Location of meeting:
Thomas Jefferson University + Philadelphia University
Home of Sidney Kimmel Medical College
Dorrance H. Hamilton Building
1001 Locust St, Philadelphia, Pennsylvania 19107
United States of America

 

2013 International Consensus Meeting on Periprosthetic Joint Infection

The battle against infection is as old as human civilization. During the last few centuries, great scholars such as Louis Pasteur, Ignaz Philipp Semmelweis, Alexander Fleming, and Joseph Lister have transformed the practice of medicine through their extraordinary discoveries. Despite the progress made and strides gained, our mission to prevent infection following surgery remains unaccomplished. It is not an exaggeration to claim that fear of infection lives in the hearts of every surgeon who steps into the operating room daily.

Periprosthetic joint infection (PJI), with all its disastrous implications, continues to pose a challenge to the orthopaedic community. Practicing orthopaedic surgeons have invested great efforts to implement strategies that may minimize surgical site infection (SSI). Although high-level evidence may support some of these practices, many are based on little to no scientific foundation. Thus, there is a remarkable variation in practices across the globe for prevention and management of PJI.

Should one use a laminar flow room for elective arthroplasty? How much and which antibiotic should one add to cement spacers? What metric should one use to decide on the optimal timing of reimplantation? What are the indications and contraindications for irrigation and debridement? How many irrigation and debridement in a joint should be attempted before resection arthroplasty needs to be considered? And what is the best type of skin preparation prior to surgery? These are among the many questions that the orthopaedic community faces on a daily basis. While some aspects of our practice are in dire need of a higher level of evidence to support them, others can hardly be subjected to the scrutiny of a randomized study, and an effort to generate evidence in support of these practices may be laborious and difficult indeed.

The medical community comprehends the importance of high-level evidence and engages in the generation of such whenever possible. The community also recognizes that some aspects of medicine will never lend themselves to the generation of high-level evidence nor should one attempt to do so. It is with the recognition of the latter that the International Consensus Meeting on Periprosthetic Joint Infection was organized. Delegates from various disciplines including orthopaedic surgery, infectious disease, musculoskeletal pathology, microbiology, anesthesiology, dermatology, nuclear medicine, rheumatology, musculoskeletal radiology, veterinary surgery, pharmacy, and numerous scientists with interest in orthopaedic infections came together to evaluate the available evidence, when present, or reach consensus regarding current practices for management of SSI/PJI. The process of generating the consensus has spanned 10 months. Every stone has been turned in search of evidence for these questions, with over 3,500 related publications evaluated. The evidence, when available, has been assessed. Otherwise, the cumulative wisdom of 400 delegates from 58 countries and over 100 societies has been amassed to reach consensus about practices that lack higher level of evidence. The members of the Musculoskeletal Infection Society (MSIS) and the European Bone and Joint Infection Society (EBJIS), the two societies whose mission is to improve care of patients with musculoskeletal infection, have contributed to this initiative immensely. The delegates have been engaged every step of the way by communicating through a "social" website generated for this purpose, with over 25,000 communications exchanged. The consensus document has been developed using the Delphi method under the leadership of Dr. Cats-Baril, a world-renowned expert in consensus development. The design of the consensus process was to include as many stakeholders as possible, allow participation in multiple forums, and providing a comprehensive review of the literature. The topics that were covered included the following: mitigation and education on comorbidities associated with increased SSI/PJI, perioperative skin preparation, perioperative antibiotics, operative environment, blood conservation, prosthesis selection, diagnosis of PJI, wound management, spacers, irrigation and debridement, antibiotic treatment and timing of reimplantation, one-stage versus two-stage exchange arthroplasty, management of fungal or atypical PJI, oral antibiotic therapy, and prevention of late PJI. Every consensus statement has undergone extreme scrutiny, especially by those with expertise in a specific area, to ensure that implementation of these practices will indeed lead to improvement of patient care.

After synthesizing the literature and assembling a preliminary draft of the consensus statement, over 300 delegates attended the face-to-face meeting in Philadelphia and were involved in active discussions and voting on the questions/consensus statements. The delegates first met on July 31 in smaller workgroups to discuss and resolve any discrepancies and finalize their statements. Then, the delegates met in the general assembly for further discussion of questions and consensus statements. After revising the consensus statements, the finalized consensus statement was assembled and the document was forwarded to the Audience Response System that evening for voting to begin the next day. On August 1, 2013 the delegates came into the general assembly and voted on the 207 questions/consensus statements that were being presented. The voting process was conducted using electronic keypads, where one could agree with the consensus statement, disagree with the consensus statement, or abstain from voting. The strength of the consensus was judged by the following scale: 1) Simple Majority: No Consensus (50.1-59% agreement), 2) Majority: Weak Consensus (60-65% agreement), 3) Super Majority: Strong Consensus (66-99% agreement) and 4) Unanimous: 100% agreement. Of the 207 questions, there was unanimous vote for one question (controlling OR traffic), 202 questions received super majority (strong consensus), two questions had weak consensus, and only two questions did not achieve any consensus.

The document presented here is the result of innumerable hours of work by the liaisons, leaders and delegates dedicated to this historic initiative. The information conveyed in this document is based on evidence, whenever present, or is the result of cumulative wisdom of over 400 of the world's experts in musculoskeletal infection from 58 countries. We are certain that the "best practice guide" set forth by this initiative will serve many of our patients for years to come. It is essential to state that the information contained in this document is merely a guide to practicing physicians who treat patients with musculoskeletal infection and should not be considered as a "standard of care". Clinicians should exercise their wisdom and clinical acumen in making decisions related to each individual patient. In some circumstances this may require implementation of care that differs from what is stated in this document.

On with our fight again infection.

Thorsten Gehrke MD

Javad Parvizi MD, FRCS

 
About the Delphi Process

The Delphi Process can be viewed in full by clicking here

 

Countries Involved

Afghanistan Mohammadi, Faizullah

Afghanistan
Mohammadi, Faizullah

Algeria HAMIDANI, Mourad

Algeria
HAMIDANI, Mourad

angola Gonçalves, Bruno Joaquim, Guilhermino

angola
Gonçalves, Bruno
Joaquim, Guilhermino

ARGENTINA Autorino, Carlos M Burgo, Federico J Buttaro, Martin Carbo, Lisandro Del Sel, Hernan Farfalli, Germán Luis Ottolenghi, Juan Sanchez, Marisa Sayago, Gustavo Slullitel, Gaston  

ARGENTINA
Autorino, Carlos M
Burgo, Federico J
Buttaro, Martin
Carbo, Lisandro
Del Sel, Hernan
Farfalli, Germán Luis
Ottolenghi, Juan
Sanchez, Marisa
Sayago, Gustavo
Slullitel, Gaston
 

Australia Aboltins, Craig A Choong, Peter Clark, Ben de Steiger, Richard Graves, Stephen Khan, Riaz Manning, Laurens Page, Richard Peel, Trisha N Rapisarda, Antony Solomon, Bogdan Sorial, Rami Tetsworth, Kevin van der Rijt, Adrian Yates, Piers  

Australia
Aboltins, Craig A
Choong, Peter
Clark, Ben
de Steiger, Richard
Graves, Stephen
Khan, Riaz
Manning, Laurens
Page, Richard
Peel, Trisha N
Rapisarda, Antony
Solomon, Bogdan
Sorial, Rami
Tetsworth, Kevin
van der Rijt, Adrian
Yates, Piers
 

Austria Winkler, Heinz

Austria
Winkler, Heinz

azerbaijan Alizadeh, Chingiz Gahramanov, Aydin Jalilov, Yashar Janbakhishov, Galandar  

azerbaijan
Alizadeh, Chingiz
Gahramanov, Aydin
Jalilov, Yashar
Janbakhishov, Galandar
 

Bangladesh AMJAD HOSSAIN, Mohammad  

Bangladesh
AMJAD HOSSAIN, Mohammad
 

Belarus  Gerasimenko, Michael

Belarus 
Gerasimenko, Michael

Belgium Cornu, Olivier Metsemakers, Willem-Jan Neyt, Jeroen Stuyck, Jose Thienpont, Emmanuel Yombi, Jean  

Belgium
Cornu, Olivier
Metsemakers, Willem-Jan
Neyt, Jeroen
Stuyck, Jose
Thienpont, Emmanuel
Yombi, Jean
 

bolivia Flores, Henry Fuentes, Christian

bolivia
Flores, Henry
Fuentes, Christian

Bosnia and herzegovina Gavrankapetanović, Ismet

Bosnia and herzegovina
Gavrankapetanović, Ismet

brazil Alencar, Paulo Barretto,  João Mauricio Costa Salles, Mauro Jose Cury, Marco Bernardo Gomes, Luiz S Marcelino Hernandez, Arnaldo Ivo de Carvalho, Pedro Matos, Juliana Munhoz Lima, Ana Lucia Pécora, José Ricardo Roberto Galia, Carlos Rudelli, Sergio Teloken, Marco

brazil
Alencar, Paulo
Barretto,  João Mauricio
Costa Salles, Mauro Jose
Cury, Marco Bernardo
Gomes, Luiz S Marcelino
Hernandez, Arnaldo
Ivo de Carvalho, Pedro
Matos, Juliana
Munhoz Lima, Ana Lucia
Pécora, José Ricardo
Roberto Galia, Carlos
Rudelli, Sergio
Teloken, Marco

bulgaria Kinov, Plamen Mihov, Kalin

bulgaria
Kinov, Plamen
Mihov, Kalin

Cameroon BAHEBECK, Jean

Cameroon
BAHEBECK, Jean

Canada Abdelbary, Hesham Backstein, David Carli, Alberto Embil, John M Ghert, Michelle Malo, Michel Masri, Bassam A Matar, Wadih I O'Shea, Tim Safir, Oleg Turgeon, Thomas Vasarhelyi, Edward  

Canada
Abdelbary, Hesham
Backstein, David
Carli, Alberto
Embil, John M
Ghert, Michelle
Malo, Michel
Masri, Bassam A
Matar, Wadih I
O'Shea, Tim
Safir, Oleg
Turgeon, Thomas
Vasarhelyi, Edward
 

chile Diaz, Claudio Mella, Claudio Parra Aguilera, Samuel Schweitzer, Daniel  

chile
Diaz, Claudio
Mella, Claudio
Parra Aguilera, Samuel
Schweitzer, Daniel
 

China Cao, Li Chen, Jiying Dang, Xiaoqian Guo, Shengjie Hu, Ruyin Huang, Wei Lin, Jianhao Shao, Hongyi Shen, Bin Shen, Hao Tang, Wai Man Tian, Shaoqi Wang, Qiaojie Weng, Xisheng Wu, Lidong Yan, Chun Hoi Zeng, YiRong Zhang, Wenming Zhang, Xianlong Zhou, Yixin Zhou, Yong Gang  

China
Cao, Li
Chen, Jiying
Dang, Xiaoqian
Guo, Shengjie
Hu, Ruyin
Huang, Wei
Lin, Jianhao
Shao, Hongyi
Shen, Bin
Shen, Hao
Tang, Wai Man
Tian, Shaoqi
Wang, Qiaojie
Weng, Xisheng
Wu, Lidong
Yan, Chun Hoi
Zeng, YiRong
Zhang, Wenming
Zhang, Xianlong
Zhou, Yixin
Zhou, Yong Gang
 

colombia Bonilla León, Guillermo A Calixto, Luis F Cortes Jiménez, Luis E García Ricaurte, Julio César Lara Cotacio, Gilberto Llinas Volpe, Adolfo Lopez, Juan Carlos Manrique, Jorge Martínez, Saùl Monsalvo, Daniel Palacio Villegas, Julio César Ramirez, Isabel Restrepo, Camilo Reyes, Francisco Rocha, Cesar H

colombia
Bonilla León, Guillermo A
Calixto, Luis F
Cortes Jiménez, Luis E
García Ricaurte, Julio César
Lara Cotacio, Gilberto
Llinas Volpe, Adolfo
Lopez, Juan Carlos
Manrique, Jorge
Martínez, Saùl
Monsalvo, Daniel
Palacio Villegas, Julio César
Ramirez, Isabel
Restrepo, Camilo
Reyes, Francisco
Rocha, Cesar H

Costa Rica Villafuerte, Jorge

Costa Rica
Villafuerte, Jorge

CroAtia Bićanić, Goran Bohaček, Ivan Ivković, Alan

CroAtia
Bićanić, Goran
Bohaček, Ivan
Ivković, Alan

Czech Republic Gallo, Jiří Jahoda, David

Czech Republic
Gallo, Jiří
Jahoda, David

Democratic Republic of the Congo PANDA, Mbutu

Democratic Republic of the Congo
PANDA, Mbutu

Denmark Gromov, Kirill Gundtoft, Per Husted, Henrik Kirketerp-Moller, Klaus Kjaersgaard-Andersen, Per Lange, Jeppe Moser, Claus Overgaard, Soeren  

Denmark
Gromov, Kirill
Gundtoft, Per
Husted, Henrik
Kirketerp-Moller, Klaus
Kjaersgaard-Andersen, Per
Lange, Jeppe
Moser, Claus
Overgaard, Soeren
 

Dominican Republic Leibnitz, Martinez

Dominican Republic
Leibnitz, Martinez

ecuador Alemán, Washington Barredo, Ramón Gomez, José Naula, Victor  

ecuador
Alemán, Washington
Barredo, Ramón
Gomez, José
Naula, Victor
 

Egypt Abdel Karim, Mahmoud Ebied, Ayman ElGanzoury, Ibrahim Emara, Khaled Osman, Wael Samir Saleh, Usama H  

Egypt
Abdel Karim, Mahmoud
Ebied, Ayman
ElGanzoury, Ibrahim
Emara, Khaled
Osman, Wael Samir
Saleh, Usama H
 

El Salvador Orlando Villanueva, Andres

El Salvador
Orlando Villanueva, Andres

Estonia Märtson, Aare Mitt, Piret  

Estonia
Märtson, Aare
Mitt, Piret
 

Finland Huotari, Kaisa Puhto, Ari-Pekka Puhto, Teija Virolainen, Petri  

Finland
Huotari, Kaisa
Puhto, Ari-Pekka
Puhto, Teija
Virolainen, Petri
 

Former Yugoslav Republic of Macedonia Bozinovski, Zoran Cirivri, Jasmin Talevski, Darko  

Former Yugoslav Republic of Macedonia
Bozinovski, Zoran
Cirivri, Jasmin
Talevski, Darko
 

France Argenson, Jean Noël Bauer, Thomas Ferry, Tristan Jacquot, Adrien Jenny, Jean-Yves Lustig, Sébastien Senneville, Eric  

France
Argenson, Jean Noël
Bauer, Thomas
Ferry, Tristan
Jacquot, Adrien
Jenny, Jean-Yves
Lustig, Sébastien
Senneville, Eric
 

Georgia Loria, Giorgi Zimlitski, Mikheil  

Georgia
Loria, Giorgi
Zimlitski, Mikheil
 

Germany Alt, Volker Citak, Mustafa Fayaz, Hangama Frommelt, Lars Gehrke, Thorsten Grupp, Thomas Haasper, Carl Hube, Robert Janz, Viktor Kendoff, Daniel Krenn, Veit Lohmann, Christoph Perka, Carsten Ploeger, Milena M Richter, Jens Rohde, Holger Stiehler, Maik Suda, Arnold Thomas, Peter Wagner, Christof Wimmer, Matthias Winkler, Tobias Zahar, Akos

Germany
Alt, Volker
Citak, Mustafa
Fayaz, Hangama
Frommelt, Lars
Gehrke, Thorsten
Grupp, Thomas
Haasper, Carl
Hube, Robert
Janz, Viktor
Kendoff, Daniel
Krenn, Veit
Lohmann, Christoph
Perka, Carsten
Ploeger, Milena M
Richter, Jens
Rohde, Holger
Stiehler, Maik
Suda, Arnold
Thomas, Peter
Wagner, Christof
Wimmer, Matthias
Winkler, Tobias
Zahar, Akos

Greece Babis, George Karachalios, Theofilos Komnos, Georgios Malizos, Konstantinos (Kostas) Mavrogenis, Andreas F Nikolaou, Vasileios Papadopoulos, Antonios I Papagelopoulos, Panayiotis J Tsiridis, Eleftherios  

Greece
Babis, George
Karachalios, Theofilos
Komnos, Georgios
Malizos, Konstantinos (Kostas)
Mavrogenis, Andreas F
Nikolaou, Vasileios
Papadopoulos, Antonios I
Papagelopoulos, Panayiotis J
Tsiridis, Eleftherios
 

Guatemala Herrera, Donaldo Neftali Manzo

Guatemala
Herrera, Donaldo Neftali Manzo

Hungary Bucsi, Laszlo Skaliczki, Gábor

Hungary
Bucsi, Laszlo
Skaliczki, Gábor

India Ashraf, Jamal Johari, Ashok Malhotra, Rajesh Mullaji, Arun Pachore, Javahir Poojary, Aruna Prabhoo, Ramchandra Rajgopal, Ashok Sancheti, Parag Sharma, Rajeev Shetty, Gautam Shyam, Ashok Tapasvi, Sachin Vaidya, Shrinand  

India
Ashraf, Jamal
Johari, Ashok
Malhotra, Rajesh
Mullaji, Arun
Pachore, Javahir
Poojary, Aruna
Prabhoo, Ramchandra
Rajgopal, Ashok
Sancheti, Parag
Sharma, Rajeev
Shetty, Gautam
Shyam, Ashok
Tapasvi, Sachin
Vaidya, Shrinand
 

Indonesia Budhiparama, Nicolaas

Indonesia
Budhiparama, Nicolaas

Iran Aalirezaie, Arash Abolghasemian, Mansour Alijanipour, Pouya Enayatollahi, Mohammad Ali Ghazavi, Mohammad Javid, Mahzad Mortazavi, Javad Parsa, Ali Shahcheraghi, Hossain Vahedi, Hamed

Iran
Aalirezaie, Arash
Abolghasemian, Mansour
Alijanipour, Pouya
Enayatollahi, Mohammad Ali
Ghazavi, Mohammad
Javid, Mahzad
Mortazavi, Javad
Parsa, Ali
Shahcheraghi, Hossain
Vahedi, Hamed

Iraq Saeed, Mohammad Wahhab, Mahmood Shihab  

Iraq
Saeed, Mohammad
Wahhab, Mahmood Shihab
 

Ireland Beverland, David Brady, Deirdre Cashman, James Kenny, Paddy Keogh, Peter Lynch, Maureen Mallon, Paddy Mulhall, Kevin O'Byrne, John Sheehan, Eoin  

Ireland
Beverland, David
Brady, Deirdre
Cashman, James
Kenny, Paddy
Keogh, Peter
Lynch, Maureen
Mallon, Paddy
Mulhall, Kevin
O'Byrne, John
Sheehan, Eoin
 

Israel Heller, Snir Kosashvili, Yona Schwaber, Mitchell Shohat, Noam Velkes, Steven  

Israel
Heller, Snir
Kosashvili, Yona
Schwaber, Mitchell
Shohat, Noam
Velkes, Steven
 

italy Arciola, Carla Renata Ascione, Tiziana Balato, Giovanni Baldini, Andrea Benazzo, Francesco Burastero, Giorgio Calafiore, Giuseppe Capanna, Rodolfo Catani, Fabio Da Rin de Lorenzo, Ferdinando De Vecchi, Elena Drago, Lorenzo Esposito, Silvano Franceschini, Massimo Maracacci, Maurilio Moretti, Biagio Pellegrini, Antonio Riccio, Giovanni Romanó, Carlo L. Rossi, Roberto Sessa, Giuseppe Zagra, Luigi  

italy
Arciola, Carla Renata
Ascione, Tiziana
Balato, Giovanni
Baldini, Andrea
Benazzo, Francesco
Burastero, Giorgio
Calafiore, Giuseppe
Capanna, Rodolfo
Catani, Fabio
Da Rin de Lorenzo, Ferdinando
De Vecchi, Elena
Drago, Lorenzo
Esposito, Silvano
Franceschini, Massimo
Maracacci, Maurilio
Moretti, Biagio
Pellegrini, Antonio
Riccio, Giovanni
Romanó, Carlo L.
Rossi, Roberto
Sessa, Giuseppe
Zagra, Luigi
 

japan Hyonmin, Choe Inaba, Yutaka Kobayashi, Naomi Matsushita, Kazuhiko Morii, Takeshi Tanaka, Yasuhito Tsuchiya, Hiroyuki Uchiyama, Katsufumi Yamada, Koji  

japan
Hyonmin, Choe
Inaba, Yutaka
Kobayashi, Naomi
Matsushita, Kazuhiko
Morii, Takeshi
Tanaka, Yasuhito
Tsuchiya, Hiroyuki
Uchiyama, Katsufumi
Yamada, Koji
 

Jordan Yousef, Hasan

Jordan
Yousef, Hasan

Kazakhstan Birzhan, Malik

Kazakhstan
Birzhan, Malik

kenya Kigera, James W M Lelei, Kibor Page, Jonathan  

kenya
Kigera, James W M
Lelei, Kibor
Page, Jonathan
 

Kosovo Karakushi, Ardian

Kosovo
Karakushi, Ardian

Kyrgyzstan Sheraliev, Azat

Kyrgyzstan
Sheraliev, Azat

laTvia Studers, Peteris Vigante, Dace  

laTvia
Studers, Peteris
Vigante, Dace
 

lebanon Chaftari, Raja Ghanem, Elie  

lebanon
Chaftari, Raja
Ghanem, Elie
 

Libya RASHED, Mohamed

Libya
RASHED, Mohamed

Lithuania Kvederas, Giedrius Smailys, Alfredas Stucinskas, Justinas  

Lithuania
Kvederas, Giedrius
Smailys, Alfredas
Stucinskas, Justinas
 

Malaysia Choon, David

Malaysia
Choon, David

Mexico Diaz-Borjon, Efrain Encalada, Iván Franco-Cendejas, Rafael Gómez-García, Felipe MERIDA, Everth Ortega-Peña, Silvestre Rivero-Boschert, Salvador Rubio-Avila, Jorge Velázquez Moreno, Job Diego  

Mexico
Diaz-Borjon, Efrain
Encalada, Iván
Franco-Cendejas, Rafael
Gómez-García, Felipe
MERIDA, Everth
Ortega-Peña, Silvestre
Rivero-Boschert, Salvador
Rubio-Avila, Jorge
Velázquez Moreno, Job Diego
 

Moldova Antoci, Valentin Antoci, Valentin (Senior)

Moldova
Antoci, Valentin
Antoci, Valentin (Senior)

Morocco BENZAKOUR, Thami

Morocco
BENZAKOUR, Thami

Nepal Jha, Sudhanshu

Nepal
Jha, Sudhanshu

Netherlands Geurts, Jan Glaudemans, Andor Goosen, Jon Hellemondt, Gijs Jutte, Paul Meermans, Geert Moojen, Dirk-Jan Nelissen, Rob Nijhof, Marc Ploegmakers, Joris Poolman, Rudolf Scheper, Henk Schreurs, Berend Willem van de Sande, Michiel van de Wal, Robert Verhaar, Jan (A.N.) Vogely, Charles Wagenaar, Frank-Christiaan Willems, Jaap Wouthuyzen-Bakker, Marjan  

Netherlands
Geurts, Jan
Glaudemans, Andor
Goosen, Jon
Hellemondt, Gijs
Jutte, Paul
Meermans, Geert
Moojen, Dirk-Jan
Nelissen, Rob
Nijhof, Marc
Ploegmakers, Joris
Poolman, Rudolf
Scheper, Henk
Schreurs, Berend Willem
van de Sande, Michiel
van de Wal, Robert
Verhaar, Jan (A.N.)
Vogely, Charles
Wagenaar, Frank-Christiaan
Willems, Jaap
Wouthuyzen-Bakker, Marjan
 

New Zealand Hooper, Gary Vince, Kelly Young, Simon W

New Zealand
Hooper, Gary
Vince, Kelly
Young, Simon W

Nicaragua Gutierrez, Vicky

Nicaragua
Gutierrez, Vicky

Nigeria Akonjom, Mandus Ogedegbe, Felix Saheed, Yakub Sough, Thomas  

Nigeria
Akonjom, Mandus
Ogedegbe, Felix
Saheed, Yakub
Sough, Thomas
 

Norway Berdal, Jan Erik Westberg, Marianne Wik, Tina Strømdal Witsø, Eivind  

Norway
Berdal, Jan Erik
Westberg, Marianne
Wik, Tina Strømdal
Witsø, Eivind
 

Oman Allami, Mohamad Al-Maskari, Sultan  

Oman
Allami, Mohamad
Al-Maskari, Sultan
 

Pakistan Chinoy, Muhammad Amin Najjad, Muhammad Kazim Rahim Noor, Syed Shahid Siddiqi, Muhammad Ather  

Pakistan
Chinoy, Muhammad Amin
Najjad, Muhammad Kazim Rahim
Noor, Syed Shahid
Siddiqi, Muhammad Ather
 

Panama Ford Jr, Edmundo Saldaña, Ariel

Panama
Ford Jr, Edmundo
Saldaña, Ariel

Peru Lizarraga Ferrand, Marcelo Luque, Jose Quevedo, María S Suárez, Rolando  

Peru
Lizarraga Ferrand, Marcelo
Luque, Jose
Quevedo, María S
Suárez, Rolando
 

Philippines Paner, Nilo

Philippines
Paner, Nilo

poland Bialecki, Jerzy Kruczyński, Jacek Marczyński, Wojciech Markuszewski, Jacek  

poland
Bialecki, Jerzy
Kruczyński, Jacek
Marczyński, Wojciech
Markuszewski, Jacek
 

Portugal Barreira, Pedro Cabral, Rui Manuel Vicente Claro, Rui Fonseca de Freitas, João Paulo Nogueira de Sousa, António Sousa, Ricardo  

Portugal
Barreira, Pedro
Cabral, Rui Manuel Vicente
Claro, Rui
Fonseca de Freitas, João Paulo
Nogueira de Sousa, António
Sousa, Ricardo
 

Qatar Abuodeh, Yousef

Qatar
Abuodeh, Yousef

Romania Iovanescu, Liviu

Romania
Iovanescu, Liviu

russia Bozhkova, Svetlana Murylev, Valeriy Oshkukov, Sergei Reznik, Leonid Sankaranarayanan Arumugam, Saravanan Shubnyakov, Igor Tikhilov, Rashid Voloshin, Viktor Zagorodniy, Nikolay  

russia
Bozhkova, Svetlana
Murylev, Valeriy
Oshkukov, Sergei
Reznik, Leonid
Sankaranarayanan Arumugam, Saravanan
Shubnyakov, Igor
Tikhilov, Rashid
Voloshin, Viktor
Zagorodniy, Nikolay
 

Saudi Arabia Ilyas, Imran Manzary, Mojieb  

Saudi Arabia
Ilyas, Imran
Manzary, Mojieb
 

Serbia Radoičić, Dragan  

Serbia
Radoičić, Dragan
 

Singapore Nung, Ngai Yeo, Seng Jin  

Singapore
Nung, Ngai
Yeo, Seng Jin
 

Slovakia KOKAVEC, Milan

Slovakia
KOKAVEC, Milan

Slovenia Mihalič, Rene Trebše, Rihard  

Slovenia
Mihalič, Rene
Trebše, Rihard
 

south africa Ferreira, Nando Frantzen, Doron J M Kyte, Richard Lautenbach, Charles Le Roux, Theo L B Marais, Leonard Mokete, Lipalo  

south africa
Ferreira, Nando
Frantzen, Doron J M
Kyte, Richard
Lautenbach, Charles
Le Roux, Theo L B
Marais, Leonard
Mokete, Lipalo
 

south korea Chang, Chong Bum Cho, Jeongeun Ha, Yong-Chan Han, Seung Beom Kim, Kang-il Kim, Tae-Kyun Koh, In Jun Koo, Kyung-Hoi Lee, Young-Kyun

south korea
Chang, Chong Bum
Cho, Jeongeun
Ha, Yong-Chan
Han, Seung Beom
Kim, Kang-il
Kim, Tae-Kyun
Koh, In Jun
Koo, Kyung-Hoi
Lee, Young-Kyun

spain Amat Mateu, Carles Baeza, Jose Bori, Guillem Caba, Pedro Cabo, Javier Francisco Cobo Reinoso, Javier Cordero-Ampuero, José Corona, Pablo S de Benito, Natividad Del Pozo, Jose L Erice, Alejo Esteban, Jaime Font-Vizcarra, Lluís García-Bógalo, Raul Gomez-Barrena, Enrique Guerado, Enrique Guerra, Ernesto Horcajada, Juan Pablo Llopis, Rafael Lora-Tamayo, Jaime Marchán, Isidor Marín-Peña, Óliver Martinez Pastor, Juan C Montañez, Elvira Montilla, Francisco Mora, José M Murillo, Oscar Neira, Inma Núñez-Pereira, Susana Pigrau, Carles Portillo, María Eugenia Puig-Verdié, Lluis Ramirez Valencia, Manuel Rodrigo, Carlos Rodriguez-Pardo, Dolors Soriano, Alex Teixidor, Jordi Tibau Olivan, Rafael Torrens, Carlos Velez, Roberto  

spain
Amat Mateu, Carles
Baeza, Jose
Bori, Guillem
Caba, Pedro
Cabo, Javier Francisco
Cobo Reinoso, Javier
Cordero-Ampuero, José
Corona, Pablo S
de Benito, Natividad
Del Pozo, Jose L
Erice, Alejo
Esteban, Jaime
Font-Vizcarra, Lluís
García-Bógalo, Raul
Gomez-Barrena, Enrique
Guerado, Enrique
Guerra, Ernesto
Horcajada, Juan Pablo
Llopis, Rafael
Lora-Tamayo, Jaime
Marchán, Isidor
Marín-Peña, Óliver
Martinez Pastor, Juan C
Montañez, Elvira
Montilla, Francisco
Mora, José M
Murillo, Oscar
Neira, Inma
Núñez-Pereira, Susana
Pigrau, Carles
Portillo, María Eugenia
Puig-Verdié, Lluis
Ramirez Valencia, Manuel
Rodrigo, Carlos
Rodriguez-Pardo, Dolors
Soriano, Alex
Teixidor, Jordi
Tibau Olivan, Rafael
Torrens, Carlos
Velez, Roberto
 

Sudan Mustapha Al-Bushra, Emad  

Sudan
Mustapha Al-Bushra, Emad
 

Sweden Åkesson, Per Hailer, Nils Kärrholm, Johan Lazarinis, Stergios Lidgren, Lars Rolfson, Ola Stefánsdóttir, Anna W-Dahl, Annette

Sweden
Åkesson, Per
Hailer, Nils
Kärrholm, Johan
Lazarinis, Stergios
Lidgren, Lars
Rolfson, Ola
Stefánsdóttir, Anna
W-Dahl, Annette

Switzerland Achermann, Yvonne Borens, Olivier Clauss, Martin Eijer, Henk Erhardt, Johannes B Gerber, Christian Hirschmann, Michael Hoffmeyer, Pierre Kohl, Sandro Morgenstern, Mario Moriarty, Fintan Ochsner, Peter Sendi, Parham Uçkay, Ilker Wahl, Peter Zimmerli, Werner

Switzerland
Achermann, Yvonne
Borens, Olivier
Clauss, Martin
Eijer, Henk
Erhardt, Johannes B
Gerber, Christian
Hirschmann, Michael
Hoffmeyer, Pierre
Kohl, Sandro
Morgenstern, Mario
Moriarty, Fintan
Ochsner, Peter
Sendi, Parham
Uçkay, Ilker
Wahl, Peter
Zimmerli, Werner

Taiwan Chang, Yuhan Kuo, Feng Chih Lee, Mel  

Taiwan
Chang, Yuhan
Kuo, Feng Chih
Lee, Mel
 

Tanzania MUSERU, Lawrence M

Tanzania
MUSERU, Lawrence M

Thailand Chotanaphuti, Thanainit Tanavalee, Aree  

Thailand
Chotanaphuti, Thanainit
Tanavalee, Aree
 

Tunisia Kallel, Sofiene

Tunisia
Kallel, Sofiene

Turkey Atilla, Bülent Azboy, Ibrahim Bozkurt, Murat Korkusuz, Feza Köse, Nusret Küçükdurmaz, Fatih Tokgözoğlu, A. Mazhar Tozun, I. Remzi Tuncay, Ibrahim

Turkey
Atilla, Bülent
Azboy, Ibrahim
Bozkurt, Murat
Korkusuz, Feza
Köse, Nusret
Küçükdurmaz, Fatih
Tokgözoğlu, A. Mazhar
Tozun, I. Remzi
Tuncay, Ibrahim

Ukraine Bondarenko, Stanislav Pidgaiska, Olga Volodymyr, Filipenko Zazirnyi, Igor  

Ukraine
Bondarenko, Stanislav
Pidgaiska, Olga
Volodymyr, Filipenko
Zazirnyi, Igor
 

The United Arab Emirates Al Belooshi, Ali Tarabichi, Samih

The United Arab Emirates
Al Belooshi, Ali
Tarabichi, Samih

The united kingdom Achan, Prim Ahuja, Sashin Alvand, Abtin Berendt, Anthony R Blom, Ashley Falworth, Mark Gambhir, Anil GANT, Vanya Giannoudis, Peter Goswami, Karan Grammatopoulos, George Haddad, Fares Heidari, Nima Hughes, Harriet Iyer, Shabnam Jeys, Lee Jones, Stephen Kay, Peter Konan, Sujith Kunutsor, Setor Lambert, Simon Levy, Ofer McNally, Martin Meek, Dominic Mitchell, Philip Murray, James Oussedik, Sam Petrie, Michael J Porteous, Andrew Rai, Am Reed, Mike Saeed, Kordo Sarungi, Martin Scarborough, Matthew Simpson, Hamish Stockley, Ian Taylor, Adrian Thomas, Peter Timperley, John Townsend, Robert Webb, Jason Wilson, Matthew Wynn-Jones, Henry

The united kingdom
Achan, Prim
Ahuja, Sashin
Alvand, Abtin
Berendt, Anthony R
Blom, Ashley
Falworth, Mark
Gambhir, Anil
GANT, Vanya
Giannoudis, Peter
Goswami, Karan
Grammatopoulos, George
Haddad, Fares
Heidari, Nima
Hughes, Harriet
Iyer, Shabnam
Jeys, Lee
Jones, Stephen
Kay, Peter
Konan, Sujith
Kunutsor, Setor
Lambert, Simon
Levy, Ofer
McNally, Martin
Meek, Dominic
Mitchell, Philip
Murray, James
Oussedik, Sam
Petrie, Michael J
Porteous, Andrew
Rai, Am
Reed, Mike
Saeed, Kordo
Sarungi, Martin
Scarborough, Matthew
Simpson, Hamish
Stockley, Ian
Taylor, Adrian
Thomas, Peter
Timperley, John
Townsend, Robert
Webb, Jason
Wilson, Matthew
Wynn-Jones, Henry

the united states of america Abboud, Joseph Abdel, Matthew Abraham, John Adib, Farshad Aiyer, Amiethab Alexander, Bryan Amanatullah, Derek Archdeacon, Michael T Arnold, William V Austin, Matthew Aynardi, Michael Babic, Maja Barrack, Robert Battenberg, Andrew Bauer, Thomas W Bechtel, Christopher Bedair, Hany Belden, Katherine Benevenia, Joseph Berbari, Elie F Berend, Keith Berríos Torres, Sandra I. Berry, Daniel Bingham, Joshua Bini, Stefano Blaha, John David Blevins, Kier Booth, Robert E Bowker, John Bozic, Kevin Bradbury, Thomas Brause, Barry Bravo, Tricia Brown, Scot A Brown, Timothy Callaghan, John J Castillo, Renan Cats-Baril, William Chen, Antonia Ciccotti, Michael Cil, Akin Cohen, Steven B Conway, Janet Courtney, Paul M Craig, Chad Cross, Michael Cvetanovich, Gregory Danoff, Jonathan Darouiche, Rabih de Beaubien, Brian Deirmengian, Carl Deirmengian, Gregory K Del Gaizo, Daniel Della Valle, Craig J Dennis, Douglas Di Cesare, Paul E Dodson, Christopher Duquin, Thomas Egol, Kenneth Ehrlich, Garth D Ellington, Kent Englund, Kristin Esterhai, John L Fehring, Thomas K Fillingham, Yale Fleischman, Andrew Frankle, Mark Fraser, James Freedman, Kevin Galatz, Leesa Garrigues, Grant E Garvin, Kevin L Geller, Jeffrey Giori, Nicholas Goel, Rahul Goodman, Stuart Goodman, Susan Goyal, Nitin Granger, Jeffrey Green, Andrew Greenky, Max Greenwald, Seth Griffin, William Gutowski, Christina Haggard, Warren Hamlin, Brian Hammoud, Sommer Hansen, Erik Harris, Mitch Hasan, Samer S Hendershot, Edward Henderson, R. Andrew Henry, Michael Hernandez, Victor Hewlett, Angela Hickok, Noreen Higuera, Carlos A Hirose, Christopher Holtom, Paul Horan, Annamarie Hsu, Jason Huang, Ronald Huddleston, James Iannoti, Joseph Indelli, Pier Francesco Iorio, Richard Itamura, John Jennings, Jason Jennings, Jessica Amber Jiranek, William Johnson, Lucileia Joshi, Manjari Kaplan, Jonathan Karam, Joseph Kates, Stephen Keener, Jay Kelly, Jim Kelly, Michael Kepler, Christopher Ketonis, Constantinos Khatod, Monti Khazzam, Michael Kheir, Michael Kim, Han Jo King, Joseph J Klatt, Brian A Klement, Mitchell Krebs, Viktor Krieg, James Kudrna, James Kurtz, Steve Lachiewicz, Anne Lachiewicz, Paul Lange, Jeffrey Lee, Gwo-Chin Leopold, Seth S Levine, Brett Levy, Jonathon Lewallen, David G Lieberman, Jay Lombardi, Adolph Lonner, Jess H Lowenberg, David  

the united states of america
Abboud, Joseph
Abdel, Matthew
Abraham, John
Adib, Farshad
Aiyer, Amiethab
Alexander, Bryan
Amanatullah, Derek
Archdeacon, Michael T
Arnold, William V
Austin, Matthew
Aynardi, Michael
Babic, Maja
Barrack, Robert
Battenberg, Andrew
Bauer, Thomas W
Bechtel, Christopher
Bedair, Hany
Belden, Katherine
Benevenia, Joseph
Berbari, Elie F
Berend, Keith
Berríos Torres, Sandra I.
Berry, Daniel
Bingham, Joshua
Bini, Stefano
Blaha, John David
Blevins, Kier
Booth, Robert E
Bowker, John
Bozic, Kevin
Bradbury, Thomas
Brause, Barry
Bravo, Tricia
Brown, Scot A
Brown, Timothy
Callaghan, John J
Castillo, Renan
Cats-Baril, William
Chen, Antonia
Ciccotti, Michael
Cil, Akin
Cohen, Steven B
Conway, Janet
Courtney, Paul M
Craig, Chad
Cross, Michael
Cvetanovich, Gregory
Danoff, Jonathan
Darouiche, Rabih
de Beaubien, Brian
Deirmengian, Carl
Deirmengian, Gregory K
Del Gaizo, Daniel
Della Valle, Craig J
Dennis, Douglas
Di Cesare, Paul E
Dodson, Christopher
Duquin, Thomas
Egol, Kenneth
Ehrlich, Garth D
Ellington, Kent
Englund, Kristin
Esterhai, John L
Fehring, Thomas K
Fillingham, Yale
Fleischman, Andrew
Frankle, Mark
Fraser, James
Freedman, Kevin
Galatz, Leesa
Garrigues, Grant E
Garvin, Kevin L
Geller, Jeffrey
Giori, Nicholas
Goel, Rahul
Goodman, Stuart
Goodman, Susan
Goyal, Nitin
Granger, Jeffrey
Green, Andrew
Greenky, Max
Greenwald, Seth
Griffin, William
Gutowski, Christina
Haggard, Warren
Hamlin, Brian
Hammoud, Sommer
Hansen, Erik
Harris, Mitch
Hasan, Samer S
Hendershot, Edward
Henderson, R. Andrew
Henry, Michael
Hernandez, Victor
Hewlett, Angela
Hickok, Noreen
Higuera, Carlos A
Hirose, Christopher
Holtom, Paul
Horan, Annamarie
Hsu, Jason
Huang, Ronald
Huddleston, James
Iannoti, Joseph
Indelli, Pier Francesco
Iorio, Richard
Itamura, John
Jennings, Jason
Jennings, Jessica Amber
Jiranek, William
Johnson, Lucileia
Joshi, Manjari
Kaplan, Jonathan
Karam, Joseph
Kates, Stephen
Keener, Jay
Kelly, Jim
Kelly, Michael
Kepler, Christopher
Ketonis, Constantinos
Khatod, Monti
Khazzam, Michael
Kheir, Michael
Kim, Han Jo
King, Joseph J
Klatt, Brian A
Klement, Mitchell
Krebs, Viktor
Krieg, James
Kudrna, James
Kurtz, Steve
Lachiewicz, Anne
Lachiewicz, Paul
Lange, Jeffrey
Lee, Gwo-Chin
Leopold, Seth S
Levine, Brett
Levy, Jonathon
Lewallen, David G
Lieberman, Jay
Lombardi, Adolph
Lonner, Jess H
Lowenberg, David
 

Mabry, Tad Malchau, Henrik Malkani, Arthur Manner, Paul Manson, Theodore Marculescu, Camelia Mason, J Bohannon Matsen Ko, Laura Matsen, Frederick McFarland, Edward McIntosh, Amy McLaren, Alex McLawhorn, Alexander McPherson, Ed Mehta, Smair Memtsoudis, Stavros G Miller, Andy O Molloy, Robert Mont, Michael A Moore, Christopher Morrey, Mark Morris, Brent Murawski, Christopher D Nam, Denis Namdari, Surena Nana, Arvind Nandi, Sumon Natoli, Roman Nelson, Sandra Bliss Noble, Philip C Nodzo, Scott R Nunley, Ryan Obremskey, William T O'Donnell, Judith O'Donnell, Richard Odum, Susan Oliashirazi, Ali O'Malley, Michael Ong, Kevin L Orozco, Fabio Osmon, Douglas R Otero, Jesse O'Toole, Robert Otto, Michael Padgett, Douglas Paprosky, Wayne G Parekh, Selene Parvizi, Javad Patel, Nirav K Patel, Preetesh Patel, Robin Patzakis, Michael Paxton, E. Scott Pedowitz, David Pelt, Christopher E Perry, Kevin Phillips, K. Scott Plancher, Kevin Polkowski, Gregory Ponzio, Danielle Pottinger, Paul Poultsides, Lazaros Prieto, Hernan Pring, Maya E Pulido, Luis Purtill, James J Quinnan, Stephen Raikin, Steven Randall, R. Lor Ricchetti, Eric Romeo, Anthony Rondon, Alexander Sabesan, Vani Saleh, Khaled J Sawyer, Robert Schaer, Thomas Schlatterer, Daniel R Schmitt, Steven Schwarz, Edward Schwarzkopf, Ran Schwechter, Evan Scuderi, Giles Sculco, Peter Segreti, John Seyler, Thorsten Shahi, AliSina Shapiro, Irving M Sharkey, Peter Sheth, Neil Shilling, Jack Shirtliff, Mark Sierra, Rafael J Silibovsky, Randi Simpfendorfer, Claus Smeltzer, Mark Smith, Eric Solomkin, Joseph S. Somerson, Jeremy Spangehl, Mark Sporer, Scott Springer, Bryan D Squire, Matthew W Stocks, Greg Stoodley, Paul Suarez, Juan Suh, Gina Ann Swiontkowski, Marc F Talati, Naasha Tan, Tim Tande, Aaron J Tarabichi, Majd Tarity, T. David Tashjian, Robert Tornetta III, Paul Tuan, Rocky S Urish, Kenneth Vaccaro, Alexander Virk, Mandeep Vulcano, Ettore Ward, Derek Warren, David Watson, J. Tracy Weaver, Michael J Wellman, Samuel Wenke, Joseph Westrich, Geoffrey Whiteside, Leo Williams, Dustin Williams, Gerald Winters, Brian Wongworawat, Montri D Yates, Adolph J Yian, Edward Zalavras, Charalampos Zmistowski, Benjamin Zuckerman, Joseph





Mabry, Tad
Malchau, Henrik
Malkani, Arthur
Manner, Paul
Manson, Theodore
Marculescu, Camelia
Mason, J Bohannon
Matsen Ko, Laura
Matsen, Frederick
McFarland, Edward
McIntosh, Amy
McLaren, Alex
McLawhorn, Alexander
McPherson, Ed
Mehta, Smair
Memtsoudis, Stavros G
Miller, Andy O
Molloy, Robert
Mont, Michael A
Moore, Christopher
Morrey, Mark
Morris, Brent
Murawski, Christopher D
Nam, Denis
Namdari, Surena
Nana, Arvind
Nandi, Sumon
Natoli, Roman
Nelson, Sandra Bliss
Noble, Philip C
Nodzo, Scott R
Nunley, Ryan
Obremskey, William T
O'Donnell, Judith
O'Donnell, Richard
Odum, Susan
Oliashirazi, Ali
O'Malley, Michael
Ong, Kevin L
Orozco, Fabio
Osmon, Douglas R
Otero, Jesse
O'Toole, Robert
Otto, Michael
Padgett, Douglas
Paprosky, Wayne G
Parekh, Selene
Parvizi, Javad
Patel, Nirav K
Patel, Preetesh
Patel, Robin
Patzakis, Michael
Paxton, E. Scott
Pedowitz, David
Pelt, Christopher E
Perry, Kevin
Phillips, K. Scott
Plancher, Kevin
Polkowski, Gregory
Ponzio, Danielle
Pottinger, Paul
Poultsides, Lazaros
Prieto, Hernan
Pring, Maya E
Pulido, Luis
Purtill, James J
Quinnan, Stephen
Raikin, Steven
Randall, R. Lor
Ricchetti, Eric
Romeo, Anthony
Rondon, Alexander
Sabesan, Vani
Saleh, Khaled J
Sawyer, Robert
Schaer, Thomas
Schlatterer, Daniel R
Schmitt, Steven
Schwarz, Edward
Schwarzkopf, Ran
Schwechter, Evan
Scuderi, Giles
Sculco, Peter
Segreti, John
Seyler, Thorsten
Shahi, AliSina
Shapiro, Irving M
Sharkey, Peter
Sheth, Neil
Shilling, Jack
Shirtliff, Mark
Sierra, Rafael J
Silibovsky, Randi
Simpfendorfer, Claus
Smeltzer, Mark
Smith, Eric
Solomkin, Joseph S.
Somerson, Jeremy
Spangehl, Mark
Sporer, Scott
Springer, Bryan D
Squire, Matthew W
Stocks, Greg
Stoodley, Paul
Suarez, Juan
Suh, Gina Ann
Swiontkowski, Marc F
Talati, Naasha
Tan, Tim
Tande, Aaron J
Tarabichi, Majd
Tarity, T. David
Tashjian, Robert
Tornetta III, Paul
Tuan, Rocky S
Urish, Kenneth
Vaccaro, Alexander
Virk, Mandeep
Vulcano, Ettore
Ward, Derek
Warren, David
Watson, J. Tracy
Weaver, Michael J
Wellman, Samuel
Wenke, Joseph
Westrich, Geoffrey
Whiteside, Leo
Williams, Dustin
Williams, Gerald
Winters, Brian
Wongworawat, Montri D
Yates, Adolph J
Yian, Edward
Zalavras, Charalampos
Zmistowski, Benjamin
Zuckerman, Joseph

Uruguay Motta, Fernando

Uruguay
Motta, Fernando

Venezuela Castro, Julio Garcia, Gustavo A Grieco Silva, Francisco Rafael Limas, Ruben Molano, Miguel Serrano F., Alberto J Silva, Rosa Socorro, Nelson Enrique Medina

Venezuela
Castro, Julio
Garcia, Gustavo A
Grieco Silva, Francisco Rafael
Limas, Ruben
Molano, Miguel
Serrano F., Alberto J
Silva, Rosa
Socorro, Nelson Enrique Medina

Wales Morgan-Jones, Rhidian

Wales
Morgan-Jones, Rhidian

Yemen Binlaksar, Ruwais

Yemen
Binlaksar, Ruwais