On December 30th 1981 Dr. Jacques Evrard, orthopaedic surgeon in Hospital Cochin in Paris wrote a letter to several Orthopaedic surgeons in Europe. It was a short letter with the text in French as well in English:
Dear Colleague,
It has been my belief for the past several years, especially after the SICOT 
congress, that Orthopaedic surgeons interested in Osteo-articular infection should be associated . We would thus be able to exchange our ideas more easily, group communications on this subject and discuss them among ourselves. A more ambitious program could even be envisioned: perform teamwork studies, meet once or twice a year, keep an updated bibliography and even think about a periodical publication. If this idea interests you, I would appreciate your informing me and, at the same time, sending me the names of your colleagues who would be interested in joining us. Thanking you in advance, I remain.
Sincerely, Dr. Evrard
During the congress of the SICOT in Japan he had discussed the initiation of such a group with some orthopaedic surgeons, e.g. Lars Lindberg from Sweden. I answered him that I was interested indeed, and at 14-02-1982 he wrote me that a certain number of colleagues have already consented, signifying that we may begin organizing the group. A preparatory meeting was organized in Lyon at May 19, 1982. Seven could attend: Evrard, G.Jenny, Livio, Martini, Steen Jensen, Vidal and Walenshy kamp. Twelve others had also given a positive reaction: Fernandez Sabate, Kemp, Klemm, Lannelongue, Letournel, Lidgren, Lindberg, Lortat-Jacob, Mounier-Kuhn, Valette, and Vasey. In Lyon, the organisation of a Studygroup was discussed. Membership should be acquainted in two phases via an associated membership, after presentation of scientific work on the field of orthopedic infections. It was decided that also a limited number of non surgeons could be a member, as well as non-Europeans. It should be a more or less informal group, later a more official character could be given. The official language should be French and English, and meetings should be held on different places in Europe. Publication of an own journal was postponed to later years.
The foundation meeting of the Studygroup was planned in Paris: at Friday 12 November 1982, at the
Palais de Congres, after the SOFCOT meeting. Evrard send an invitation in English and French for this meeting. In Paris altogether 26 members founded the Studygroup on Bone and Joint Infection; or Groupe d’ Etude de l’ Infection Osseuse articulaire. The founding members were the 19 orthopaedic surgeons as mentioned above, as well as the following seven: Acar, Bascoulergue, Boda, Hedstroum, Lob, Marotte, and Papineau. Members of the first Board were: Evrard (President), Lindberg (Vice President), Letournel (Secretary), Vasey ( Treasurer), Martini (Archivist), and Vecsei (member). During the scientific part of the following meeting seven papers were presented.
Since then the number members of this Studygroup gradually increased. New members passed a short period of candidature to prove their commitment via presentation of a paper and their presence at the annual meetings. Members had to be doctors, with a high reputation in treatment and research of infections of the Musculoskeletal system. Most of them were orthopaedic surgeon or trauma surgeon, and a few were bacteriologist. The number was limited to a maximum of sixty (fig 1) and the members should be at least 70% surgeons. The official languages were French, German and English.
The Studygroup indeed created the platform for those who were actively involved in Europe in orthopaedic infections. However the limitations of the Studygroup as defined in their bylaws became gradually more an obstacle, than the guarantee for high quality. The system of co-optation and the good relationship between the relative small and constant number of members did not invite enough new colleagues. Also the inspiration and introduction of new ideas gradually decreased. Therefor the structure of the Studygroup was exchanged to that of an open Society.
At 20 April 1993 the Studygroup was transformed to the “European Bone and Joint Infection Society. In this Society the number of members is not any more limited, nor the profession.
Membership is open for all physicians, interested to Musculoskeletal infections from a scientific or clinical point of view. There is no period of candidature any more. When retired members become emeritus-members. Dr. Guy Jenny became honorary member in 1997, due to his work during 14 years in the Board. Since then the number of members increased in a few years and stabilised since 1996 around 110 members (fig 1). Members come from all European countries, and some of other continents: US, Taiwan, Turkey.
Goal and structure
The objective of the Society is to promote the knowledge of all infections affecting the Musculoskeletal system (bone and joint infections), and to promote the prevention and treatment of these infections. The Society is a non -profit organisation. The annual fee at this moment is 100 euro. Members who not pay there fee for 2 years are skipped as member.
There is no direct benefit of commercial parties. Since 2 years a scientific price of 1000 euro is given for the best paper during the annual meeting, payed by Biomet-Merck. The annual meetings are partly organised with financial help of the industry, but it appears to be difficult to get sponsoring of international meetings by national companies.
The Board consists of a President (table 2), assisted by a Vice-President (the next President) and a Past-President, all in that function for 2 years. This guarantees a continuity for each of 6 years with an overlap. They are assisted by a General Secretary, Treasurer, Archivist, and member of the Board. They can be re-elected and form a more permanent factor. The Board meets three to four times a year. All administrative work must be done by the members themselves, the relative small society with limited finance cannot afford professional support.
Meetings
Every year a general and scientific meeting is organised somewhere in Europe: to find as many interested potential members as possible the location alternates if anyway possible from north to south and east to west (table 1). A meeting contains instructional courses, round tables as well as free paper sessions, every year main subjects are chosen. The meetings are mostly organised in May, from Thursday afternoon up to Saterday morning, with a welcome party and gala dinner. The next meetings are in Milano 27 – 29 May 2004, and in Ljubljana 19 – 21 May 2005.
The Society does not combine its annual meeting with the bi-annual EFORT meetings. Such a combination of meetings appeared to decrease the internal contact of the Society too much. However some combined meetings during the Specialty day of the EFORT were organised: with the European Hip Society (Barcelona) as well as with European Foot and Ankle Society (Brussel). Members of the EBJIS are often involved in courses throughout Europe, sometimes individual, often as a group on behalf of the Society.
Publications
During the meetings abstract books are given to those attending the meeting. The papers of the first years were published as internal reports to the members, and since a few years a selection of the abstracts are published in supplements of the JBJS-Br.
For several years the EBJIS has published in one of the European orthopaedic journals, being its official journal. Members however had to subscribe, and also the reduced subscription fee appeared to be relative expensive, as related to their membership fee. Important disadvantage is also that the impact factor of all starting journals remains relative low. Members send their valuable manuscripts to journals with a higher ranking, and their remains hardly any advantage for the members to be associated with a Journal.
Conclusions
A Society as the EBJIS may have several aims. It tries to offer the opportunity to meet colleagues with the same interest. Especial in more specialised kinds of healthcare, it may be very difficult to find colleagues to share experience, ideas and problems. Such a Society creates a network in Europe by which members easily communicate, having met each other regularly.
A Society as the EBJIS has the potential to be the ideal platform to set up and perform multicenter studies. Indeed it was the ideal network to discuss and test new ideas. Some trials and studies were performed in Europe with members of the Society, but the Society up to now was not able to perform large studies by itself.
The number of abstracts in most of the meetings has increased to about hundred. important is that also the scientific level of the work, as presented increased evidently. Not only description of clinical experience, ever important in this field of surgery, but also good experimental en epidemiological work is presented.
It took some years before the strongest national feelings were decreased, however sometimes all well known European disputes are recognizable at our small scale. The distribution of nationalities of the members varies in the years, but the main centres in Europe are involved, and there is a growing interest of the eastern countries too.
The EBJIS is one of the first European Specialty Societies. It has proven in its 22 years of existence that it is able to offer a platform for those who are interested in bone and joint infections. All interested colleagues are invited to become a member.
Geert HIM Walenkamp
Associate Professor of Orthopedic Surgery
Dept. Orthopedic Surgery, Academic Hospital Maastricht
P.O. Box 5800, 6202 AZ Maastricht, the Netherlands
email: gwa@sort.azm.nl
Secretary: dr. Jos Stuyck
Dept. Orthopedic Surgery, University Hospital
Weligerveld 1, B-3212 Pellenberg, Belgie
email: Jose.Stuyck@uz.kuleuven.ac.be
