Paul Manson presenting the AOCMF journal

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AOVET’s mission is to advance the practice of veterinary surgery to improve patient outcomes by promoting experimental and clinical research, education and development

value to its active, contributing members as well as clear and transparent career opportuni-ties for young members. Furthermore AOVET will follow a partnership oriented approach with other scientific societies to further foster its reputation and importance.

Rejuvenation of a communityAOVET is seeking to strengthen its position as a global community of veterinary orthopedic specialists, focused on surgeon education. Therefore, in mid-2010 the AOVET Specialty Board reviewed and redefined the existing AOVET membership scheme with the aim of expanding the network and providing col-leagues worldwide with clear value and im-proved benefits, while maintaining the strong community spirit.

In order to make the AOVET community ac-cessible to young members while preserving the prestigious character of the existing mem-bership, the new program seeks to address the new social and communications needs of these members, without compromising the high value of the existing network. It is focused on a lean and efficient central administra-tion, while making it easier for members to build personal relationships. The new scheme makes a distinction between four categories of members (Affiliate, Active, Ambassador, and Acknowledged), each of which has different

Structural changes forge aheadAOVET has undergone significant changes in 2010. In an effort to expand the value of its network of veterinary surgeons and rejuve-nate the membership, the decision was taken to adopt a new set of guidelines that estab-lished AOVET as an AO Specialty in its own right. These guidelines were submitted to the members of the previous AO Vet Association in November 2010 and, with an overwhelm-ing approval rate of 92%, the new AOVET community was officially inaugurated. As a consequence the original AO Vet Center, as an administrative unit, was closed and integrated into the AOVET Specialty structure. The for-mer Director of the AO Vet Center, Joerg Auer, was thanked for his continuing dedication and commitment to the community over the last several decades by the AOVET International Specialty Chairman Jean-Pierre Cabassu.

In order to determine the future strategic direction of AOVET, the AOVET Specialty Board conducted a strategy retreat in 2010. There, it was decided that going forward the AOVET Specialty will focus on emphasizing its global reach, and multi-specialty character. Furthermore, high quality educational output (CME, faculty development programs, concep-tual teaching with highest quality implants/instruments) will be the key focus. AOVET as a community will aim to deliver significant

1 Faculty and participants Equine Principles Course, Sao Paolo, Brazil

2 AOVET Faculty at Principles Course, La Jolla, USA

Jean-Pierre Cabassu AOVET Chairman

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prerequisites and benefits attached to it. As valued contributors to the AOVET community, existing members have been invited to join the new AOVET membership at the level of an AOVET Ambassador.

Under the auspices of the Community De-velopment Commission, AOVET officially launched the new program in July 2010 at the European College of Veterinary Surgeons congress in Helsinki, Finland. In a few short months since its launch the number of new members has almost doubled while the majori-ty of pre-existing members of the AO Vet group have been transferred to the new AOVET com-munity. One of the principal advantages of this program is the improved educational and professional opportunities offered to members throughout their professional career. It has become clear that web-based communications will have an increased importance in achiev-ing this. In return for their commitment to the AOVET community, our members now have access to several online scientific subscriptions as well as AOVET-specific educational materi-als. In December 2010, AOVET members were given the opportunity to participate in live webcasts of several lectures given during the annual Davos Courses.

Education to lead the wayEducation continues to lead the way as the primary activity for the Specialty with the Education Commission working to create new educational opportunities. There were 23 AOVET courses delivered around the world

in 2010. Of particular note were first time courses launched in Latin America (Brazil) and Asia Pacific. Meanwhile in Europe the time-honored tradition of the annual small and large animal course in France is still flour-ishing after an impressive 22 years. This thrust to increase the number of teaching activities in the Regions continues in 2011 with a soon-to-be-launched first time course in Thailand in 2011, while the AOVET Davos courses will be refreshed with new formats and approaches. The number of courses and participants will be significantly increased within the coming years. Also, the role of AOVET Education as part of the specialist training in several coun-tries worldwide will be fostered.

The AOVET Education Commission is cur-rently working on establishing:• Continuous pre and post course

evaluation worldwide, with quality and relevance of the course objectives and content being of the highest priority

• Faculty development activities• Strategic course planning• AOVET specific Fellowships

The Research and Development Commission was established at the end of 2010 and gaining a veterinary representative in the AO’s exten-sive R&D network is a significant milestone for the AOVET Specialty. The R&D Commission is currently identifying focus fields for future grants and there will be a call for proposals in 2011 for projects with a commencement date in 2012.

1 AOVET Faculty Advances Course, Sao Paolo, Brazil

2 Participants at Principles Course, La Jolla, USA

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AOVET—education leads the wayAnnual Report 2010 AOVET

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The key focus of AO Service Unit activities continues to be on producing new concepts for improved fracture care, delivering evidence-based decision making, guaranteeing rigor-ous concept and product approval as well as timely and comprehensive dissemination of knowledge and expertise. The following eight pages offer insights into the core processes and

Annual Report 2010 Service Units

1 Innovation presentation to the AcC members

2 Discussions during the eCMXI conference, Davos

AO value chain

Education

Exploratory research

Clinical investigation

Clinical work

Approval

Applied/trans lational research

Good news for ARIIn 2010 the AO Research Institute Davos (ARI) published 61 papers with an average impact factor of 2.95. This year was the 10th anniversary of the eCM True Open Access Jour-

nal which received an Impact Factor of 5.378, making it the number one trauma research journal, surpassing 10,000 registered readers, with an average of 6,000 monthly visits, and 3,000 monthly direct links/paper downloads made from PubMed.

Musculoskeletal Regeneration ProgramPolymers. The potential applications of the thermoreversible hyaluronan hydrogel plat-form developed in ARI are investigated in this program. In the field of bone, cartilage and spine repair, the tailored hydrogels could be valuable as injectable cell and drug delivery systems and as a biodegradable antibacterial carrier for controlled delivery of antibiotics.

Stem Cells. A combination of human bone marrow derived stem cells and gene transfer offers huge potential for the repair of trau-matic musculoskeletal injuries. Gene therapy is still in its infancy but some of its perceived negative side effects, such as potential im-munological reactions, could be offset by the immunosuppressive nature of stem cells. In addition, this research has optimized 3D gene transfer in order to obtain the same level of transgene expression, while using less than 5% of the gene vector. This would also reduce any immunological risks. The developed

method could be simply applied within an operating theater.

Intervertebral Disc. Large scale gene expres-sion profiling of human intervertebral disc cells identified new cell surface markers that can potentially be used for targeted delivery of biological agents to the disc. It was found that the expression of these surface markers on human nucleus pulposus cells may vary with aging and/or degeneration grade of the disc. Modulation of these molecules may thus be considered for therapeutic application. Methods have been developed to deliver cell suspensions in the thermoreversible hyaluro-nan hydrogel into large animal discs ex-vivo. Cells embedded in the hydrogel survived well in the disc space, confirming the potential of the hyaluronan hydrogel as a cell carrier.

Bone Defects. The lack of implant neo-vascu-larisation in the treatment of large size bone defects still is an unsolved problem impairing the success of the healing process. Our aim is to develop a pre-cellularized/pre-vascularized implant based on the combination of a syn-thetic scaffold (eg, polyurethane) and autolo-gous cells, both Endothelial Progenitor Cells (EPC) and Bone Marrow Mesenchymal Stem Cells (BMSC), in the presence of autologous growth factors, Platelet Rich Plasma (PRP). The in-vitro studies show that the association of EPC with BMSC within a polyurethane scaffold promotes the formation of tubular structures that are positive for key endothelial cell markers within the 3D implant.

Research and Development The future of trauma research

activities undertaken by the AO Service Units in 2010. Joint projects between AO Service Units and clinical divisions, with a unique Specialty focus, are reported on in the dedi-cated Specialty sections from pages 18–39. An overview of Foundation-wide strategic initia-tives implemented in 2010, can be found on pages 22 and 23.

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Strategically aligned value chain Service Units pursue excellence in patient care

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expert knowledge in the field of traumatic and degenerative disc and cartilage diseases. ARI also hosted the 18th conference of the European Orthopaedic Research Society (EORS) in Davos during the summer. EORS was attended by more than 300 researchers and clinicians and featured a strong scientific program with 100 oral presentations in three parallel sessions, 140 posters and 17 invited keynote lecturers. The presence of ARI and AOTrauma as scientific conference partners underlined the strong position of the AO within orthopedic research and education in Europe.

The AO Research Fund (AORF)In 2010 a total of 90 grant applications re-questing over 8 million CHF in research funding were received. All applications were subject to a rigorous vetting procedure by

an appointed pool of experts, and 22 new projects were approved. The AORF currently supports 32 projects costing 1.8 million CHF. This was the final year in which the AORF was responsible for reviewing the Start-Up Grant applications and making funding de-cisions. According to the AO Foundation’s peer-review policy, from 2011 onward the tasks of reviewing and making funding de-cisions must be strictly separated; thus the AO Research Fund Commission becomes the AO Research Review Commission. This new commission is responsible for implement-ing the centralized peer review process for all research projects supported by the AO Foundation. In addition, it will be respon-sible for launching calls for AO Start-Up Grant applications and administering the approved projects. The decision-making body for the AO Start-Up Grants is the newly established

Academic Council Grant Com-mittee, in which all Specialties as well as the AO Exploratory Research Board are repre-sented. The committee will be chaired by the AO Foundation’s past President.

Berton Rahn Prize AwardEach year the best AORF project is awarded the annual Berton Rahn Prize Award. After a rigor-ous evaluation, Teppo Järvinen of Finland was awarded the 2010 prize for his project


Musculoskeletal Infection GroupThe limited penetration of systemically delivered prophylactic antibiotics to poorly vascularized tissues is a risk factor for the development of infection. In collaboration with the polymer team, an antibiotic loaded degradable hydrogel has been developed and tested that may be applied to an open wound or applied as an implant coating or as filler for dead spaces. The gel continuously delivers effective concentrations of antibiotic upon gel degradation and does not require any removal surgery.

Innovations GroupThe team started a new approach to support onsite continuous education of orthopedic trauma surgeons with an osteosynthesis training kit (OSKIT). This kit does not require a special setup, can be reused and is inexpen-sive. OSKIT permits practice between courses to help develop and maintain a surgeon’s skills and understanding of fundamental principles.

Biomedical Services ProgramBoyko Gueorguiev-Rüegg became Biomedi-cal Services Program Leader in autumn and redefined the research and service work within Biomechanical R&D, Concept De-velopment and Prototyping. Biomechanical testing facilities—with tailored models, set-ups and protocols for a variety of anatomical regions—offer in-situ and ex-vivo experi-mentation to answer clinical questions. State-

of-the-art computer simulations are applied in order to assess biomechanical behavior; these techniques increase the efficiency in terms of time, material and effort for implant optimization and mechanical testing. Concept development solutions for musculoskeletal healthcare are driven by efficiency, simplicity and clinical relevance.

GCTM PreClinical DivisionIn 2010, Global Clinical Trials Management AG (GCTM), PreClinical Division studies conducted included long- and short- term tissue reactions to bone filling materials in cancellous bone and iliac wing defect models, ISO10993-6 studies to test soft tissue reactions to novel implant materials; cartilage regen-eration studies in goats; histological analysis of dental implants; tissue engineering solu-tions for the treatment of long bone defects; a GLP-like study to test osseointegration of novel implant materials; ex-vivo analysis of novel augmentation techniques; and testing of new orthopedic devices. Overall in 2010, 24 projects with a turnover close to 1 million CHF were subcontracted to the ARI which provided the required personnel, facilities, and equipment.

Congress organizationThe Eleventh eCM Conference was held in Davos in June 2010 attracting 150 par-ticipants. The organization into single ses-sions and the 14 highly recognized keynote speakers optimally promoted exchange of

1 Cellular network formation involving both endothelial progenitor cells and bone marrow mesemchymal stem cells

2 Berton Rahn Prize award presentation to Teppo Järvinen

3 Poster evaluation at EORS in Davos, Switzerland

1 Osteosynthesis Training Kit (OSKIT)

2 Poster presentation at EORS in Davos, Switzerland

AO Research Fund Projects support by area:

SubjectNumber of projects

Amount in CHF 1000 %

Biomaterials/Metallurgy 5 277 18.0Biomechanical fixation 1 58 3.8Biomechanical joints 2 121 7.9Bone healing 8 421 27.4Clinical 8 261 17.0Implant development 2 118 7.7Maxillofacial 1 60 3.9Spine 2 90 5.9Tissue reaction 2 78 5.1Transplantation 1 53 3.4 Total 32 1’537 100

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The future of trauma research

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Service orientation in 2010Steps were taken to better serve the AO Specialties and external customers in 2010. All of AO Clinical Investigation and Docu-mentation’s (AOCID) clients are now assigned a dedicated contact person. Further improve-ments were made possible through an AOVA-approved core funding concept and a retainer fee from AOCID’s main industrial partner. The first-ever AOCID customers’ day was so successful that it will now be held annually. AOCID was also recertified (ISO 9001:2008) until 2013.

Supporting the AO Regions The situation for clinical research in China and Latin America was assessed. Awareness of surgeons’ educational needs in these countries incentivized AOCID to develop e-learning modules in the field of evidence-based medi-cine. They are currently in development and surgeons worldwide will benefit from these packages once they are launched.

Notable changes in AOCID personnelDavid Helfet, who molded AOCID into its cur-rent form over the past decade, stepped down as AOCID Chairman to be replaced by Mark Vrahas. In Davos, employee Riitta Schmid retired after 16 years at AOCID.

Certified Study Center concept AOCID was mandated to develop a system for hospitals involved in clinical studies to be certified on behalf of the AO Specialties. Processes were developed, pilot runs were conducted, and a full global launch is slated for 2011.

Clinical Research FellowshipPratik Desai from Florida, USA, became AOCID’s ninth clinical research fellow. Two peer-reviewed publications resulted from his work in Switzerland.

Davos CoursesBesides giving several lectures at the annual courses, AOCID took more than 300 balance measurements at its stand in Davos. The data will be analyzed to see what correlations exist between surgeons’ balance, sporting activity and operating experience.

Studies of note in 2010The SI Screw final report was released. This randomized multicenter trial evaluated the precision of sacroiliac screw placement using computer-assisted navigation compared to the conventional technique.

Studies currently recruiting include the Midfoot Fusion Bolt (MFB), a randomized controlled multicenter study to assess the effectiveness of surgical treatment with MFB in the early stage of diabetic-neuropathic Charcot feet. Orbita3 is a prospective multi-center study to compare the accuracy of orbital reconstruction after fractures of the medial orbital wall and/or orbital floor with preop-eratively preformed versus non-preformed orbital plates.

Twenty-five peer reviewed publications were published in 2010, and over 30 presentations on scientific work currently being conducted by AOCID were given at pretigious international conferences.

Clinical Investigation A leader in evidence-based clinical trials


Collaborative Research ProgramsAO Exploratory Research (AOER) contin-ued the implementation of its consortium funding strategy and its international collaborative research programs (CRPs). In 2010 two open calls for proposals were issued, one of them addressing the clini-cal problem of “Annulus Fibrosus Rupture” (AFR) and the other “Acute Cartilage In-jury” (ACI). Following a thorough screen-ing of pre-proposals and subsequent peer-reviewed full proposals, the AOER program committees selected five AFR and four ACI research partners, respectively. The teams will start working collaboratively with the AO Research Institute Davos (ARI) in 2011 toward solutions to these important clini-cal problems. Together with the already es-tablished CRP “Large Bone Defect Healing (LBDH),” the three AOER programs now address all the AOER focus fields (ie, bone, disc and cartilage repair and regeneration).

Large Bone Defect HealingThe CRP LBDH, which includes seven re-search partners from Canada, Germany, and the US plus two research groups from ARI, started its second funding round in January 2010. The Fifth Annual LBDH Meeting held in September 2010 was hosted by Prof Chris Evans from Harvard Medical School, Boston, US. The venue included an introduction and guided tour of Evans’ research facilities, fol-lowed by progress updates from all research partners. For the first time two well-known experts in the field of bone healing, Prof Thomas Einhorn and Prof Steve Goldstein, were invited as keynote speakers, an addition

to the agenda that was very well received by the LBDH CRP meeting participants. AOER board members Prof Michael Schütz and Prof Steven Buchman, who are assigned by the AOER board to monitor program progress and to provide direction setting, also actively participated in the meeting.

Annulus Fibrosus RuptureThe two year funding of the CRP AFR (which includes five external research partners from Ireland, Japan, the Netherlands, Switzerland and the US and two research groups from ARI) commences in April 2011. The AOER board assigned Prof Brigitte Vollmar and Prof Keita Ito to monitor program progress and to provide direction setting as appropriate.

Acute Cartilage InjuryThe two year funding of the CRP ACI (which includes four external research partners from Germany, Spain and the US and two research groups from ARI) also begins in April 2011. The AOER board assigned Prof Peter Roughley and Prof Takeshi Sawagucchi to monitor pro-gram progress and to provide direction setting as appropriate.

OutlookAOER is hosting its first “Where Science meets Clinics” symposium on September 2–3, 2011, at the Congress Center in Davos, Switzerland. This biennial event provides an international platform for scientists and clinicians to come together and discuss, in a multidisciplinary environment, current issues and novel strate-gies for bone, disc and cartilage repair and regeneration.

Exploratory Research Where science meets clinics

1 Pratik Desai receiving his clinical research fellowship certificate from AOCID Director Beate Hanson

2 Steve Schelkun, AOTEC Chair testing his body balance by V-skiing during the Davos Courses 2010

1 Research network partners in discussion during the LBDH meeting in Boston

2 Presenting research findings during the LBDH meeting in Boston

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Entering new areas in distance educationiPhone apps, interactive videos, blended e-learning modules, and educational online games—the AO Education production teams entered a new era in technology-enabled distance education. In particular the AO-Trauma Education Commission put strategic emphasis on new delivery methods and chan-nels in education. Launched in mid November 2010, the “AO Surgery Reference” iPhone app was downloaded 11,152 times by the end of December while the Müller AO Classification 8,070 times in the same six week period. For the first time in their history the AOTrauma Davos Principles and Advances Courses were delivered with blended online modules to be worked through prior the face-to-face course.

Building an entire curriculum from scratchThe newly installed AO Education Program Development Group was invited by AOSpine to facilitate the building of a completely new curriculum focused on pathologies and differ-ent levels of experience of AOSpine surgeons. With the involvement of surgeons from all of the Regions, representing the diverse clini-cal challenges in spine surgery, AOSpine now owns a competency-based curriculum which allows them to align and build all future edu-cational offerings on a common base. This enables AOSpine to integrate new topics and developments faster and in a highly targeted fashion into future educational activities. In AOTrauma Asia Pacific the newly founded Program Development support rebuilt the pro-gram for education in othogeriatric fracture care and aligned the AOTrauma Principles and Advances Program, adding new blended ele-ments to the established face-to-face events.

Innovation, research, and strategic initia-tivesThe AO Education Platform (the education representatives from all of the AO’s clini-cal divisions under the guidance of the AO Foundation’s President-Elect Jaime Quintero) met twice in 2010. Three new educational re-search initiatives were implemented, focusing on performance improvement measurement, learning patterns of surgeons, and the effi-ciency of technology-enabled education for surgeons. Several projects and initiatives espe-cially dealing with new technologies and new delivery channels were discussed and orga-nizationally aligned between the Specialties. With its mandate to look at mid- and long-term trends, innovations, and developments in medical education, the Education Platform has established its role as an educational think tank and visionary body.

with EGs that define their tasks and projects on the base of their members’ Specialty and experience.

Focus fields and knowledge acquisitionIn addition to the defined EGs, new cross-Specialty Task Forces (TF) were initialized: Looking for ways to improve the treatment of periprosthetic fractures, wiring, cerclage and cable techniques were evaluated by one TF; the CT Database TF evaluated what kind of centrally stored image data and meta-data is necessary for development of surgical techniques, while the Biomaterials TF was appointed to provide a clinical perspective on product development efforts in this area. The TK Experts Symposia are used to screen clinical problems at an early stage in order to expand or limit the indications, trigger further developments and support education by iden-tifying tips and tricks. With the intention of generating a worldwide overview of regional differences, similarities and specific solu-tions, three symposia with the same format and content were held in Asia, Europe and North America. Each involved 40–60 highly experienced surgeons. For the first time a comparison could be made between three different regions.

In 2010 the TK System consolidated its activi-ties to remain one of the key pillars in the AO Foundation’s activities, supporting the AO’s essential role in global knowledge exchange and conveyance of new treatment aspects. More information on the products which were approved in 2010 can be found in the clinical divisions’ chapters.

Fully integrated TK SystemAs planned, the organizational and manage-ment structure of the TK System was changed with particular focus on the integration of the Spine TK into the overall framework. All four AO Specialties are now directly represented in the TK System with Trauma, Spine and CMF having their own Technical Commissions for the approval of products developed with AO’s industrial partners. At the same time collaboration with AO’s clinical divisions and service units intensified and direct communi-cation lines were defined. This generates more efficient use of pre-clinical and clinical research services and ensures the effective integration of new techniques into the edu-cational activities of the AO Specialties. Con-sequently the TK System is now considered a Service Unit. In order to provide optimal services for all groups and individual members of the TK System, new personnel were hired and new responsibilities and roles within the TK management were defined.

Challenges & structural changesWith growing regulatory requirements, product development in the field of medical devices is facing new challenges. This has led the TK System to put more emphasis on the systematic definition of clinical problems and to evaluate its priorities across all medical divisions. The Spine TK already implemented structural changes in 2009: Maintaining the same number of Expert Groups (EGs), the current structure is more effective in treatment-related development and allows for a closer alignment with the producers’ ac-tivities. Following this example the CMF TK replaced its former anatomical differentiation

Education Major new education initiatives

TK System A year of planned change


1 Participants of the Asian TK Experts Symposium 2010 in Shanghai, China

2 Tim Pohlemann (Chairman, right) and Claas Albers at a meeting of the TK Executive Board

1 2

1

1 Blended learning module concept

2 AO Surgery Reference iPhone app

2

Postcourse eLearning

Precourse eLearning

Course

46 47

AOTrauma

AOSpine

AOCMF

AOVET

ARI

AOCID

TK Office

AO Education

Support Units

Board of Trustees

Academic Council (AcC) Board of Directors (AOVA)

Executive Management (AOEM)

AOTrauma International Board

AOSpine International Board

AO CMF International Board

AO VET International Board

AO Exploratory Research Board

AO R&D Committee

AOCID Committee

TK Executive Board

AO Education Platform

Amended Bylaws strengthen the role and authority of the surgeons

With the approval of the amended Bylaws at the Board of Trustees Meeting in Lisbon, the AO Foundation’s Trustees further enhanced the clinical leadership of the organization, which was established by Swiss surgeons more than 50 years ago. The Board of Trustees resolved on the role of the President of the AO Foundation, who will not only chair the Academic Council (AcC) and the Presiden-tial Team as before, but who will—in addi-tion—assume Chairmanship of the Board of Directors (AOVA). In line with the stronger leadership through clinicians, the Presiden-tial Team became the only group authorized to nominate a candidate for the President-Elect to the Nominating Committee.

The role of the former Chairman was changed to the one of a Vice-Chairperson of the Board of Directors. This person will act as an advisor

to the President of the AO Foundation and the Board of Directors in all governance, compliance, business and management matters. Since the role of the Vice-Chairperson is also combined with the tasks and responsibilities of a CEO, this change is expected to further improve the collaboration between Executive Management and the Board of Directors.

Shared Values set standards for employees and officersIn parallel with the Bylaws of the AO Foun-dation, the Board of Trustees approved the Shared Values as behavioral guidelines for all AO employees and officers.

The following pages give an overview of the AO governing bodies and the AO Foundation’s financial development.

Enhancing the clinical guidance of the AO FoundationAnnual Report 2010 Governance

48 49

33%

28%

14%

7%

7%

6% 3% 2%

The new structure of the AO Organization—with its three pillars of the Specialties, Service Units and Support Units—was fully reflected during the whole 2010 financial year.

Financial Overview Overall, the operating result amounted to -26 million CHF in 2010 compared to -22 million CHF in the previous year. With a financial re-sult of 5 million CHF, the net result amounted to -21 million CHF. Consequently, the Founda-tion’s equity decreased 2% to 962 million CHF by the end of 2010.

Operating income increased by 7% versus 2009. It includes the income from the Coop-eration Agreement with Synthes of 56 million CHF (+8% versus previous year) and other third party income amounting to 14 million CHF (+5% versus previous year).

Finance Financial reporting aligned with new organizational structure

Annual Report 2010 Governance

The spending for educational activities had the biggest stake with 33% of total expenses. Overall 618 AO courses took place in 2010 with almost 35,000 course participants globally.

Profit & Loss Statement 2010 2010 Actual AO Total in million CHF

AO Foundation Contribution 82 Cooperation & Support Agreement 56 Contribution Asset Management 5 Change in Reserves 21Third-party Income 14

Total Income 96R&D 27Reference Centers and Fellowships 5Technical Commissions 3Education 32Community Development 6General and Administrative 14Global and Regional Boards 6Others 3

Total Expenses 96

Trauma 263 Spine 115

Operating Room Personnel 107

Craniomaxillofacial 73

Socio Economic Committee 34

Veterinary 26

Total Courses 618Total Course Participants 34,852Total Participant Days 99,709

Others

Global

Gen

CommDev

Edu

Gen

RD

Edu

Expenses by main activity

Education 33% R&D 28% General and Administrative 14% Community Development 7% Global and Regional Boards 7% Reference Centers and Fellowships 6% Technical Commissions 3% Others 2%

Alternative assests

Liquidity

Bonds

Total shares

Financial Assets Portfolio Structurein million CHF

Shares 531 Bonds 177 Liquidity 108 Alternative assets 82

Total 898

AO Financial Overview2009 2010

Variance 10/09

in million CHF abs. abs. abs.

Operating Income 66 70 5Operating Expenses 88 96 9Operating Result -22 -26 -4Financial Result 58 5 -53Net Result 36 -21 -57

Equity per 31.12. 982 962 -21

Full-time Equivalents 2010 year end in %

International* 211 89%Asia Pacific 8 3%Europe* 4 2%Latin America 9 4%Middle East* 1 1%North America 4 1%

Total 237 100%

* International, Middle East and Europe are based in Switzerland

EmployeesThe number of employees increased by ten full-time equivalents (FTEs) versus 2009 and reached a level of 237. Overall 26 employees were fully dedicated to regional activities.

Others

Support Units

Spec

service

Employee Overview (Full-Time Equivalents by year-end)

Service Units 126 Specialties 63 Support Units 43 Others incl. Exploratory Research 5

Total 237

96 million CHF

59%

53%

20%

12%

9%

27%

18%

2%

237 FTE

898 million CHF

AO Course Activities 2010

Operating expenses grew by 10% versus the previous year to 96 million CHF. Taking into account the 10% decrease in spending in 2009 versus 2008, the compounded annual growth rate from 2007 to 2010 is 1%.

Asset Management With an actual return of 0.4% on the underlying financial assets, the financial result was 5.4 million CHF below the benchmark of 3.4%. The total asset value amounted to 898 million CHF by the end of 2010. The underperformance was driven by the negative performance of the Synthes stake, with a 32% share in the portfolio. Excluding the Synthes position, the portfolio achieved a return of 4% well in line with the benchmark. Looking at the Foundation’s portfolio performance since January 2007, the total actual return amounted to -4.2% versus the benchmark of -9.6% for the same period.

50 51

Board of TrusteesThe Board of Trustees is the “AO parliament,” consisting of 165 leading surgeons from around the world, includ-ing ex-officio Trustees. The Trustees approve amend-ments to the charter and elect the members of the Academic Council (AcC). They function as ambassadors for AO in their country or region and communicate the AO philosophy. They transmit AO information to national institutions and other AO surgeons and bring feedback regarding special needs into AO.

Since each Trustee serves for a limited number of years, constant rejuvenation of the Board is guaranteed.

Academic Council—AcCThe Academic Council (AcC) is responsible for the AO Foundation’s medical and scientific goals. Elected by the Board of Trustees, it is supported by four Specialty Academic Councils (SAcCs), specialized steering boards, and other ex-officio members.

Front row, left to right:—Beate Hanson—Rolf Jeker (CEO and Vice Chairperson AOVA from January 1, 2011)—R Geoff Richards—Norbert Haas— Peter Matter (Founding Member)— Thomas Rüedi (Founding Member)

Middle row:—Gregorio Sanchez—Thiam Chye Lim— Hansjörg Wyss (Founding Member)—Tim Pohlemann—Steven Schelkun—Nikolaus Renner— Jaime Quintero— Keita Ito

Back row:—Michel Orsinger (Permanent Guest)—Defino Helton—Ian A Harris —Tobias Hüttl—Jörg Auer—Mark Markel—James F Kellam—Adrian Sugar—Mark Vrahas—Jeffrey Wang

Board of Directors—AOVAThe Board of Directors is responsible for the business conduct of the AO Foundation, ensuring implementa-tion of the goals and proposals of the Academic Council. Its members include a majority of surgeons and non-voting representatives of the AO’s industrial partners.

Front row, left to right:—Jaime Quintero (President-Elect)—Paul Manson (Past-President)—Markus Rauh (Chairman AOVA and CEO)—Norbert Haas (President)— Hansjörg Wyss

Middle row:—Rolf Jeker (CEO and Vice Chairperson AOVA from January 1, 2011) —Pierre Hoffmeyer—Michael Ehrenfeld—Suthorn Bavonratanavech—Luiz Vialle—Roland Brönnimann (Synthes Inc.)—Michael Janssen

Back row: —Michael Wagner—Eric Johnson—Ciro Römer (Synthes Inc.)—Lukas Kreienbühl (COO)—Michel Orsinger (Synthes Inc.) —Urs Weber-Stecher (Minutes)—Jean-Pierre Cabassu

Annual Report 2010 Governance

Governing bodies of the AO Foundation

AO Executive Management—AOEMThe AO Executive Management (AOEM) reports directly to the Board of Directors. It includes the CEO and line managers responsible for operational management within their respective areas.

From left to right:—Rolf Jeker (CEO and Vice Chairperson AOVA from January 1, 2011) —Urs Rüetschi, AO Education— Beate Hanson, AO Clinical Investigation and Documentation—Alain Baumann, AOSpine—Markus Rauh, CEO and Chairman AOVA—Claas Albers, AOTK—Lukas Kreienbühl, COO—Tobias Hüttl, AOCMF and AOVET—Claude Martin, AOTrauma—R Geoff Richards, AO Research and Development

5352

Annual Report 2010 Addresses

AO Head OfficeAO Foundation

Clavadelerstrasse 8

7270 Davos

Switzerland

Phone +41 81 414 28 01

Fax +41 81 414 22 80

[email protected]

www.aofoundation.org

AO Specialties, International Headquarters*

AOTrauma

Stettbachstrasse 6

8600 Dübendorf

Switzerland

Phone +41 44 200 24 20

Fax ++41 44 200 24 21

[email protected]

www.aotrauma.org

AOSpine

Stettbachstrasse 6

8600 Dübendorf

Switzerland

Phone +41 44 200 24 25

Fax ++41 44 200 24 12

[email protected]

www.aospine.org

AOCMF

Clavadelerstrasse 8

7270 Davos

Switzerland

Phone +41 81 414 25 55

Fax +41 81 414 25 80

[email protected]

www.aocmf.org

AOVET

Clavadelerstrasse 8

7270 Davos

Switzerland

Phone +41 81 414 25 55

Fax +41 81 414 25 80

[email protected]

www.aovet.org

*Contact information for Regional Offices can be found on individual Specialty websites

Concept, editing, and layout:

AO Foundation, Communications and Events, Davos, Switzerland

Photography:

AO Foundation, Communications and Events, Davos, Switzerland

Keystone (p 14–15)

Print:

Südostschweiz Print AG, Chur, Switzerland

© May 2011 AO Foundation

This annual report is climate neutral,

compensation through www.climatepartner.com

Certificate No SC2011041203

AO Service Units

AO Research Institute Davos (ARI)

Clavadelerstrasse 8

7270 Davos

Switzerland

Phone +41 81 414 22 11

Fax +41 81 414 22 88

[email protected]

www.aofoundation.org/ari

AO Clinical Investigation and Documentation (AOCID)

Stettbachstrasse 6

8600 Dübendorf

Switzerland

Phone +41 44 200 24 20

Fax +41 44 200 24 60

[email protected]

www.aofoundation.org/cid

TK System

Clavadelerstrasse 8

7270 Davos

Switzerland

Phone +41 81 414 24 70

Fax +41 81 414 22 90

[email protected]

www.aofoundation.org/wps/portal/aotk

AO Education

Clavadelerstrasse 8

7270 Davos

Switzerland

Phone +41 81 414 26 01

Fax +41 81 414 22 83

[email protected]

www.aofoundation.org

54 55

AO Foundation

Clavadelerstrasse 87270 DavosSwitzerland

Phone +41 81 414 28 01Fax +41 81 414 22 80

[email protected]

annual report 2010

Documents