The 22nd edition of the annual Brussels/Genval Symposium will take place on Friday January 24 and Saturday January 25, 2014, again in the beautiful Château du Lac at Genval. As always, the Symposium will be dedicated to a specific interdisciplinary topic involving the hand and the upper limb. The previous meetings have been attended by 80-150 participants, from 15-25 different countries. In 2014 the topic of upper extremity tendon problems will be the main feature. Rotator cuff/long biceps tendinosis and tears are leading causes of shoulder pain, especially after the age of 50. “Epicondylosis”, either lateral or medial, causes severe professional and sportive disabilities. The results of flexor tendon lacerations are suboptimal in too many cases. The Brussels/Genval Symposium has a long tradition of mixing basic researchers, clinicians and physiotherapists - with the ultimate aim to improve the care of our patients. New knowledge of tendon anatomy (including variations, vascularisation and innervation), physiology and biomechanics will be first presented in up-to-date lectures. In the second part of the symposium, the causes of tendon degeneration leading to rupture and the healing potential, with or without tendon repair, will be discussed. In particular, the aetiologies of shoulder, elbow and wrist tendon degeneration will be reviewed (impingement, infectious, inflammatory, microcrystalline, tendon attrition in presence of an arthroplasty or osteosynthesis implant). How do tendons heal, in particular what is the intrinsic healing potential of poorly vascularized tendons? Can we enhance tendon healing, by pharmaceutical agents, stem cells or genetic modifications? Is smoking or other toxics deleterious? The third part of the program will deal with diagnostic aspects. The diagnosis is indeed challenging in many cases (eg : rupture of pectoralis major at the shoulder or of triceps at the elbow). The imaging modalities have markedly improved in the last fifteen years; it is important in the context of cost control of medical expenses to define the optimal investigation for each suspected diagnosis. For example, what is the best technique to confirm a rotator cuff lesion, simultaneously evaluating the possible osteoarthrotic associated lesions and the state of the muscles? How to evaluate tendon healing after surgical repair? In the fourth part of the symposium, the treatment of tendon disorders and injuries will be discussed, starting with non-surgical management. What is the place of new techniques of physiotherapy? of platelet-rich plasma injections? of infiltrations, new medications, of physical therapy? These techniques should be scrutinized in the light of new surgical (open or arthroscopic) options. The surgical management of tendon diseases has evolved tremendously in recent years, and many lesions previously treated with open technique are now addressed with minimally open procedures (distal biceps reinsertion) or arthroscopically, with the use of special knots, double-row repair at the rotator cuff, anchors etc. What are the results of these sophisticated techniques, including in elderly patients with poor tendons and inferior bone quality? How to treat re-tears? At the hand, stronger flexor tendons sutures allow early active finger motion, what are the results in terms of adherences and re-ruptures? In general, what are the relative indications of tenotomy, tendon suture, augmentation, transfer, graft, tendon prosthesis – or neglect? In case of tendon repair, which type of postoperative immobilization/protected mobilization should be instaured, what are the indications and limitations of unprotected motion, what is the place of botulinum toxin muscular injections? The symposium will indeed end with aspects of physiotherapy and evaluation of the clinical results, including return to sport activities. The primary goals of the Brussels/Genval annual upper limb symposium are to promote the exchange of ideas, to establish guidelines on a consensual basis, and to foster collaborative investigations among various specialists. Much time will be set aside for the discussions.

P. Amadio (Rochester, MN, USA) 
J. Bahm (Aachen and Brussels, Germany and Belgium) 
O. Barbier (Brussels, Belgium) 
E. Brassine (Brussels, Belgium) 
K. Cermak (Brussels, Belgium) 
V. Creteur (Brussels, Belgium) 
N. Cuylits (Brussels, Belgium) 
L. De Smet (Leuven, Belgium) 
Degreef (Leuven, Belgium) 
L. Dewilde (Ghent, Belgium) 
K. Drossos (Brussels, Belgium) 
W. El Kazzi (Brussels, Belgium) 
V. Feibel (Brussels, Belgium) 

F. Handelberg (Brussels, Belgium) 
M. Jayankura (Brussels, Belgium) 
J. Leijnse (Brussels, Belgium) 
D. Mouraux (Brussels, Belgium) 
F. Mulpas (Brussels, Belgium) 
N. Pouliart (Brussels, Belgium) 
Ch. Robert (Brussels, Belgium) 
F. Schuind (Brussels, Belgium) 
M. Shahabpour (Brussels, Belgium) 
R. van Riet (Deurne and Brussels, Belgium) 
Van Tongel (Ghent, Belgium) 
O. Verborgt (Deurne, Belgium) 
D. Warwick (Southampton, United Kingdom)

CONGRESS SECRETARIAT

Mrs L Ectors

King Conventions
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