It is a privilege for me to introduce this Instructional Lecture book for the 11th EFORT Congress. The format of the Congress combines a National society, SECOT, and the European Federation, EFORT. For this lecture book,the topics selected are original and attractive and will predicate further lectures. The main goal of EFORT is to convey the latest knowledge of diseases and trauma of the Musculoskeletal system to all European Surgeons. We also wish to welcome colleagues from all over the world,especially from Latin-America and Asia, who are joining us. The Scientifc programme combines multiple aspects of Orthopaedics and Traumatology, paying attention particularly to the latest treaments for infections, m- astatic disease, Trauma care and arthroplasty registers, from a European perspective. Our Instructional Lecturers are from all over Europe, and present topics from diverse areas of interest. These lectures give the opportunity to learn about various deseases but also our speakers' special experience based on their National philosophy - again a chance to widen our European horizons. As the chairman of the Local Organising Committee. I thank all of our Lecturers for their for excellent contributions for publication in this collection. My special thanks go the Professor George Bentley for organising this edition. EFORT should be congratulated for all its efforts in providing training material for all Orthopaedic surgeons,and particularly for this selection of Instructional Lectures for the Congress in Madrid. This tenth volume in the EUROPEAN INSTRUCTIONAL LECTURES series continues the format of educational chapters from across Orthopaedics and Traumatology contributed by notable surgeons in Europe. It provides up-to-date material and major advances covering a range of topics including: -General Orthopaedics -Musculo-Skeletal Tumours -Paediatric Orthopaedics -Trauma -Spine -Upper Limb -Hip -Knee -Ankle and Foot All the lectures were presented at the 11th EFORT Congress in Madrid, Spain. The lectures are an authoritative source of information illustrated by radiographs, MRI and CT Scans, operative photographs, tables and line drawings. They are a valuable source of instruction for Surgeons and Trainees alike. This book has been edited by Professor George Bentley. Chairman of Scientific Publications Committee of EFORT.