• Foundation and Subsequent Progress of the Asian Shoulder Association
• Development of the Asian Shoulder and Elbow Association Since the 2011 Meeting in Japan

The Development of the Asian Shoulder and Elbow Association: Since the 2011 Meeting in Japan, the COVID-19 Pandemic, and Beyond

Japan Shoulder Association
President
Hiroyuki Sugaya

The history of the establishment of the ASA (Asian Shoulder Association) and the 7th meeting of ACASA (Academic Congress of the Asian Shoulder Association) held in Okinawa in 2011 are described in detail in the 40-year history of the Japan Shoulder Society, thanks to the efforts of Hiroaki Tsutsui, and can be found here. I have been involved as the Secretary General of Society since the 7th meeting in 2011, and I would like to describe society up to the present.

Two Indian members (Nicholas Antao and Sanjay Desai) were approved as board members of the Asian Shoulder Association at the 2011 board meeting in Okinawa. President Hiroaki Tsutsui suggested that the Asian Shoulder Association be changed to the Asian Shoulder and Elbow Association. The ambiguous position definitions of the organizations were redefined as follows:

The Founding President

Katsuya Nobuhara

The Founding Board Members

Executive Board Members

Term of Presidency

• Current President (2011-2014): Hiroaki Tsutsui
• Past President (2008-2011): Kai-Ming Chan
• Past President (2005-2008): Gong-Yi Huang
• Past President (2002-2005): Kwang-Jin Rhee
• Past President (1999-2002): Chehab R. Himly
• Past President (1999-1996): Peter Hales
• Past President (1996-1994): Jiunn-Jer Wu

Future Host

2014 will be in Philippines and 2017 will be in India

• Figure 1. Board Meeting participants at the 7th ACASA

The 8th ACASA

The 8th ACASA was held in Cebu, Philippines, November 25-26, 2014, in conjunction with the Philippines Orthopaedic Association and Dr. Alberto Ma. Molano as President (Figs. 2 and 3). Drs. Laurent Lafosse and Gilles Walch from France were invited as guest speakers for the first time from outside Asia, including Japan, Korea, Malaysia, India, China, Israel, Brunei, Singapore, Indonesia, the United States, New Zealand, Taiwan, Thailand, Vietnam, Sri Lanka, and the Philippines. Dr. Katsuya Nobuhara, the founding president, and live surgeries by Dr. Lafosse and myself (Sugaya) were also held for the first time at the ACASA (Fig. 4).

The 8th ACASA Executive Board Meeting was held on November 26 at the Radisson Blu Hotel on Cebu Island. First, Dr. Hishamudin Masdar, President of Malaysia Arthroscopy Society (MAS), was approved as a board member from Malaysia. The previous homework assignment from the ASA to the ASEA was also unanimously approved, and it was decided that the name of the society would be the Asian Shoulder and Elbow Association (ASEA) and the name of the society would be the Academic Congress of the Asian Shoulder and Elbow Association (ACASA. Dr. Sanjay Desai reported that preparations for the 9th ACASEA to be held in Mumbai, India in 2017 progressed smoothly. It was also decided that Singapore would be the host in 2020, with Dr. Denny Lie as the Congress president. (Fig. 5)

• Figure 2. The final pre-conference newsletter (left) and website (right) of the 8th ACASA

• Figure 3. Snapshots at the banquet. Left: Hiroaki Tsutsui, former president, and Dr. Alberto Ma. Molano, current president. Bottom right: From left to right: Dr. Molano, congress president, Mrs. Nobuhara, Mrs. Molano, Dr. Nobuhara, and Dr. Jih-Yan Ko from Taiwan (11th congress president to be elected).

• Figure 4. Post-conference Newsletter

• Figure 5. Members of the Board Meeting at the 8th ACASA

The 9th ACASEA

The 9th ACASEA was held in Mumbai, India in 2017. Dr. Katsuya Nobuhara, Founding President of ACASEA, was unable to attend this year's meeting for personal reasons; however, many guest speakers were invited from Europe and the United States (Fig. 6). The conference gave the impression that ACASEA, an Asian congress, is evolving into an increasingly open international conference like SECEC in Europe (Fig. 7).

• Figure 6. Program Book of the 9th ACASEA in 2017

• Figure 7. Opening Ceremony of the 9th ACASEA

• Figure 8. Participating Members of the Executive Board Meeting at the 9th ACASEA

At the 9th Board Meeting, Sugaya was officially nominated as Secretary General of ASEA, and it was confirmed that he would be working with Dr. Nobuyuki Yamamoto, Tohoku University, as Secretary of ASEA.

• Dr. Katsuya Nobuhara, who had been nominated as Permanent Society President at the 2nd ACASA meeting, expressed his wish to resign from this position.
• It was confirmed that the number of Executive Board Members (EBM), which varied from country to country and region to region, would be unified into two members in principle, and that a policy to actively promote young members would be adopted.
• For the advancement of shoulder and elbow surgery in Asia, it was decided to hold an annual meeting every two years starting from the 11th Annual Meeting in 2020, which was held every three years.
• It was confirmed that the 10th Congress will be held in Singapore in 2020, with Dr. Denny Lie as President, the 11th Congress will be held in New Zealand in 2022, and the 12th Congress will be held in Taiwan in 2024.
• Finally, it was suggested that the ACASEA should be held independently. However, it is premature to establish rules for independent conferences because there are still many countries and regions in Asia where it is difficult to hold independent conferences in terms of both human resources and finances. However, it was agreed that the Presidents of ACASEA would make efforts to make ACASEA as close as possible to an independent conference.

ASEA during the COVID-19 pandemic

The corona disaster that began in early 2020, forced most national and international conferences to be canceled or held online, and the ASEA was also severely affected. The 10th Singapore Congress in 2020 was held in December 2022, five years after the previous Congress, with repeated postponements.

The 10th ACASEA

The 10th ACASEA was held in Singapore in conjunction with the Singapore Orthopaedic Association (SOA) from December 5 to 10, 2022, at the Shangri-La Hotel (Figures 9, 10, and 11). However, due to the confusion caused by the COVID-19 pandemic and the delay in announcement, there were few participants from Japan and other Asian countries.

• Figure 9. Brochure of the 10th ACASEA

• Figure 10. Symposium at the 10th ACASEA

The Board Meeting was held on December 8 and the following 11 members attended:

• Greg Hoy (AUSTRALIA)
• Roshan Wade, Sanjay Desai (INDIA)
• Andri Lubis (INDONESIA)
• Nobuyuki Yamamoto (JAPAN)
• Yong-Girl Rhee (KOREA)
• Denny Lie, VP Kumar (SINGAPORE)
• Bancha Charnchujit (THAILAND)
• Alberto Ma. Molano (PHILIPPINES)
• Hishamudin Masdar (MALAYSIA)

Dr. Nobuyuki Yamamoto moderated the meetings in place of Sugaya, who was absent. First, a silent prayer was offered in the memory of Dr. Katsuya Nobuhara, Honorary Society President, who passed away on March 13, 2022.

• The 11th ACASEA will be held in Taiwan in 2024 under Dr. Jih-Yang Ko’s presidency. The next meeting, in 2026, is expected to be held in New Zealand under Dr. Craig Ball’s presidency, but this is uncertain because of domestic circumstances. Malaysia will host 2028 and Thailand will host 2030.
• The number of Executive Board Members (EBM) was discussed, excluding Founding Board Members and Secretaries, with a maximum of two EBM in each country/region. It was also confirmed that younger members should successively replace by younger members. It was decided that the EBM members would be promoted in each country/region and reported to the Secretariat.

• Figure 11. Members Participating in the Executive Board Meeting at the 10th ACASEA

Relationship between ASEA and Japan Shoulder Society

Dr. Hiroaki Tsutsui, the successor of Dr. Nobuhara, had long been concerned that “the ASA originated from a private meeting of Katsuya Nobuhara and was not officially recognized by the Japan Shoulder Society.” On the other hand, due to the COVID-19 pandemic, secretariat functions, including the website of the society, were suspended. At the 10th ASEA Congress in 2022, Dr. Yong-Girl Rhee of Korea pointed out to Dr. Nobuyuki Yamamoto that Japan should take the lead in managing the ASEA now that Dr. Nobuhara had passed away. In light of the above, Hiroaki Tsutsui strongly requested that the secretariat function of the ASEA be improved and that the ASEA should be managed under the leadership of the Japan Shoulder Association. The relationship between the ASEA and Japan Shoulder Association was clarified with approval from the board of directors.

The following is an excerpt from the minutes of the 51st meeting of the board of directors of the Japan Shoulder Society, held on April 3, 2023: “The ASA (now ASEA). Dr. Hiroyuki Sugaya, President of the Board of Directors, received a request from Dr. Hiroaki Tsutsui, Honorary Member who served as President of the ACASA in 2011, regarding the relationship of the Japan Shoulder Society with the ASEA. Since the first ACASA meeting in 1994, the Japan Shoulder Society has not been clearly positioned in relation to ASA (ASEA) since the first ACASA Society of Anesthesiologists and the functions of the secretariat have become ambiguous. Therefore, board members from other countries requested that the Japan Shoulder Society take the lead in managing the ASEA. The board of directors agreed that it was meaningful for Japan to play a central role and actively manage ASEA within Asia and approved the proposal. It was also decided that ASEA's homepage, which currently exists on another server without being updated, would be suspended, and a new homepage would be created on the Japan Shoulder Society's server, the cost of which would also be borne by the Japan Shoulder Society. It was also decided that the contents of the website would be prepared by Drs. Hiroyuki Sugaya and Nobuyuki Yamamoto, who served as secretariats of the ASEA. Since the name has now been changed to ASEA, secretariat staff will be added from the Japan Elbow Society, and Noriko Kawamura of the ISS will assist with the secretariat duties.”

The 15th ICSES in Rome

At ICSES 2023, a “Day 0 meeting was held the day before the conference, with meetings divided into regions worldwide. ASEA also held a Day 0 meeting, organized its own program under the leadership of President Denny Lie, and invited abstracts from Asia. In memory of Dr. Katsuya Nobuhara, Honorary Founding President, who passed away in March 2023, Nobuyuki Yamamoto gave the “Katsuya Nobuhara Memorial Lecture” at the beginning of the meeting. All participants reminisced about Nobuhara's past. Subsequently, the participants from Asia had a heated discussion on the themes of the shoulder and elbow.

Simultaneously, an Executive Board Meeting (EBM) is held in 2026 to discuss the renewal of EBM members and how to hold the 12th ACASEA (Fig. 12).

• Figure 12. Members Participating in the Extraordinary Executive Board Meeting at the 15th ICSES

ASEA Board Meeting in Rome, Italy on Sep. 5, 2023

Participants

• Richard Page, Mark Ross (AUSTRALIA)
• Qing-Yun Xue, Guoqing Cui (CHINA)
• Patrick Yung (HONG KONG)
• Ram Chidambaram, Kr Prathapkumar (INDIA)
• Andri Lubis, Renaldi Nagarasyid (INDONESIA)
• Hiroyuki Sugaya, Nobuyuki Yamamoto (JAPAN)
• Jin-Young Park, Joo-Han Oh, Jae-Chul Yoo (KOREA)
• Hishamudin Masdar (MALAYSIA)
• Craig Ball, Marc Hirner (NEW ZEALAND)
• Denny Lie, Bryan Tan (SINGAPORE)
• Alberto Molano, Jonathan Ronquillo (PHILIPPINES)
• Jih-Yang Ko (TAIWAN) (On line)

First, everyone offered a silent prayer to Prof. Hermawan Nagar Rasyid of Indonesia, who passed away in March 2023.

• The 12th ACASEA will be held in 2026. New Zealand, the host country of the 12th ACASEA, expressed that it would not be possible to host the conference by itself due to financial difficulties and the large-scale construction of the venue in Auckland, and requested Australia to host the conference on its behalf. It was reaffirmed that the 13th ACASEA will be held in Malaysia in 2028 and the 14th ACASEA will be held in Thailand in 2030, as scheduled.
• Professor Jih-Yang Ko updated the progress of the 11th ACASEA, which is to be held in Taiwan by 2024.
• Current Executive Board Members (EBM)
  Australia (2): Richard S Page, Mark Ross
  China (3): Qing-Yun Xue, Guoqing Cui, Chunyang Jiang
  Hong Kong (2): Patrick Yung, Michael Ong
  India (4): Sanjay Desai, Roshan Wade, Ram Chidambaram, Kr Prathapkumar
  Indonesia (2): Andri Lubis, Iman Aminata
  Japan (4): Hiroyuki Sugaya*, Nobuyuki Yamamoto*, Teruhisa Mihata, Kotaro Yamakado
  Korea (3): Jin-Young Park, Joo-Han Oh, Jae-Chul Yoo
  Malaysia (2): Hishamudin Masdar, Mohd Nizlan Mohd Nasir
  New Zealand (2): Craig Ball, Marc Hirner
  Philippines (2): Alberto Molano, Jonathan Ronquillo
  Taiwan (2): Jih-Yang Ko, Wei Ren Su
  Singapore (2): Denny Lie, Bryan Tan
  Thailand (2): Bancha Charnchujit, Chanakarn Phormphukul
  *Secretary

Subsequently, a proposal was made by both countries that the 12th ACASEA in 2026 could be replaced by a “Day 0 Meeting” at the 16th ICSES to be held in Canada in the same year, to be jointly hosted by Australia and New Zealand. After repeated e-mail discussions among the Board members, it was finally decided that the “Day 0 Meeting” would not be a substitute for ACASEA, and that AUS/NZ would preside over the “Day 0 Meeting” in 2026, and that the 12th Meeting will be held in Malaysia in 2027.

Concluding Remarks

As you can see from the 40 Years of the Asian Shoulder Association by Dr. Hiroaki Tsutsui, the ASA was developed mainly through the personal connections of Dr. Katsuya Nobuhara and was founded under his efforts. Dr. Nobuhara was the Founding Society President from the beginning and became the Honorary Founding President of the 9th ASEA in 2017. However, owing to the COVID-19 pandemic, he did not participate in any subsequent conferences after the 8th ACASA in 2014 and passed away in March 2023, approximately 10 years later. Approximately half of the Founding Members have passed away, and the number of Executive Board Members has changed significantly. Shoulder and elbow surgery in Asia has improved beyond comparison since the establishment of the ASA of Anesthesiologists in 1994, and arthroscopic surgery and arthroplasty are now widely practiced. I hope that the Japan Shoulder Society will continue to take the lead in discussions led by Executive Board Members, and that the ASEA will become an organization comparable to the SECEC in Europe and the ASES in North America.