Annual Report 2016 - efort.orgProf. Dr. Jan Verhaar Mr. David Limb Prof. Dr. Jan Verhaar EFORT...

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EFORT Annual Report 2016

Quality Education: A Community Commitment

Annual Report 2016

Annual Report 2016 3

CONTACT

EFORT Head OfficeZA La Pièce 21180 Rolle, SwitzerlandPhone +41 (0)21 343 4400Fax +41 (0)21 343 [email protected]

Table of Contents

MESSAGE FROM THE PRESIDENTS AND SECRETARIES GENERAL 5

GOVERNING BOARD AND ORGANISATION Members of the Executive Board and Executive Committee 6 Work on strategy plan 7 MEMBERSHIP NETWORK 8Cooperation at national level 9 EDUCATIONEOTEP concept 10 LEARNING RESOURCESEFORT Annual Congress 2016 in Geneva: A look back 11 - 12 Fellowship Programmes 13 EFORT Open Reviews, the EFORT Journal and Instructional Lecture Book 14 e-Science 14 EFORTnet and e-Library 15 TOWARDS EUROPEAN STANDARDSNORE (Network of Orthopaedic Registries of Europe) 16 OUTREACHWebsite 17 Orthopaedics Today Europe 18 Social media 18 FINANCIAL STATEMENT/FINANCESAuditor‘s report 20 - 21 Income and balance sheet statements 22 Cash flow and changes in restricted and general funds statements 23 Notes to the financial statements 24 - 39


Message from the Presidents and Secretaries General

Prof. Dr. Jan Verhaar Mr. David Limb

Prof. Dr. Jan Verhaar EFORT President 2016/2017

Mr. David Limb Secretary General

Prof. Dr. Enric Cáceres Palou

Prof. Dr. Enric Cáceres Palou EFORT President 2015/2016

Ass. Prof. Dr. Per Kjaersgaard-Andersen

Ass. Prof. Dr. Per Kjaersgaard-Andersen Secretary General

2016 – Quality Education: A Community Commitment

2016 was the year in which EFORT’s focus was on the final development of the strategic plan for 2016-2018, unveiled at our Congress in Geneva. However it was also the start of the implementation of these plans, work which began directly after the change of the presidency as soon as the meeting was over. Planning and acting in the same year.

The four key areas outlined in the strategic plan for 2016-2018 are Education, Research, European Health Policy and the harmonisation of guidelines and clinical standards. To initiate the development of a clear European Health Policy a successful meeting was organised in July 2016 in Amsterdam, creating the foundation for active policy development with respect to European Affairs.

In the key area of Education we are happy with the progress of the implementation of our planned strategy. Hard work by our Education Committee brought about a framework for structured educational developments. The name given to this education platform is EOTEP – the European Orthopaedic and Trauma Platform. EOTEP should present a clear overview of our available opportunities and resources for those seeking educational advancement in orthopaedics and traumatology including those wishing to advance in their continuing professional development.

Other education initiatives also pressed ahead according to plan: the dissemination of the European curriculum, the creation of a basis for the development of an e-Learning programme and the initial discussion of an accreditation process for subspecialty fellowships. EFORT is proud to have initiated and stimulated these developments and is networking with all other organisations involved or interested in this field.

There has been a significant shift in the state of the Federation’s finances: much earlier than forecast EFORT has turned round its fortunes to recover a very healthy financial basis. Rigorous spending reduction and better contractual agreements, achieving efficient business practices, have all contributed to these encouragingly positive results.

Risks remain - in 2018 the final implementation of MedTech Europe’s code of ethical business practice is coming. EFORT has been active in meetings on this topic, on behalf of our members. We aim to make the experience of lifelong learning more attractive, in the face of industry reducing its financial support for surgeons attending scientific meetings. EFORT attaches enormous importance to the task of supporting orthopaedic surgeons in being able to devote enough time to educational activities, and to having adequate resources for their training and education needs.

This year began not only with the annual transfer of the presidency from Prof. Enric Cáceres-Palou to Prof. Jan Verhaar, but also a change of Secretary General. Mr David Limb succeeded Ass. Prof. Per Kjaersgaard-Andersen, who has fulfilled the duties of this position for a full six years with great dedication and success. Based on his commitment to, and knowledge of, the organisation Ass. Prof. Per Kjaersgaard-Andersen was appointed as Second Vice-President. Mr. David Limb brings to us his experience as Secretary General of BOA and a long history of work in the field of training and education.

Together a committed team is driving the changes approved in our strategy. We would like to take this opportunity to extend our thanks to the membership network, colleagues active in the EFORT Board, committees and subgroups, for their support and drive shown during the past year which has made our achievements possible.

6 Annual Report 2016

Governing Board and Organisation

2016 MEMBERS OF THE EXECUTIVE BOARD

Prof. Dr. Jan Verhaar President NetherlandsProf. Dr. Enric Cáceres Palou Immediate Past President SpainProf. Dr. Önder Aydingöz First Vice President TurkeyAss. Prof. Kjaersgaard-Andersen Second Vice President DenmarkMr. David Limb Secretary General United Kingdom Prof. Dr. Maurilio Marcacci Treasurer ItalyDr. António Cartucho Member at Large PortugalProf. Dr. Klaus-Peter Günther Member at Large GermanyProf. Dr. Leszek Romanowski Member at Large PolandDr. Rene Mihalič Member at Large Slovenia

2016 MEMBERS OF THE EXECUTIVE COMMITTEE

Co-opted Members:

Prof. Dr. Thierry Bégué FranceMr. Michael Benson United KingdomDr. Paulo Felicissimo PortugalProf. Dr. Enrique Gómez-Barrena SpainProf. Dr. Pierre Hoffmeyer SwitzerlandDr. George Macheras GreeceProf. Dr. Bjarne Møller-Madsen DenmarkProf. Dr. Rob Nelissen NetherlandsProf. Dr. Philippe Neyret FranceProf. Dr. Ulrich Stöckle GermanyProf. Dr. Karl-Göran Thorngren SwedenAss. Prof. Dr. João Vide PortugalProf. Dr. Elke Viehweger GermanyProf. Dr. Luigi Zagra Italy

EFORT is the platform organisation working on behalf of Europe‘s national orthopaedic associations, linking with European specialty societies and International societies.

Our aim is to promote the exchange of scientific knowledge and experience in the field of prevention as well as the conservative and surgical treatment

of diseases and injuries of the musculoskeletal system.


Governing Board and Organisation

Produce a curriculum which contains guidance to continue to develop activities in basic education

Implement a process of accreditation and assessment for educational products within the range of EOTEP

WORK ON STRATEGY PLAN

Last year we were reporting work on progress in relation to the strategic plan including respective outputs.

In the developement phase of the European Orthopaedic and Traumatology Education Platform (EOTEP), which aims at offering a framework for educational structure, we noticed the huge variety in Orthopaedics and Traumatology training. Thus a European curriculum was established to try and streamline educational activities and cristallise an educational pathway.

The European Orthopaedic and Traumatology Education Platform (EOTEP) has now progressed and helped to firm the main target audiences: within the physician category, we wish to address a large part for trainees in orthopaedics and traumatology, given that most of the content of the platform is concentrated in general education.

But of course, with the growing use of the platform, it will increasingly address orthopaedics and traumatology surgeons to become be the second largest target group within the physicians.

WHERE WE ARE TODAY: EOTEP – a framework for educational structure

Using Education to Strengthen European Knowledge & Beyond

The EOTP arose from the goals of the EFORT Education Committee because:

• EBOT Exam• Definition of target audience to develop further educational programmes e.g. eLearning

• Paving the way to an EFORT educational path

• European Curriculum

Huge variety of educational

events in Orthopaedics &

Trauma

Streamlining educational activities in

Orthopaedics & Trauma

Leading to unified

assessment system

Reaching out to trainees &

increasingly to surgeons in

specialization

EFORT Strategic Plan 2016‐2018: summary overview

EFORT Head Office | Rolle | Switzerland | March 2016 Click on the image to access the full EFORT strategy presentation

https://www.efort.org/education/educational-courses/

https://www.efort.org/ebotexam

https://www.efort.org/education/elearning/

https://www.efort.org/education/european-curricula/

https://issuu.com/efort_com/docs/efort_strategic_plan_sum_overview_m



Membership Network

NATIONAL MEMBER SOCIETIES

Albania AAOST Albanian Association of Orthopaedic Surgery and Traumatology

Austria ÖGO Austrian Society of Orthopaedics and Orthopaedical Surgery

Belarus BRSMTOS Belarus Republic Scientific Medical Society of Trauma and Orthopaedic Surgeons

Belgium BVOT Belgian Association of Orthopaedics and Traumatology

Belgium SORBCOT Belgian Royal Society of Orthopaedic Surgery and Traumatology

Bosnia and Herzegovina OTSABH Orthopaedic and Traumatology Surgeons Association of Bosnia and Herzegovina

Bulgaria BOTA Bulgarian Orthopaedics and Trauma Association

Croatia COTA/HUOT Croatian Orthopaedic and Traumatology Association

Croatia CrOS Croatian Orthopaedic Society of the Croatian Medical Association

Cyprus CAOST Cyprus Association of Orthopaedic Surgery and Traumatology

Czech Republic CSOT Czech Society for Orthopaedics and Traumatology

Denmark DOS Danish Orthopaedic Society

Estonia ETOS Estonian Orthopaedic Society

Finland SOY-FOA Finnish Orthopaedic Association

Former Yugoslav Republic of Macedonia MAOT Macedonian Association of Orthopaedics and Traumatology

France SOFCOT French Society of Orthopaedic Surgery and Traumatology

Germany DGOU German Society of Orthopaedics and Traumatology

Greece HAOST Hellenic Association of Orthopaedic Surgery and Traumatology

Hungary MOT/HOA Hungarian Orthopaedic Association

Iceland IBF Icelandic Orthopaedic Society

Ireland IOA Irish Orthopaedic Association

Italy SIOT Italian Society of Orthopaedics and Traumatology

Kosovo KSOTS Kosovo Society of Orthopaedics and Trauma Surgeons

Lithuania LSOT/LOTD Lithuanian Society of Orthopaedics and Traumatology

Luxembourg SLOT Luxembourgian Society of Orthopaedics and Traumatology

Malta AOTSM Association of Orthopaedic and Trauma Surgeons of Malta

Montenegro AMOT Association of Orthopaedics and Traumatologists of Montenegro

Netherlands NOV Dutch Orthopaedic Association

Norway NOF Norwegian Orthopaedic Association

Poland PTOiTR Polish Orthopaedic and Traumatologic Society

Portugal SPOT Portuguese Society of Orthopaedics and Traumatology

Romania SOROT Romanian Society of Orthopaedics and Traumatology

Serbia SOTA Serbian Orthopaedic Trauma Association

Slovakia SOTS Slovak Orthopaedic and Traumatologic Society

Slovenia SOA/ZOSZD Slovenian Orthopaedic Society

Spain SECOT Spanish Orthopaedic and Traumatology Society

Sweden SOF Swedish Orthopaedic Association

Switzerland Swiss Society of Orthopaedics and Traumatology (swiss orthopaedics)

Turkey TSOT/TOTBID Turkish Society of Orthopaedics and Traumatology

Ukraine UAOST Ukrainian Association of Orthopaedic Surgeons and Traumatologists

United Kingdom BOA British Orthopaedic Association

ASSOCIATE SCIENTIFIC MEMBERS

Armenia AOTRA The Association of Orthopaedists, Traumatologists and Rehabilitologists of Armenia

Asia Pacific APOA Asia Pacific Orthopaedic Association

Australia AOA Australian Orthopaedic Association

Azerbaijan AAOT Azerbaijan Association of Orthopaedics and Traumatology

Bangladesh BOS Bangladesh Orthopaedic Society

Cameroon CSOST Cameroonian Society of Orthopaedics and Trauma Surgery

Egypt EOA Egyptian Orthopaedic Association

Israel IOA Israeli Orthopaedic Association

Jordan JOA Jordanian Orthopaedic Association

Lebanon LOA Lebanese Orthopaedic Association

Northern Europe NOF Nordic Orthopaedic Federation

Saudi Arabia SOA Saudi Orthopaedic Association

Iran POTA Persian Orthopaedic Trauma Association

EUROPEAN SPECIALITY SOCIETIES AND OTHER COLLABORATING ORGANISATIONS

EBJIS European Bone and Joint Infection Society

EFAS European Foot and Ankle Society

EHS European Hip Society

EORS European Orthopaedic Research Society

EPOS European Paediatric Orthopaedic Society

ESSKA European Society of Sports Traumatology, Knee Surgery and Arthroscopy

EuroSpine EuroSpine – the Spine Society of Europe

FESSH Federation of European Societies for Surgery of the Hand

FORTE Federation of Orthopaedic Trainees in Europe

SECEC European Society for Surgery of the Shoulder and Elbow


Membership Network

COOPERATION AT NATIONAL LEVEL

This year several meetings took place between national member societies and EFORT.

Let us highlight the adopted solution of DGOU (German Society of Orthopaedics and Traumatology) uniting the former 3 German societies into one key contact partner for EFORT. In a meeting of 8 December 2016 the respective Boards declared “Having overcome the issue of an initially desired third German member. The current solution of DGOU membership is recognised as promising from all parties. Communication between German Societies and EFORT Board members is considered as extremely fruitful and positive.”

On the level of European activities, France, Italy, Spain, Germany and United Kingdom met with EFORT with the desire to determine a strategic plan for the development of the joint European affairs project which would stretch over the next 5 years.

Guiding principles were taken out of the EFORT strategy plan. Thus the overarching approach should revolve around Harmonisation of guidelines/standards and Influencing the European Health Policy.

EFORT FORA proved to be again a good way of interacting with our stakeholders. This series of sessions, launched in 2002, aims at organising specific EFORT symposia during the annual congresses of our member National Societies. In recent years the EFORT Fora have enjoyed a very high scientific level and provided an excellent exchange between National Societies and EFORT. Accordingly, the interest in such Fora has grown significantly.

Watch from EFORT Youtube channel: why networking, free papers and new developments at the EFORT Congress will help engage with our membership and bridge disparities in the field of orthopaedics and traumatology.

2016 EFORT Fora sessions

• Dubrovnik, Croatia | 23 April 2015 : Joint-preserving knee reconstruction

• Knokke, Belgium | 29 April 2016 Registry & Quality in Arthroplasty

• Palanga, Lithuania | 13 May 2016 Open fractures

• Varna, Bulgaria| 13 May 2016 Unhappy Hip Replacement

• Lublin, Poland | 23 September 2016 Modern methods and prospects of bone

and soft tissue tumour treatment

• Larnaca, Cyprus | 24 September 2016 Polytrauma

• Coruña, Spain | 29 September 2016 Open fractures: Update in 2016

• Athens, Greece | 14 October 2016 Advances in the Treatment of the Spinal

Injuries

• Belgrade, Serbia | 14 October 2016 Modern Trends in Hip Arthroplasty

• Antalya, Turkey | 26 October 2016 Turkish Arthroplasty Registry

• Porto, Portugal | 28 October 2016 Advances in hip preserving surgery

techniques

• Turin, Italy | 28 October 2016 Surviving polytrauma the first week? How

to manage common problems and pitfalls

https://www.efort.org/wp-content/uploads/2015/06/EFORT_Fora_SEEFORT_2015.pdf

https://www.efort.org/wp-content/uploads/2016/03/EFORT_FORA_Programme_Belgium2016.pdf

https://www.efort.org/wp-content/uploads/2016/05/EFORT_FORA_Programme_Lithuania2016.pdf

https://www.efort.org/wp-content/uploads/2016/05/EFORT_FORA_Programme_Bulgaria2016.pdf

https://www.efort.org/wp-content/uploads/2016/06/EFORT-FORA_Poland_2016.pdf

https://www.efort.org/wp-content/uploads/2016/06/EFORT-FORA_Poland_2016.pdf

https://www.efort.org/wp-content/uploads/2016/06/EFORT_FORA_Cyprus_2016.pdf

https://www.efort.org/wp-content/uploads/2016/07/EFORT_FORA_Spain_2016.pdf

https://www.efort.org/wp-content/uploads/2016/06/EFORT_Fora_Greece_2016.pdf

https://www.efort.org/wp-content/uploads/2016/06/EFORT_Fora_Greece_2016.pdf

https://www.efort.org/wp-content/uploads/2016/06/EFORT_FORA_Serbia_2016.pdf

https://www.efort.org/wp-content/uploads/2016/06/EFORT_FORA_Turkey_2016.pdf

https://www.efort.org/wp-content/uploads/2016/07/EFORT_Fora_Portugal_2016.pdf

https://www.efort.org/wp-content/uploads/2016/07/EFORT_Fora_Portugal_2016.pdf

https://www.efort.org/wp-content/uploads/2016/06/EFORT-FORA_Italy_2016.pdf

https://www.efort.org/wp-content/uploads/2016/06/EFORT-FORA_Italy_2016.pdf

https://www.youtube.com/watch?v=dUGC86F74mo


Education

EOTEP CONCEPT

The European Orthopaedics & Traumatology Education Platform is the new tool EFORT has developed as the comprehensive approach for those in search of an educational overview in orthopaedics and traumatology (O&T) and wishing to advance in their professional development. This would include the project to build on the three course types addressing areas such as scientific structure, logistics and financials. As a good example, two pilot programmes were conducted, as shown in the right hand side margin.

With a click of a button, information is generated per type of event, specialty and subspecialty; and perhaps even more importantly by “course constellation,” including frame of partnerships and involved parties, certainly firming the scientific level of the selected events. There was a risk of creating another list of many existing events. EFORT went the extra mile by including the situational dimension of becoming surgeons, making it easy for them to mirror where they possibly stand in their respective curriculum; and moreover, to suggest what can still be accomplished.

Reaching out to whom? Prof. Dr. Klaus-Peter Günther, chairman of the EFORT Education Committee declared in a recent interview that the wish was to address several stakeholders: physicians, national and specialty societies, health politicians and industry.

It is important for EFORT to let transpire the partnership vision with national and specialty societies and to give both, societies having their own structures and those who will see the EOTEP as a source of inspiration to structure educational endeavors, as an opportunity to join the dynamism of the exchange in the field of cross-border lifelong learning.

EU Health politicians are part of organisations responsible to shape medical education. They try to establish standards in orthopaedics and traumatology through the accreditation of programs. The European Orthopaedics & Traumatology Education Platform should be the tangible demonstration that harmonisation within education is on its way, but will request more funding.

As for industry, they organise many of their own courses, with good reason, toward the effective use of their implant products. However, the EOTEP tackles the educational need differently and covers the full array within O&T through a more neutral approach. We believe that this unbiased perspective preparing the becoming surgeons is of vetted interest for those companies aware of differentiated use of prosthesis and innovation. In the quest of these different levels of education, we wish to convince industry to grant more funding for these programs and support safe use for implant technology.

Let us not forget that surgical technical aspects within the musculoskeletal field also need to cover basic science and conservative treatment fostering a general approach able to support a safe application of medical treatment. This requires the industry to support activities in a broader sense.

The first European orthopaedic Summer School was held in Faro, Portugal from 22 to 26 August 2016. This event, developed by FORTE received the scientific support from EFORT.

EFORT and the Polish Society of Orthopaedics and Traumatology announced the first Orthopaedic Convention for Eastern Europe, which was held from 03 to 05 November 2016 at the Congress and Teaching Centre of the Poznań University of Medical Sciences in Poznań, Poland.

https://www.efort.org/education/eotep-roadmap/



Learning Resources

“What one needs in life is ambition, a desire to improve, a desire to succeed and passion. ”

— Edurne Pasaban, first woman in the world to climb all 14 of the world‘s peaks over 8,000m

EFORT ANNUAL CONGRESS 2016 IN GENEVA: A LOOK BACK

For its 17TH Annual Congress, EFORT collaborated with swiss orthopaedics to offer attendees a combined programme featuring a wide array of topics, ranging from basic research to areas focused on daily practice and trauma.

In partnership with EFORT, swiss orthopaedics helped develop the scientific programme, particularly by organising many invited sessions and co-chairing the free papers sessions.

As part of its mission to provide attendees with a forum for the state-of-the-art advances in orthopaedics and traumatology, the programme was enhanced by new feature. One such addition was the Congress’ main theme of “Maintaining Activity Through Life”. Many of the sessions focused on this tagline, making it an essential component for EFORT to advocate and keep patients active, mobile and pain-free.

During her keynote presentation, Edurne Pasaban, the first woman to climb all 14 eight-thousander peaks in the world explored the practice of mountain climbing and the importance of maintaining a more active lifestyle. She said that what one needs in life is ambition, a desire to improve, a desire to succeed and passion. “Without passion, you will never arrive anywhere,” she said.

Richard Wallensten, MD, PhD, associate Professor of orthopaedics, Karolinska University Hospital, Stockholm, tackled the training programme for becoming a specialist in orthopaedic surgery in Europe, as well as the current needs of the programme. Attendees of this Erwin Morscher Honorary Lecture, Wallensten said, will learn “more about current problems for the trainees and their mentors, and perhaps have some ideas on how to improve the situation for their own trainees.”

The topic of the Michael Freeman Honorary Lecture was given by Martin Krismer, MD, Professor and chairman of the department of orthopaedics, Innsbruck Medical University, Austria, and addressed the migration of hip implants.

For Alain Farron, MD, now immediate past president of swiss orthopaedics and full professor and chief of the orthopaedics and traumatology service, University Hospital, Lausanne, Switzerland, one of the highlights of this combined congress was the Maurice Edmond Müller honorary lecture delivered by Werner Müller, MD. “Werner Müller will share with us his passion and lifetime activities in the field of knee surgery,” Farron said.

In order to improve the quality of the EFORT Annual Congress and its programmes, surveys are conducted on a regular basis.


Learning Resources

n Indices - average performance: the assessed sessions achieve excellent satisfaction results.

• Satisfaction: How would you rate this session overall?

• Relevance: To what extent do you agree with the following aspects?

“Highly relevant topics for my professional education”

“Useful knowledge for my daily practice”

• Multiplication: To what extent do you agree with the following?

“I will talk about the session’s content with colleagues”

• Quality: How do you rate the scientific programme?

• Format: How do you rate the choice of scientific session formats for delivering information in the most effective way?

0

20

40

60

80

100

2016 2015 2016 2015 2016 20152016 20152016 20152016 2015

82 81

87 83

79 79 80 78 85

83 80 81

n 85 - 100: Excellent result n 70 - 84: Good result n 60 - 69: Result to be monitored n 0 - 59: Result to be improved

n=1,375/1,842 // 1,281/1,697 // 1,361/1,822 // 1,297/1,748 // 1,369/1,831 // 1,361/1,820

Definition based on scaled measurements. Questions are aggregated to KPIs and transformed into indices ranging from 0 to 100.

The survey ran from 27 May to 29 May 2015 and was performed by Fair Control GmbH. The response rate was 11%.

Performance FormatSatisfaction Relevance Multiplication Quality

Click on the image to access the video Meet EFORT

https://www.youtube.com/watch?v=50CbVSsZ_uc&feature=youtu.be



Learning Resources

FELLOWSHIP PROGRAMMES

The EFORT Travelling Fellowship | The Mark Paterson Bone and Joint Journal | EFORT Travelling Fellowship

The EFORT Travelling Fellowship Programmes were held in Austria from 19 to 23 April 2017 in Vienna, Graz, Linz and Krems; and in Poland from 4 to 10 September 2017 in Otwock and Poznan.As a reminder this programme is open to surgeons from European countries selected by their National Association, with the aim to foster exchanges between the travelling fellows and the hosting experts of the inviting nation.

No doubt, that when one reads the shared reports the most cited aspects are gaining of orthopaedic knowledge and making friends with fellow orthopaedic surgeons from all over Europe. We believe that some of the following quotes may motivate surgeons in training to apply for future programmes.

“In the final year of my residency with a lot of questions and unclarity about future in my mind; it was a unique opportunity to meet with other fellows who are in the same position with me and share our ideas, experiences and future plans.” - Nihat Demirhan Demirkıran

“This fellowship was very helpful for me as I was introduced with new method of treatment that I did not had possibilities to see before. I will share the knowledge with colleagues in my department and share this experience with them.” -Edvin Selmani

From 23 May to 3 June 2016, Dr. Daniël De Kam (Nijmegen, The Netherlands), Dr. Ozren Kubat (Zagreb, Croatia) and Dr. Maik Stiehler (Dresden, Germany) attended the Mark Paterson Bone and Joint Journal & EFORT Travelling Fellowship.

Every year three young orthopaedic surgeons are selected to spend two weeks visiting orthopaedic centres of excellence in either the UK or mainland Europe, culminating in attendance at either the EFORT or BOA Congresses. At each centre the Fellows will learn about the specialty work of that unit and will participate in clinical conferences and presentations.

In 2016 the programme took place in the UK and the first place visited was Bristol followed by London and Manchester before concluding with the visit to 17th EFORT Annual Congress in Geneva, Switzerland.

One of the many highlights of the programme was certainly the stay at the Wrightington Hospital, where Sir John Charnley had carried out his pioneering work in the field of total hip arthroplasty. Another exciting moment for the fellows was the visit to the fascinating Charnley exhibition that witnesses the development of modern total joint replacement strategies.

Participants to the Spring Travelling Fellowship, Austria:• Rezeart Dalipi (Macedonia)• Nihat Demirhan Demirkiran (Turkey)• Iershov Dmytro (Ukraine)• JessicaEhne (Sweden)• SergioFigueiredo (Portugal)• Jan Kloc (Slovakia)• KonstantinosKyriakidis (Cyprus)• Mihai Lazar Mioc (Romania)• JakobMerkac (Slovenia)• DarkoMilovanovic (Serbia)• Aurimas Sirka (Lithuania)• Szymon Skwarcz (Poland)• EricSundqvist (Norway)• Stefanvan Vendeloo (Netherlands)

Participants to the Autumn Travelling Fellowship, Poland:• Grigorios Avramidis (Greece)• Ivan Bohacek (Croatia)• Olan Carmody (Ireland)• Sini Hanhisuanto (Finland)• Annika Hättich (Germany)• Lukas Holzer (Austria)• Anna-Helena Kase (Estonia)• Marko Labaš (Croatia)• Jérôme Murgier (France)• Francesco Niccolai (Italy)• Radoslav Petrov (Bulgaria)• Nderim Salihaj (Kosovo)• Jeppe Schjerning (Denmark)• Edvin Selmani (Albania)

Participants to the Mark Paterson Bone and Joint Journal & EFORT Travelling Fellowship 2016• Daniël De Kam (The Netherlands)• Ozren Kubat (Croatia)• Maik Stiehler (Germany)



Learning Resources

EFORT OPEN REVIEWS, THE EFORT JOURNAL AND INSTRUCTIONAL LECTURE BOOK

New this year was the official launch of EFORT Open Reviews (EOR), an open-access journal published by EFORT and The British Editorial Society of Bone & Joint Surgery. The objective is to deliver current, comprehensive information for practicing surgeons and for colleagues undergoing training.

“We will try to do so in a way that is accurate and as succinct as possible. After all, busy surgeons do not have time to read the whole of primary literature to keep abreast of basic research” says the Editor-in-Chief of EFORT Open Reviews, Pierre Hoffmeyer, EFORT past-president and Professor of orthopaedic surgery, head of the Division of Orthopaedics and Musculoskeletal trauma, and chair of the Department of Surgery at the University Hospitals of Geneva.

Further one printed copy is issued for every EFORT Annual Congress. This collection includes manuscripts for all of the Instructional Lectures presented during sessions (replacing the traditional EFORT Instructional Lectures book), in addition to a small selection of high-quality review articles that have been published in EFORT Open Reviews to date.

With EFORT Open Reviews well positioned to take the next big step towards an Impact Factor, the quality of the journal is now more important than ever in order to receive as many citations as possible. Recently EFORT Open Reviews successfully met all PubMed requirements and is now being indexed in PMC.

The publication requires no subscription and features online CME questions and certification. Key sections of the Journal include hip, knee, foot and ankle, shoulder and elbow, wrist and hand, spine, trauma, oncology, children’s orthopaedics, sports injuries and arthroscopy.

E-SCIENCE

The European Federation of National Associations of Orthopaedics and Traumatology (EFORT) has introduced the EFORT e-Science online platform that provides the scientific content from past EFORT Annual Congresses as well as an online course section for the future.

e-Science at a glance (as of 31 December 2016): n 4,557 audio presentations available from last 5 EFORT Annual Congresses n 519,369 viewed presentations since its creation in 2012 | 72,872 visits since its creation in 2012 n 209,370 viewed presentations & 26,925 visits in 2016 (+8.6% annual progression) for an average length of 6 min 16 sec n 69.6% of users from Europe n 30 social media posts on e-Science presentations (on all EFORT social media accounts)

Associate Editors:

n Stephen R. Cannon Oncology

n Manuel Cassiano Neves Paediatrics

n Dishan SinghFoot & Ankle

n Mehmet DemirhanShoulder & Elbow

n Daniel FritschySports & Arthroscopy

n Philippe KopylovHand & Wrist

n Hermes MiozzariKnee

n Ian NelsonSpine

n Ulrich StöckleTrauma

n Luigi ZagraHip

http://www.efortopenreviews.org/


Learning Resources

EFORT AND -LIBRARY: A UNIQUE ORTHOPAEDIC AND TRAUMATOLOGY RESOURCE CENTRE

EFORTnet e-Library content by Congress (in %)

EFORTnet e-Library by Scientific Topic Tree Level1 (in %)

0.0 10.0 20.0 30.0 40.0 50.0 60.0

Orthopaedics

Traumatology

General Topics

Continous Education

Nurse

EFORTnet e‐Library by Scientific Topic Tree Level1 (in %)

Nurse

Continuous Education

General Topics

Traumatology

Orthopaedics

EFORTnet e-Library content by format (in %)

0.00 5.00 10.00 15.00 20.00 25.00 30.00 35.00 40.00 45.00 50.00

Free Papers

Posters

Symposia

Instructional Lectures

Clinical Cases

Speciality Societies

ExMex Expert Sessions

General Education sessions

CRC

Debate Forum

Case Discussions

Evidence Based Medicine

EFORTnet e‐Library content by format (in %)

Evidence Based Medicine

Case Discussions

Debate Forum

CRC

General Education sessions

ExMex Expert Sessions

Speciality Societies

Clinical Cases

Instructional Lectures

Symposia

Posters

Free Papers

0.2%

0.4%

0.3%

0.2%

0.7%

1.2%

2.8%

2.8%

3.4

3.9%

39.6%

44.5%

0.20

4.40%

19.50%

22.1%

53.9%

EFORTnet at a glance (as of 31 December 2016): n 15,047 users (+29.86% annual progression) n 75.3% of users from Europe n 115 countries represented n 17,324 documents available in the e-Library (+13.83% annual progression) n 59,333 visits and 344,132 pages views in 2016 (5.8 page views per visit) n Average length of visit 5 min 30 sec

EFORTnetmembership

From National Society member of EFORT

From an EFORT Associate Scientific Member

From an European Speciality Society Member of EFORT

From other society linked to EFORT

Unknown membership

From National Society

Member of EFORT

28.9%

Unknown membership

31.7%

From an EFORT Associate

Scientific Member

4%

From other Society

linked to EFORT

19.5%

From an European Speciality

Society Member of EFORT

16.3%

EFORTnet users by membership (in %)

Geneva 2016

Prague 2015

London 2014

Istanbul 2013

Berlin 2012

Copenhagen 2011

Madrid 2010

Copenhagen 2011

10%

Madrid 2010

13%

Geneva 2016

14%

Prague 2015

16%Berlin 2012

12%

Istanbul 2013

16%

London 2014

20%

net e

https://efortnet.efort.org


Towards European Standards

NORE (NETWORK OF ORTHOPAEDIC REGISTRIES OF EUROPE)

NORE activities report 2016

The Network of Orthopaedic Registries of Europe (NORE) is a standing committee of EFORT. This platform aims at discussing and educating on the value of implant registries.

In January together with TODBID representatives NORE had the chance to discuss the creation and mini-mal requirements to set up the Turkish arthroplasty register. This opportunity to jointly assist in the set-ting up of a possible new structure which would be linked to all in-hospital patient information including a mandatory scoring system, is a new milestone in NORE’s history. Prof. Dr. Murat Bozkart and NORE’S chair Rob Nelissen coordinate this project.

Further NORE hopes to conclude on minimum variable set and government and/or structure of registries in Europe with an ongoing survey.

Last year’s congress also served as an opportunity for the network to present symposia on the following topics and to increase its visibility:

n Registries and your practice (organised by NORE) | Wednesday 01 June 2016 n NORE interest group meeting (presentation of TOTBID, NJR, Report) | Thursday 02 June 2016 n Lessons Learned From Registries | Wednesday 01 June 2016 n Long-term outcome of total knee arthroplasty including Registry Studies | Wednesday 01 June 2016

The other activities which shaped the 2016 NORE agenda revolved around meetings of the Intervision group with an initial conference call on 06 July, followed by a meeting on 07 September at the EHS annual hip meeting in Munich, during which NORE participated in a panel discussion on Quality of Implants and patient safety.

A roundtable discussion with MedTech Europe with the topic on value real-world data (registries) took place in Brussels on 21 September.

As mentioned earlier in the section of “cooperation at national level” we highlighted the EFORT Fora during the TOTBID annual meeting in Antalya from 26-27 October which focused on “Quality of Implants and Registries”

In preparation to the EFORT Annual Congress in Vienna 2017 the Intervision group met one more time in 2016 to discuss a metal-on-metal survey and other activities to be presented during this upcoming congress.

We hope that with this brief report you will see the value of the platform as an ally to you and your patients improving Value Based Healthcare by evidence based medicine.

Prof. Dr. Rob Nelissen Chairman NORE


Outreach

DemographicsVisits by Gender

Geographical repartition in Europe (in %)

0 10000 20000 30000 40000 50000 60000

Western Europe

Southern Europe(incl. Iberian p.)

Northern Europe(incl. UK ‐ BALTIC)

Eastern Europe

Geo repartition in Europe 2016

Eastern Europe

Northern Europe (incl. UK - BALTIC)

Southern Europe (incl. Iberian Peninsula)

Western Europe

11%

23%

24%

42%

Visits by age (in %)

1 2 3 4 5 6

DemographicsVisits by age

18-24 65+55-6445-5435-4424-34

7.6%

37.9%

25.8%

14.9%

9.4%

4.3%

Visits by gender (in %)

Length of visits (in minutes)

0

50000

100000

150000

200000

250000

300000

350000

Visit duration Less 3 minutes 3‐10 minutes 10‐30 minutes Over 30 minutes

Lenght of visits (in minutes)

Series1 Series2 Series3 Series4 Series5Less than 3 min. 3-10 min. 10-30 min. Over 30 min.

n 2016

n 2015

n 2014

n 2013

n 2012

Male

56%Female

44%

WEBSITE

EFORT Websphere at a glance (as of 31 December 2016): n 567,638 visits in 2016 n Top five visited pages:• Geneva Congress Homepage www.efort.org/geneva2016 (14.8%)• Orthopaedic Event Calendar www.efort.org/event-calendar (13.4%)• Homepage www.efort.org (13%)• Geneva 2016 Scientifc Programme www.efort.org/geneva2016-programme (7.4%)• Vienna 2017 Congress Homepage www.efort.org/vienna2017 (3.20%)

Unique visitors - geographical repartition (in %)

Oceania

1.6%

Europe

53.2%

Africa

2.5%

South America

3%

North America

6.2%

Asia

23.5%

MENA

10%

0

50000

100000

150000

200000

250000

300000

1 2 3 4 5

Unique visitors

2012 2013 2014 2015

108,101

147,901

243,198250,654

Unique visitors (in volume)

2016

240,437


ORTHOPAEDICS TODAY EUROPE

Orthopaedics Today Europe, the official newspaper of EFORT, delivers news on the latest advances in the practice of orthopaedic medicine throughout Europe. It also provides practical, useful and timely coverage of scientific congresses and new surgical techniques.

Orthopaedics Today Europe at a glance (as of 31 December 2016): n 33,949 contacts | 25,660 readers (+ 51.5% / 2015) | 12 issues per year | n 608,354 emails sent in 2016 | 20.7% open rate (2.5% click through) | 51.5% new visits n 534,157 pages views in 2016 | 3,498,542 pages views since creation n Top ten countries: UK IT SP DE FR CH TR GR DK AT n 21.3 pages viewed per visit | Users spend 3 min 12 sec per visit

SOCIAL MEDIA

EFORT has developed a range of short films to showcase its many facets and educational opportunities. The long version of this footage was produced during the 17TH EFORT Annual Congress in Geneva in 2016. The short films and long version are available on the EFORT Youtube channel, with a total of 60 videos.

1,665 followers

(+49.9% year progression)

1,237 tweets

(created in 2013)

2,308 followers


380,276 impressions


(created in 2011)

3,023 members

(+61% year progression)

723,324 post views

(created in 2011)

397 subscribers


74,557 videos views

(created in 2011)

Outreach


NOTES


Financial statements

AUDITOR‘S REPORT



AUDITOR‘S REPORT


Ass. Prof. Per Kjaersgaard-Andersen

EFORT Secretary General

Prof. Dr. Jan Verhaar

EFORT President 2016/2017


BALANCE SHEET STATEMENT

2016 2015

As of 31 December notes CHF CHF

Cash and cash equivalents 3.1 1,611,050 1,474,786

Accounts receivable 3.2 753,436 990,649

Other receivables 3.3 298,577 301,582

Prepaid expenses 109,192 210,813

Total current assets 2,772,255 2,977,830

Tenant‘s guarantee/deposits 7.1 29,120 29,117

Leasehold improvements 3.4 189,476 315,041

Equipment 3.5 19,511 27,959

Intangible assets 3.6 - 43,302

Total non-current assets 238,107 415,419

Total assets 3,010,362 3,393,249

Bank loan 4.1 75,000 75,000

Finance lease liabilities 4.1 31,027 31,027

Congress pre-financing 4.1 - 1,094,265

Accounts payable 159,401 70,535

Other payables 4.2 62,575 192,233

Accruals 4.3 184,797 206,051

Provision 4.5 66,276 37,995

Deferred revenue 4.4 1,846,014 2,406,085

Total current liabilities 2,425,090 4,113,191

Bank loan 4.1 108,821 190,795

Finance lease liabilities 4.1 6,570 40,451

Total non-current liabilities 115,391 231,246

Restricted funds 221,187 -

Total restricted funds 221,187 -

General funds (951,188) 593,724

Result for the year 1,199,882 (1,544,912)

Total general funds 248,694 (951,188)

Total liabilities and reserve funds 3,010,362 3,393,249

INCOME STATEMENT

2016 2015

01 January to 31 December CHF CHF

Membership fees 199,973 152,328

Donations received for education 221,187 -

Education 188,490 124,461

Annual Congress 5.1 5,893,177 1,349,161

Post Graduate Training Programme 5.2 826 61,543

Publications 152,136 34,222

Association management 46,413 25,920

Miscellaneous - 1,704

Net revenues 6,702,202 1,749,339

Personnel 6.1 1,323,412 1,208,271

Administration 6.2 513,833 580,928

Executive Committee 6.3 222,812 174,816

Marketing & communication 6.4 237,744 256,411

Publications 6.5 150,370 78,539

Annual Congress 5.1 2,431,522 542,580

Post Graduate Training Programme 5.2 2,720 38,712

External affairs 6.6 86,069 80,833

Education 6.7 233,117 194,826

Total operating expenses 5,201,599 3,155,916

Operating income/(loss) 1,500,603 (1,406,577)

Interest income 4 1,311

Interest expense (38,914) (25,777)

Foreign exchange loss 6.8 (40,624) (113,869)

Financial loss (79,534) (138,335)

Result before variation of restricted funds 1,421,069 (1,544,912)

Variation of restricted funds (221,187) -

Net income/(loss) 1,199,882 (1,544,912)

22 May 2017

notes



CASH FLOW STATEMENT

2016 2015

As of 31 December notes

CHF CHF

Net income/(loss) 1,199,882 (1,544,912)

Depreciation 182,484 176,561

Change in restricted funds 221,187 -

Financial result 41,035 78,865

Change in provisions 27,189 (61)

Cash flow before change in working Capital

1,671,777

(1,289,547 )

Changes in operating assets and liabilities:

Debtors 238,306 (971,643)

Deposits (3) (8)

Other receivables and prepaid expenses 102,500 (183,425)

Accounts payable 88,865 (75,580)

Other payables (129,658) 100,374

Accruals (21,254) 81,762

Deferred revenue (560,071) 2,406,085

Interests paid (50,568) (14,123)

Cash flow from operating activities 1,339,895 53,895

Purchase of equipment 3.5 (5,169) (5,426)

Interests received 4 1,311

Cash flow from investing activities (5,165) (4,115)

Repayment of loans and finance lease liabilities

(1,198,466)

(97,900)

Proceeds from loans and finance lease liabilities

-

1,056,602

Cash flow from financing activities (1,198,466) 958,702

Net change in cash and cash equivalents 136,264 1,008,482

Balance at 01 January 1,474,786 466,304

Balance at 31 December 1,611,050 1,474,786

Change in cash and cash equivalents 136,264 1,008,482

CHANGES IN RESTRICTED AND GENERAL FUNDS STATEMENT

General Funds

Restricted Funds

Total

2016 CHF

Opening balance at 01 January 2016

(951,188)

-

(951,188)

Result for the year 1,199,882 -

Allocations - 221,187 1,421,069 Closing balance at 31 December 2016

248,694

221,187

469,881

General Funds

Restricted Funds

Total

2015 CHF

Opening balance at 01 January 2015

593,724

-

593,724

Result for the year (1,544,912) - (1,544,912) Closing balance at 31 December 2015

(951,188)

-

(951,188)

22 May 2017 Ass. Prof. Per Kjaersgaard-Andersen

EFORT Secretary General

Prof. Dr. Jan Verhaar

EFORT President 2016/2017



NOTES TO THE FINANCIAL STATEMENTS

General information

The European Federation of National Associations of Orthopaedics and Traumatology (“EFORT”) is an association located in Rolle, Switzerland.

The aim of the Federation is the promotion of the sciences of orthopaedics and traumatology. To accomplish these objectives, the Federation organises European congresses and training programmes, collaborates with universities and other qualified institutions, stimulates basic and clinical research and undertakes any other activity which might be useful in fulfilling its aims. The funds of the Federation may be used only for the aims outlined above.

In 2016 and in 2015, the Federation employed less than 50 full-time equivalent employees.

1. Summary of significant accounting policiesThe principal accounting policies applied in the preparation of these financial statements are set out below.

1.1 Accounting principles

EFORT prepares its accounts in compliance with the policies described in the following notes. Accounting policies applied are in compliance with the Swiss GAAP FER (Swiss Accounting and Reporting Recommendations) 21.

As permitted by Swiss GAAP FER 21, the accounts were prepared in compliance with the conceptual framework, the fundamental recommendations and recommendation 21. The accounts also comply with the article 69a of the Swiss Civil Code.

Information required by Swiss GAAP FER 21 on the performance of the Federation, and not disclosed in the financial report, are included in the annual report.

The financial statements have been prepared under the historical cost convention. The income statement is presented using the classification of expenses by function. The statements are based on economic values and present a true and fair view of the Federation’s assets, financial position and results of operations.

1.2 Foreign currency translation

a) Functional and presentation currency

Items included in the financial statements were measured using the currency of the primary



economic environment in which the Federation operates (‘the functional currency’), which is Swiss Francs (“CHF”). The presentation currency is CHF.

b) Transactions and balances

Foreign currency transactions are translated into the functional currency using the exchange rates prevailing at the dates of the transaction. Foreign exchange gains and losses resulting from the settlement of such transactions and from the translation at year-end exchange rates of monetary assets and liabilities denominated in foreign currencies are recognised in the income statement.

Balances in foreign currency are revalued using the exchange rates prevailing at the dates of closing.

2. Principles of valuation

2.1 Cash and cash equivalents

Cash and cash equivalents include cash, balances in bank accounts, and short-term time deposits with a residual term of less than three months. They are valued at their nominal value.

2.2 Accounts receivable

Accounts receivable are amounts due from parties for services performed in the ordinary course of business. If collection is expected in one year or less (or in the normal operating cycle of the business if longer), they are classified as current assets

These receivables are valued at their nominal values. Credit default risks are accounted for by specific allowances.

2.3 Property, plant and equipment

Property, plant and equipment are valued at purchase cost less any depreciation required by generally accepted accounting principles. Depreciation is charged on a straight line basis over the useful life of the fixed asset. The assets’ residual values and useful lives are reviewed, and adjusted if appropriate, at the end of each reporting period.

Gains and losses on disposals are determined by comparing the proceeds with the carrying amount and are recognised in the income statement.

The useful lives of assets have been determined as follows:Furniture and Equipment 8 years


Fair booth 4 yearsComputers and hardware 4-5 yearsSoftware 4 yearsLeasehold improvements Lease term

2.4 Intangible assets

Computer software

Costs associated with maintaining software programs are recognised as an expense as incurred. Purchased software are capitalised and amortised on a straight line basis over a period their estimated useful lives, which does not exceed 4 years.

Internally developed software costs are capitalised only if the following conditions are met:• software are clearly identifiable;• costs are reliably determinable;• the group has sufficient resources to complete their development;• software bring measurable benefits to the group over the course of several years.

The amortisation of internally developed software starts when the asset is ready for use.

2.5 Impairment of assets

The value of non-current assets is assessed on the balance sheet date for signs of impairment. If there is evidence of any lasting reduction in value, the realisable value is calculated (impairment test). If the book value exceeds the realisable value, the difference is recognised in profit and loss as unscheduled depreciation.

2.6 Provisions

Provisions are recognised if an event in the past gives rise to a justified, likely obligation which is of uncertain timing or amount, but which can be estimated reliably. Provisions are measured on the basis of the estimated amount of money required to satisfy the obligation.

2.7 Trade payables and other liabilities

Trade payables are obligations to pay for goods or services that have been acquired in the ordinary course of business from suppliers. Accounts payable are classified as current liabilities if payment is due within one year or less. If not, they are presented as non-current liabilities.

Trade payables and other liabilities are stated at their nominal values.



2.8 Employee benefits

Wages, salaries, social contributions, paid annual leave, sick leave and other benefits are paid or accrued undiscounted in the year in which the associated services are rendered by employees of the group. Legal or constructive obligations such as bonus are recognised for the amount expected to be paid in the year the services are provided.

EFORT is a member of a collective occupational pension that fully insures the risks with an Insurance Company. This pension scheme is financed by employer and employee contributions.

The economic impact of existing pension schemes on the group is reviewed each year and the related economic benefit or liability recognised. The employer contribution reserves available are recognised as assets. Changes in employer contribution reserves and stated changes in economic impact arising from excess/insufficient cover for pension schemes are recognised in the income statement under personnel expenses.

2.9 Exceptional items

Exceptional items are disclosed separately in the financial statements where it is necessary to do so to provide further understanding of the financial performance. They are material items of income or expense that have been shown separately due to the significance of their nature or amount.

2.10 Revenue recognition

Revenue is recognised when the services are rendered, if the amounts can be measured reliably and if it is probable that the Federation will receive future economic benefits. The main revenue streams of the Federation are Membership fees, Annual Congress income, donations and grants for specific projects.

Membership fees are recognised in the accounting period they relate to.

Annual Congress revenue is composed of registration fees and sponsorship income.

Revenue from sponsorship and registration fees are recognised in the period when the services are rendered. Sponsorship invoiced in advance are deferred in the balance sheet.

Grants and Donations received are recognised based on the percentage of completion of the related project.



2.11 Leasing

Leases in which a significant portion of the risks and rewards of ownership are retained by the lessor are classified as operating leases. Payments made under operating leases (net of any incentives received from the lessor) are charged to the income statement on a straight-line basis over the period of the lease.

The Federation leases certain property, plant and equipment. Leases of property, plant and equipment where the Federation has substantially all the risks and rewards of ownership are classified as finance leases. Finance leases are capitalised at the lease’s commencement at the lower of the fair value of the leased property and the present value of the minimum lease payments.

Each lease payment is allocated between the liability and finance charges. The corresponding rental obligations, net of finance charges, are included in the Finance Lease Liabilities. The interest element of the finance cost is charged to the income statement over the lease period so as to produce a constant periodic rate of interest on the remaining balance of the liability for each period. The property, plant and equipment acquired under finance leases is depreciated over the shorter of the useful life of the asset and the lease term rebates and excluding taxes and value-added taxes.

3.1 Cash and cash equivalents

2016 2015

CHF CHF

Petty cash 4,245 6,766

UBS. EUR account 700,911 90,248

UBS, CHF account 901,197 1,122,828

ZKB, CHF account 4,697 254,945

Total cash and cash equivalents 1,611,050 1,474,786

The decrease in the account with the Zürcher Kantonalbank is explained by the strategy of EFORT to limit the use of the pre-financing facility with the Professional Congress Organiser.

3.2 Accounts receivable

2016 2015

CHF CHF

Receivables from third parties 756,172 994,478

Bad debt provision (2,736) (3,829)

Total accounts receivable 753,436 990,649



3.3 Other receivables

2016 2015

CHF CHF

Withholding tax Italy 254,558 256,685

Receivable from payroll insurance 10,779 2,334

Other receivables from related parties 13,915 -

Other receivables from third parties 19,325 42,563

Total other receivable 298,577 301,582

O.I.C. srl (“OIC”) handled the organisation of the Annual Congress from 2006 to 2011. OIC deducted withholding taxes on Event income by 27.5% for the fiscal year 2006 (for a total amount of CHF 374 thousands) and only 5% for the following years (for a total amount of CHF 546 thousands).

EFORT filed two separate claim of reimbursements for the tax withheld in 2006 of 22.5% and 5% respectively. As Italian Tax Authorities rejected EFORT’s claims, both parties entered into two litigations:

1. Withholding tax of 22.5% - CHF 290 thousands: this litigation is ongoing to the “Corte Suprema di Cassazione” (Supreme Court). In this litigation, EFORT lost in first instance, while gained in second instance. In March 2016, EFORT filed defensive memorials with the Supreme Court. EFORT is now waiting for the fixation of the hearing from the Supreme Court;

2. Withhodling tax of 5% - CHF 83 thousands: the Court did not accept EFORT’s request of reimbursement in both first and second instance. As a consequence, the judgement became final.

In addition, EFORT had not presented other claims of reimbursement for the tax of 5% withheld from 2007 to 2011. Considering the legal limit of 48 months to claim the reimbursement, EFORT wrote-off CHF 630 thousands in 2013, corresponding to the years 2007 to 2011, for CHF 547 thousands, and to the second litigation on the 5% of withholding tax in 2006, for CHF 83 thousands.

The remaining amount of CHF 255 thousands corresponding to the 2013 balance of CHF 290 thousands (EUR 237 thousands), which was revalued at 31 December 2016, is still considered recoverable.



3.4 Leasehold improvements

Office Conference rooms Total

2016 CHF CHF CHF

Purchase value at 01 January 2016 As at 31 December 2016

448,661 448,661

169,607 169,607

618,268 618,268

Accumulated depreciation at 01 January 2016 Depreciation As at 31 December 2016

232,291 86,598

318,889

70,936 38,967

109,903

303,227 125,565 428,792

Net book value at 31 December 2016 129,772 59,704 189,476

Thereof leased assets - 43,713 43,713

2015


448,661 448,661

169,607 169,607

618,268 618,268


151,100 81,191

232,291

33,347 37,589 70,936

184,447 118,780 303,227


Thereof leased assets - 69,733 69,733

The leasehold improvements are depreciated over the term of the lease agreement, 31 August 2018.

3.5 Equipment

Furniture / Equipment

Hardware Total

2016 CHF CHF CHF

Purchase value at 01 January 2016 Additions As at 31 December 2016

16,998 -

16,998

64,880 5,169

70,049

81,878 5,169

87,047


3,694 2,125 5,819

50,225 11,492 61,717

53,919 13,617 67,536


Thereof leased assets 11,179 - 11,179



Furniture / Equipment

Hardware Total

2015 CHF CHF CHF

Purchase value at 01 January 2015 Additions As at 31 December 2015

13,902 3,096

16,998

62,550 2,330

64,880

76,452 5,426

81,878


1,593 2,101 3,694

37,848 12,377 50,225

39,441 14,478 53,919


Thereof leased assets 13,304 - 13,304

3.6 Intangible assets

Software Total

2016 CHF CHF


208,945 208,945

208,945 208,945


165,643 43,302

208,945

165,643 43,302

208,945

Net book value at 31 December 2016 - -

Software Total

2015 CHF CHF


208,945 208,945

208,945 208,945


122,341 43,302

165,643

122,341 43,302

165,643

Net book value at 31 December 2015 43,302 43,302



4.1 Loans and financial lease liabilities

4.1.1 Bank loan

2016 2015

CHF CHF

Bank loan, BCV, current 75,000 75,000

Bank loan, BCV, non-current 108,821 190,795

Total bank loan 183,821 265,795

The bank loan with the Banque Cantonale Vaudoise (“BCV”) was contracted in 2013 in order to finance the offices at the Rolle premises. The loan is reimbursed on a quarterly basis for CHF 18,750. Interests and fees are charged on a quarterly basis and correspond to 3.75%.

In conjunction with the bank loan, EFORT signed an agreement with the Cautionnement Romand in order to guarantee the debt to the BCV. The amount covered is the amount of the bank loan with an upper limit of CHF 540 thousands.

4.1.2 Finance lease liabilities

2016 2015

CHF CHF

Finance lease liabilities, current 31,027 31,027

Finance lease liabilities, non-current 6,570 40,451

Total finance lease liabilities 37,597 71,478

In 2014, EFORT entered into lease agreements for the financing of the furniture and leasehold improvements of the conference rooms at the Rolle offices. The assets and related liabilities were recognised on the balance sheet as the agreements were classified as financial leases.

The assets are disclosed in note 3.4 Leasehold improvements, and 3.5 Equipment.

4.1.3 Congress pre-financing

2016 2015

CHF CHF

Congress pre-financing - 1,082,611

Congress pre-financing - accrued interests - 11,654

Total Congress pre-financing - 1,094,265

In 2015, EFORT entered into a new agreement with the Professional Congress Organizer (“PCO”). The PCO agreed to pre-finance the Geneva Congress that took place in Geneva in June 2016.



The total approved amount was EUR 1,060,000, of which 1,000,000 were withdrawn by EFORT at 31 December 2015, equivalent to CHF 1,082,611.

The pre-financing bears an interest of 2.95% per year which is payable upon reimbursement of the principal amount. At 31 December 2015, EFORT accrued for EUR 10,765 of interests, equivalent to CHF 11,654.

The pre-financing and accrued interests were reimbursed in full in August 2016. As at 31 December 2016, EFORT had not withdrawn any amount available for the Vienna Congress 2017.

4.2 Other payables

2016 2015

CHF CHF

Social security and payroll taxes 33,176 35,743

VAT payable 29,399 156,490

Total other payables 62,575 192,233

4.3 Accruals

2016 2015

CHF CHF

Legal fees 23,000 23,000

Congress accruals 150,309 143,908

Other accruals 11,488 39,143

Total accruals 184,797 206,051

4.4 Deferred Revenue

2016 2015

CHF CHF

Congress sponsoring deferred revenue 1,846,014 2,406,085

Total Congress pre-financing 1,846,014 2,406,085

EFORT invoiced for CHF 1,846,014 for the sponsorship of the Vienna Congress 2017. This amount will be recognised when the services will be rendered in June 2017.



4.5 Provision

2016, CHF Employees related

Total

Opening balance at 01 January 2016 Additions Usage

37,995 66,276

(37,995)

37,995 66,276

(37,995)

Closing balance at 31 December 2016 66,276 66,276

2015, CHF Employees related

Total

Opening balance at 01 January 2015 Additions Usage

41,883 37,995

(41,883)

41,883 37,995

(41,883)

Closing balance at 31 December 2015 37,995 37,995

5.1 Annual Congress

2016 2015

Congress Income Expenses Income Expenses

London 2014 Prague 2015 Geneva 2016 Vienna 2017 Barcelona 2018 Others (Committees)

- 47,571

5,845,607 - - -

19,037 -

2,377,940 31,549

447 2,550

1,349,161 - - - - -

72,563 430,046 38,134

- -

1,477

Total in CHF 5,893,177 2,431,522 1,349,161 542,580

The 2015 Congress in Prague was the last Congress managed under the core PCO contract model. The amounts of CHF 1,349,161 correspond to the guaranteed fees received in 2015.

The 2016 Congress in Geneva was conducted under the provisions of the new mandate contract model. No guaranteed fee was received from the PCO. Income were derived exclusively from the registration fees and sponsorship.



5.2 Post Graduate Training Programme

2016 2015

Course Income Expenses Income Expenses

IC Paris 2015 ExMex Ljubljana IC Paris 2017 Others

- - -

826

- 2,120

570 31

4,972 53,510

- 3,061

14,942 20,616

- 3,155

Total in CHF 826 2,721 61,543 38,712

Indirect costs 10,491 44,505

Total in CHF including indirect costs 826 13,212 61,543 83,217

In 2016, EFORT did not conduct any courses. This was part of the strategy to reduce expenses on one hand and to re-assess the format which should be constructed to match the recently developed curriculum on the other, as explained in the note 7.6 Going concern.

6.1 Personnel

2016 2015

CHF CHF

Salary 1,017,487 1,042,733

Recruitment 650 1,031

Overtime 9,045 1,898

Bonus 98,523 89,900

Vacation 28,166 5,643

Training 2,338 1,294

Other benefits 5,265 2,584

Employees contribution to parking and travel costs (5,896) (5,677)

Reimbursement from insurance companies (37,131) (38,283)

Contribution received from PCO - (107,562)

Total gross salaries 1,118,447 993,561

Social expenses 204,965 214,710

Other personnel costs - -

Total social expenses and other personnel costs 204,965 214,710

Total personnel 1,323,412 1,208,271

In 2015, a contribution for CHF 107,562 was received in compensation of the new position of business development manager. This contribution ceased in 2016.



Reimbursement for CHF 37,131 (2015: CHF 38,283) from insurance companies were received in compensation of sickness and accident of some employees.

6.2 Administration

2016 2015

CHF CHF

Rent and utilities 140,645 155,476

Leasing 36,251 36,251

Telephony and postage 25,874 26,768


Legal fees 12,844 40,711

Audit and accounting fees 115,202 112,035

Other expenses 55,327 88,806

Total administration 513,833 580,928

6.3 Executive Committee

2016 2015

CHF CHF

Professional fees 18,000 1,854

Secretary 47,602 44,721

Travel expenses 146,347 117,252


Total Executive Committee 222,812 174,816

6.4 Marketing & Communication

2016 2015

CHF CHF

CRM database 10,035 12,007

Service & support 14,000 14,000

Portal EFORT net and Public website 141,735 140,238



Total Marketing & Communication 237,744 256,411



6.5 Publications

2016 2015

CHF CHF

Printing & production - 17,468

Write-off of books held for sale 77 49,075

Editor in chief 146,296 -


Total Publications 150,370 78,539

6.6 External Affairs

2016 2015

CHF CHF

Professional fees 29,520 47,046

Marketing - 9,842


Other expenses 3,228 175

Total External Affairs 86,069 80,833

6.7 Education

2016 2015

CHF CHF

Service & support 92,756 47,235



Total Education 233,117 194,826

6.8 Foreign Exchange (Loss) / Gain

In January 2015, the Swiss National Bank (“SNB”) ceased to support the foreign exchange rate CHF/EUR. The foreign exchange rate which was approximately 1.20 at the end of December 2014 dropped to 1.00 immediately after the action from the SNB.

Due to this significant decrease of the EUR against the CHF, EFORT incurred significant revaluation losses of the assets in base currency EUR. The revenue received from the PCO in EUR were translated to a lower amount in CHF for the first semester of 2015. In addition, the Congress Pre-financing loan was contracted in June 2015 when the EUR was almost at the lowest against the CHF. As the EUR strengthened at the end of the year, the revaluation of the liability generated an unrealised loss.



7.1 Pledged assets

The rent of the Rolle offices is guaranteed by a deposit with the BCV for CHF 29,120 (2015: CHF 29,117).

7.2 Pension Fund

The position with the pension fund at the end of the year was a payable of CHF 30,962 (2015: receivable of CHF 31,241). The pension fund is fully insured with an insurance company. The capital ratio is therefore 100%.

7.3 Benefits to the Executive Committees and to the Management

Indemnities paid to the Members of the Executive Committee amounted to CHF 47,602 (2015: CHF 44,720).This amount excludes reimbursements by EFORT of the effective costs incurred by the Members of the Executive Board and other Committees in the normal course of their functions.As permitted by Swiss GAAP FER 21, benefits paid to management are not disclosed.

7.4 Transactions with related parties

Receivables and payables to related parties were disclosed in the relevant notes. Transactions with related parties other than salary and indemnities are disclosed below.The EFORT Foundation was invoiced for CHF 14,082 (2015: CHF 13,008) by EFORT for administration services.

7.5 Lease commitments

EFORT entered into operational lease agreements. The future payment commitments are:

2016 2015

CHF CHF

Printer

Due within one year 7,523 4,596

Due between one to five years 28,560 383

Total printer 36,083 4,979

Furniture

Due within one year 35,888 39,151

Due between one to five years - 35,888

Total furniture 35,888 75,039



Technical equipment

Due within one year - 8,459

Due between one to five years - -

Total technical equipment - 8,459

Total lease commitments 71,972 88,477

7.6 Going concern

With the change of the PCO contract formerly based on a core model, the Geneva congress was not only the first of its kind to be managed under the new format of a mandate contract but also benefitting from the internalisation of the sponsorship portfolio. If in July 2015, EFORT ceased to receive guaranteed income for the organisation of the Annual Congress, the 2016 results linked to the congress management reflects the full integration of the congress budget in its books.

Due to the new revenue recognition and the end of the royalty based model, guaranteed amount of which was recognised as income when invoiced, EFORT managed to fully offset the loss by 2016. This is ahead of the 3 year financial projection 2016-2018 which predicted a return to profitability by the year 2018.

From a cash perspective, the situation is stable given that the business development and subsequent promotional activities contribute significantly to sustainability and a transparent relationship with partners.

In 2016, EFORT was able to fully reimburse the pre-financing facility related to the Geneva congress and as at 31 December 2016, the use of the pre-financing facility for Vienna was not necessary.

In parallel fundraising outside of congress related products has been increased. First results are encouraging and show interest in the education arena with support focusing on fellowship programmes and marketing but also endeavours in e-learning initiatives. This diversified income stream over CHF. 220,000.

With the indirect sponsorship approach as per the MedTech Europe code of ethical business practice and a final implementation by January 2018, great care is required in planning future activities and large scale events. A thorough analysis of congress statistics points out that educational formulas need to be revisited and adapted to societal, political and professional changes. In other words, attendance to healthcare congresses and courses need to be supported by alternative products, tailor-made for members motivating them to join a community and taking into consideration the factors of time, absence and distance.

The 2016 financial statements were prepared under the going concern assumption. The Federation is confident that the measures to restore profitability mentioned above will be realised.

7.7 Subsequent events

From the balance sheet date until the financial statements were approved by the EFORT Board on 22 May 2017 no major events occurred which could adversely affect the validity of the annual financial statements.




NOTES

EFORTAbstract Awards

www.efort.org/barcelona2018

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High quality instructional review articles on all aspects of orthopaedics and traumatology

Available online, open access, at no cost, with no subscription required

All Article Publication Charges waived for members of EFORT-affiliated national associations

A print issue of selected articles is published for each EFORT Annual Congress

The Editor-in-Chief of EFORT Open Reviews is Professor Pierre Hoffmeyer, University Hos-pitals of Geneva. He is supported by a small group of Associate Editors and an Internati-onal Editorial Board.

Peer-reviewed articles summarize current knowledge and practice across a range of specialities, including:

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Indexing and Impact Factor: EFORT Open Reviews is now being indexed in PubMed with full-text provided in PubMedCentral (PMC). Following this, all authors benefits from their articles having a PMID within PubMed. Later, EFORT Open Reviews will be submitted for indexing in Web of Science with a view to obtaining an Impact Factor.

Submit your paper: https://mc04.manuscriptcentral.com/eor

Editor-in-Chief: P. HoffmeyerEdition 2016

info Subscribe to EFORT Open Reviews monthly email alerts: www.efortopenreviews.org/alerts

www.efort.org/barcelona2018

19TH EFORT Congress [Innovation &

New Technologies]

Barcelona, Spain 30 May-01 June 2018Abstract submission 15 September-12 November 2017 at 23:59 CET

Email communications of abstract acceptance status 01 February 2018

Advanced programme 15 March 2018

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Annual Report 2016 - efort.orgProf. Dr. Jan Verhaar Mr. David Limb Prof. Dr. Jan Verhaar EFORT...

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