some of you would probably knows me because I grew up in the valley and I’m
because I grew up in the valley and I’m
because I grew up in the valley and I’m an orthopedic surgeon specialized in hip
an orthopedic surgeon specialized in hip
an orthopedic surgeon specialized in hip and knee replacement and also sports
and knee replacement and also sports
and knee replacement and also sports surgery and I operate a lot of guys in
surgery and I operate a lot of guys in
surgery and I operate a lot of guys in the valley but today we are not here to
the valley but today we are not here to
the valley but today we are not here to speak about me because it’s not the most
speak about me because it’s not the most
speak about me because it’s not the most interesting but to speak how you have
interesting but to speak how you have
interesting but to speak how you have changed my a bit on my surgical practice
changed my a bit on my surgical practice
changed my a bit on my surgical practice so I guess that some of you are asking
so I guess that some of you are asking
so I guess that some of you are asking ourselves what is an artful plastic and
ourselves what is an artful plastic and
ourselves what is an artful plastic and a capacity is when you replace a
a capacity is when you replace a
a capacity is when you replace a destroyed joint by an artificial one
destroyed joint by an artificial one
destroyed joint by an artificial one which is made by metal plastic or
which is made by metal plastic or
which is made by metal plastic or ceramic so why are the patient different
ceramic so why are the patient different
ceramic so why are the patient different in Xiamen II it’s because you have seen
in Xiamen II it’s because you have seen
in Xiamen II it’s because you have seen Germany is a valley with all tubs on
Germany is a valley with all tubs on
Germany is a valley with all tubs on spots is a way of life and a lot of
spots is a way of life and a lot of
spots is a way of life and a lot of people practice spots on very strenuous
people practice spots on very strenuous
people practice spots on very strenuous spots and they have more risk of wear
spots and they have more risk of wear
spots and they have more risk of wear and tear on their joints and we have to
and tear on their joints and we have to
and tear on their joints and we have to operate them after that so we have to
operate them after that so we have to
operate them after that so we have to deal first with the sport professionals
deal first with the sport professionals
deal first with the sport professionals like skiers runners chrimbus but we have
like skiers runners chrimbus but we have
like skiers runners chrimbus but we have also to deal with mountain guys on ski
also to deal with mountain guys on ski
also to deal with mountain guys on ski instructors and for them the problem is
instructors and for them the problem is
instructors and for them the problem is different they are not only practicing
different they are not only practicing
different they are not only practicing sport for a pleasure but also it’s their
sport for a pleasure but also it’s their
sport for a pleasure but also it’s their job and they have to continue it until
job and they have to continue it until
job and they have to continue it until they are retired so it was a real
they are retired so it was a real
they are retired so it was a real challenge to be able to do that but what
challenge to be able to do that but what
challenge to be able to do that but what is also interesting in Germany there are
is also interesting in Germany there are
is also interesting in Germany there are spot amateurs because for the sports
spot amateurs because for the sports
spot amateurs because for the sports amateur sport is also very competitive
amateur sport is also very competitive
amateur sport is also very competitive and you probably know that in Germany
and you probably know that in Germany
and you probably know that in Germany you don’t have your place because of
you don’t have your place because of
you don’t have your place because of your job because of the money you earn
your job because of the money you earn
your job because of the money you earn because you have your place because of
because you have your place because of
because you have your place because of the place you add at the last run ski
the place you add at the last run ski
the place you add at the last run ski run
run
run raise the weekend before the week and if
raise the weekend before the week and if
raise the weekend before the week and if you are not an eye level spot ammeter
you are not an eye level spot ammeter
you are not an eye level spot ammeter you are not very well in Germany so
you are not very well in Germany so
you are not very well in Germany so that’s why we need to ask you to go back
that’s why we need to ask you to go back
that’s why we need to ask you to go back to these activities so that why the
to these activities so that why the
to these activities so that why the patient expectations are a bit different
patient expectations are a bit different
patient expectations are a bit different because when you go everywhere in the
because when you go everywhere in the
because when you go everywhere in the world when you operate someone for a hip
world when you operate someone for a hip
world when you operate someone for a hip replacement or hip arthroplasty the goal
replacement or hip arthroplasty the goal
replacement or hip arthroplasty the goal will be a good functional result in the
will be a good functional result in the
will be a good functional result in the live activities they want to be able to
live activities they want to be able to
live activities they want to be able to vote to up and down stairs and to do the
vote to up and down stairs and to do the
vote to up and down stairs and to do the arm work but not more in Germany is
arm work but not more in Germany is
arm work but not more in Germany is different the patient want no
different the patient want no
different the patient want no limitations during the fall activities
limitations during the fall activities
limitations during the fall activities and as they want to go soon to the
and as they want to go soon to the
and as they want to go soon to the activities they also want a fast and
activities they also want a fast and
activities they also want a fast and easy recovery and as they don’t want to
easy recovery and as they don’t want to
easy recovery and as they don’t want to stop the spots too early they also want
stop the spots too early they also want
stop the spots too early they also want to have good long-term results so you
to have good long-term results so you
to have good long-term results so you see when you are a surgeon you have to
see when you are a surgeon you have to
see when you are a surgeon you have to deal with that so you will see Beth is
deal with that so you will see Beth is
deal with that so you will see Beth is crazy how often we perform sports with
crazy how often we perform sports with
crazy how often we perform sports with an otoplasty with metal on plastic in
an otoplasty with metal on plastic in
an otoplasty with metal on plastic in the hip or in the knee and we have made
the hip or in the knee and we have made
the hip or in the knee and we have made a study to assess that with more than
a study to assess that with more than
a study to assess that with more than 1,000 patient and we try to see how they
1,000 patient and we try to see how they
1,000 patient and we try to see how they were motivated for sport after an
were motivated for sport after an
were motivated for sport after an otoplasty and in this case it was an ape
otoplasty and in this case it was an ape
otoplasty and in this case it was an ape ultra plastic and we can separate the
ultra plastic and we can separate the
ultra plastic and we can separate the slide in three parts on the left you
slide in three parts on the left you
slide in three parts on the left you have the very low spots life swimming
have the very low spots life swimming
have the very low spots life swimming fishing playing golf in the middle you
fishing playing golf in the middle you
fishing playing golf in the middle you have the moderate sport like dancing I
have the moderate sport like dancing I
have the moderate sport like dancing I think hunting and on the right you have
think hunting and on the right you have
think hunting and on the right you have the rarest when you sports like running
the rarest when you sports like running
the rarest when you sports like running or playing tennis and you see that some
or playing tennis and you see that some
or playing tennis and you see that some blood of patient practice very light or
blood of patient practice very light or
blood of patient practice very light or moderate activities but nearly 30% of
moderate activities but nearly 30% of
moderate activities but nearly 30% of patients are motivated for straining
patients are motivated for straining
patients are motivated for straining sport
sport
sport so it’s not just a philosophic question
so it’s not just a philosophic question
so it’s not just a philosophic question it’s also a reality for surgeon every
it’s also a reality for surgeon every
it’s also a reality for surgeon every day but at least do they return to their
day but at least do they return to their
day but at least do they return to their sport activity
sport activity
sport activity yes and you see that the repetition is a
yes and you see that the repetition is a
yes and you see that the repetition is a very ominous so we have a patient with
very ominous so we have a patient with
very ominous so we have a patient with light on right activity but a lot with
light on right activity but a lot with
light on right activity but a lot with strenuous activities after the
strenuous activities after the
strenuous activities after the arthroplasty so when a patient come to
arthroplasty so when a patient come to
arthroplasty so when a patient come to visit you and ask what will I be able to
visit you and ask what will I be able to
visit you and ask what will I be able to do after my surgery you can say you will
do after my surgery you can say you will
do after my surgery you can say you will be able to practice all sports but it
be able to practice all sports but it
be able to practice all sports but it will depend on your motivations your
will depend on your motivations your
will depend on your motivations your prior level experience and for our long
prior level experience and for our long
prior level experience and for our long you have stopped to practice this sport
you have stopped to practice this sport
you have stopped to practice this sport for sure if you have stopped practicing
for sure if you have stopped practicing
for sure if you have stopped practicing skiing for more than 10 years after the
skiing for more than 10 years after the
skiing for more than 10 years after the Acropolis team you won’t be able to come
Acropolis team you won’t be able to come
Acropolis team you won’t be able to come on skiing but if you have just stopped
on skiing but if you have just stopped
on skiing but if you have just stopped for 1 years it will be easier to come
for 1 years it will be easier to come
for 1 years it will be easier to come back but when we speak about
back but when we speak about
back but when we speak about arthroplasty sunspot we have to take
arthroplasty sunspot we have to take
arthroplasty sunspot we have to take account about the wrist because you know
account about the wrist because you know
account about the wrist because you know that there is a lot of energy when you
that there is a lot of energy when you
that there is a lot of energy when you practice path and you have more risk of
practice path and you have more risk of
practice path and you have more risk of breakage of the prestigious itself you
breakage of the prestigious itself you
breakage of the prestigious itself you can have fractures around the prosthesis
can have fractures around the prosthesis
can have fractures around the prosthesis on you have no risk of dislocation for
on you have no risk of dislocation for
on you have no risk of dislocation for the hip underneath and you have to
the hip underneath and you have to
the hip underneath and you have to inform your patient about this risk
inform your patient about this risk
inform your patient about this risk because it is very important and you
because it is very important and you
because it is very important and you have also to educate them to add them to
have also to educate them to add them to
have also to educate them to add them to go back to their activities some safer
go back to their activities some safer
go back to their activities some safer as you can so while my medical
as you can so while my medical
as you can so while my medical experience has changed so I made my
experience has changed so I made my
experience has changed so I made my study in yo not so far from air and I
study in yo not so far from air and I
study in yo not so far from air and I walk in and see another city of crazy
walk in and see another city of crazy
walk in and see another city of crazy guys not for for 10 years now and I had
guys not for for 10 years now and I had
guys not for for 10 years now and I had to change because at the beginning I was
to change because at the beginning I was
to change because at the beginning I was the same surgeons and the others I said
the same surgeons and the others I said
the same surgeons and the others I said to my patient you should stop spot after
to my patient you should stop spot after
to my patient you should stop spot after your arthroplasty
your arthroplasty
your arthroplasty and one day I was in the lift at the
and one day I was in the lift at the
and one day I was in the lift at the gras Monta and I saw one of my patients
gras Monta and I saw one of my patients
gras Monta and I saw one of my patients just six months after they are topless
just six months after they are topless
just six months after they are topless and from this day I said so if you want
and from this day I said so if you want
and from this day I said so if you want to practice pot you will so it may be
to practice pot you will so it may be
to practice pot you will so it may be better to lq and to fall of you that you
better to lq and to fall of you that you
better to lq and to fall of you that you then you let it do it by yourself so
then you let it do it by yourself so
then you let it do it by yourself so from this day I change my a bit and I
from this day I change my a bit and I
from this day I change my a bit and I began also to work in research and
began also to work in research and
began also to work in research and development for the prosthesis itself
development for the prosthesis itself
development for the prosthesis itself because we have to understood to
because we have to understood to
because we have to understood to understand what are the problem in the
understand what are the problem in the
understand what are the problem in the prosthesis themselves and I also work
prosthesis themselves and I also work
prosthesis themselves and I also work for the UT military mom law Health
for the UT military mom law Health
for the UT military mom law Health Commission and it’s very interesting for
Commission and it’s very interesting for
Commission and it’s very interesting for me because I love the experience of
me because I love the experience of
me because I love the experience of various training spots on the
various training spots on the
various training spots on the consequences on the joint on the global
consequences on the joint on the global
consequences on the joint on the global person so you probably say oh but if a
person so you probably say oh but if a
person so you probably say oh but if a knee arthroplasty is not for me it’s for
knee arthroplasty is not for me it’s for
knee arthroplasty is not for me it’s for my enable but you see that just for me
my enable but you see that just for me
my enable but you see that just for me per year is around 250 arthroplasty so I
per year is around 250 arthroplasty so I
per year is around 250 arthroplasty so I think that maybe 10 or 15% in this room
think that maybe 10 or 15% in this room
think that maybe 10 or 15% in this room will have a natural last year one day
will have a natural last year one day
will have a natural last year one day and I also performed some art was copy
and I also performed some art was copy
and I also performed some art was copy an ACL reconstruction and it’s very
an ACL reconstruction and it’s very
an ACL reconstruction and it’s very interesting to practice all the surgery
interesting to practice all the surgery
interesting to practice all the surgery not only a kind of surgery because we
not only a kind of surgery because we
not only a kind of surgery because we can have a continuity with the patient
can have a continuity with the patient
can have a continuity with the patient from the first trauma to the
from the first trauma to the
from the first trauma to the arthroplasty so we really know the
arthroplasty so we really know the
arthroplasty so we really know the patient and we can help them it’s easier
and I also a bit of spot experience so
and I also a bit of spot experience so don’t try to find my name in the top of
don’t try to find my name in the top of
don’t try to find my name in the top of the right but maybe at the last but I
the right but maybe at the last but I
the right but maybe at the last but I try to be in the race and I think it’s
try to be in the race and I think it’s
try to be in the race and I think it’s very interesting for me to share during
very interesting for me to share during
very interesting for me to share during training during the race the difficulty
training during the race the difficulty
training during the race the difficulty and to understand what really the sport
and to understand what really the sport
and to understand what really the sport practicing is but to protect spot reason
practicing is but to protect spot reason
practicing is but to protect spot reason arthroplasty is just not just a question
arthroplasty is just not just a question
arthroplasty is just not just a question of surgery it’s in fact a long process
of surgery it’s in fact a long process
of surgery it’s in fact a long process and we need to add some partners to be
and we need to add some partners to be
and we need to add some partners to be able to to achieve this long process and
able to to achieve this long process and
able to to achieve this long process and it begins from the surgical invitation
it begins from the surgical invitation
it begins from the surgical invitation the first time you see the patient to
the first time you see the patient to
the first time you see the patient to the best level of activity and you see
the best level of activity and you see
the best level of activity and you see that the surgery is just a point in
that the surgery is just a point in
that the surgery is just a point in the long way the first step it’s a very
the long way the first step it’s a very
the long way the first step it’s a very clear information of what the patient
clear information of what the patient
clear information of what the patient will be able to do after the
will be able to do after the
will be able to do after the arthroplasty if you have a patient we
arthroplasty if you have a patient we
arthroplasty if you have a patient we say oh I was able to work five hours and
say oh I was able to work five hours and
say oh I was able to work five hours and now I work only two hours I want to be
now I work only two hours I want to be
now I work only two hours I want to be operate it’s not a good indication but
operate it’s not a good indication but
operate it’s not a good indication but if the patient’s say I daily pain I
if the patient’s say I daily pain I
if the patient’s say I daily pain I cannot do what I did before it’s a good
cannot do what I did before it’s a good
cannot do what I did before it’s a good indication and you have to be clear
indication and you have to be clear
indication and you have to be clear about the risk because they are a
about the risk because they are a
about the risk because they are a reality then after that we try to create
reality then after that we try to create
reality then after that we try to create some groups of patients because we think
some groups of patients because we think
some groups of patients because we think it’s better to not to be alone but to be
it’s better to not to be alone but to be
it’s better to not to be alone but to be with your friends like when you prepare
with your friends like when you prepare
with your friends like when you prepare a race or something like that and we are
a race or something like that and we are
a race or something like that and we are the first proud meeting with the nurse
the first proud meeting with the nurse
the first proud meeting with the nurse with anesthesiologist surgeon and
with anesthesiologist surgeon and
with anesthesiologist surgeon and physiotherapist and we clearly prepare
physiotherapist and we clearly prepare
physiotherapist and we clearly prepare the post-operative management and we
the post-operative management and we
the post-operative management and we explain the patient what the surgery is
explain the patient what the surgery is
explain the patient what the surgery is because when you understand what will
because when you understand what will
because when you understand what will happen when we go behind the door with
happen when we go behind the door with
happen when we go behind the door with it with an operative room it’s easier
it with an operative room it’s easier
it with an operative room it’s easier for you to understand and you are it’s
for you to understand and you are it’s
for you to understand and you are it’s more clear so as I said for us create
more clear so as I said for us create
more clear so as I said for us create groups is very interesting from the
groups is very interesting from the
groups is very interesting from the beginning and then for the
beginning and then for the
beginning and then for the rehabilitation and then we go back to
rehabilitation and then we go back to
rehabilitation and then we go back to sports we can really create a group of
sports we can really create a group of
sports we can really create a group of friends and we can create an emulation
friends and we can create an emulation
friends and we can create an emulation at each step what is the first step of
at each step what is the first step of
at each step what is the first step of the rehabilitation you know when you
the rehabilitation you know when you
the rehabilitation you know when you have been operated you are afraid you
have been operated you are afraid you
have been operated you are afraid you say oh what will happen can I move can i
say oh what will happen can I move can i
say oh what will happen can I move can i watch so you have to explain to the
watch so you have to explain to the
watch so you have to explain to the patient that he can share with no
patient that he can share with no
patient that he can share with no problem and if it breaks is better if it
problem and if it breaks is better if it
problem and if it breaks is better if it breaks the day of the surgery than two
breaks the day of the surgery than two
breaks the day of the surgery than two months after because if it breaks two
months after because if it breaks two
months after because if it breaks two months after you have lost two months so
months after you have lost two months so
months after you have lost two months so that why we explain them not losing the
that why we explain them not losing the
that why we explain them not losing the automatisms so there are operating the
automatisms so there are operating the
automatisms so there are operating the day of the morning of the surgery on the
day of the morning of the surgery on the
day of the morning of the surgery on the afternoon they stand up and they begin
afternoon they stand up and they begin
afternoon they stand up and they begin to walk with crutches and we say them to
to walk with crutches and we say them to
to walk with crutches and we say them to move the leg and just you have to keep
move the leg and just you have to keep
move the leg and just you have to keep in mind pain but we also try to pain
in mind pain but we also try to pain
in mind pain but we also try to pain because if you don’t have pain when you
because if you don’t have pain when you
because if you don’t have pain when you wake up
wake up
wake up after you won’t have more pain because
after you won’t have more pain because
after you won’t have more pain because when you wake up the first thing you are
when you wake up the first thing you are
when you wake up the first thing you are searching is where do I pain I’ve been
searching is where do I pain I’ve been
searching is where do I pain I’ve been operating I scare if you just treat the
operating I scare if you just treat the
operating I scare if you just treat the pain and you move you say oh it’s not so
pain and you move you say oh it’s not so
pain and you move you say oh it’s not so bad I can go on so the treatment of pain
bad I can go on so the treatment of pain
bad I can go on so the treatment of pain is a really important and we don’t
is a really important and we don’t
is a really important and we don’t consider as a patient as patient but as
consider as a patient as patient but as
consider as a patient as patient but as spot guy and we say oh we’re going to do
spot guy and we say oh we’re going to do
spot guy and we say oh we’re going to do an early sport rehabilitation and we are
an early sport rehabilitation and we are
an early sport rehabilitation and we are not focused on the joint who had been
not focused on the joint who had been
not focused on the joint who had been operated we try to make a global job on
operated we try to make a global job on
operated we try to make a global job on the global movement because if you just
the global movement because if you just
the global movement because if you just consider underneath the patient we’ll
consider underneath the patient we’ll
consider underneath the patient we’ll watch and the problem is not only in the
watch and the problem is not only in the
watch and the problem is not only in the hip because if you move you it you have
hip because if you move you it you have
hip because if you move you it you have the feeling that the knee has nothing to
the feeling that the knee has nothing to
the feeling that the knee has nothing to do so you have to explain the patient
do so you have to explain the patient
do so you have to explain the patient the global movement and when doing that
the global movement and when doing that
the global movement and when doing that it’s easier and we try to make the
it’s easier and we try to make the
it’s easier and we try to make the rehabilitation like again and it must be
rehabilitation like again and it must be
rehabilitation like again and it must be funny
funny
funny you should try some slag lines some even
you should try some slag lines some even
you should try some slag lines some even and when you are a sport guy and say you
and when you are a sport guy and say you
and when you are a sport guy and say you have a challenge to do you know that he
have a challenge to do you know that he
have a challenge to do you know that he will be able to do that because yes it’s
will be able to do that because yes it’s
will be able to do that because yes it’s habitual for him to go to do some
habitual for him to go to do some
habitual for him to go to do some challenges then grab I’d been done we go
challenges then grab I’d been done we go
challenges then grab I’d been done we go back to produce sport activities so at
back to produce sport activities so at
back to produce sport activities so at this time we like to have group
this time we like to have group
this time we like to have group progression and we worked with my friend
progression and we worked with my friend
progression and we worked with my friend Steven bammel within the audience is a
Steven bammel within the audience is a
Steven bammel within the audience is a ski instructor and also physiotherapist
ski instructor and also physiotherapist
ski instructor and also physiotherapist and he has a nice view of the pedagogy
and he has a nice view of the pedagogy
and he has a nice view of the pedagogy on how to do the movement when you have
on how to do the movement when you have
on how to do the movement when you have been operated and I think it’s very
been operated and I think it’s very
been operated and I think it’s very interesting and when you are in group
interesting and when you are in group
interesting and when you are in group the patient can share the affair on the
the patient can share the affair on the
the patient can share the affair on the experience and they can progress
experience and they can progress
experience and they can progress together but sometimes we have also to
together but sometimes we have also to
together but sometimes we have also to practice individual on specific training
practice individual on specific training
practice individual on specific training so as is why the guy was operated after
so as is why the guy was operated after
so as is why the guy was operated after six months for at ESA so he wanted to be
six months for at ESA so he wanted to be
six months for at ESA so he wanted to be able to run when he went on and for this
able to run when he went on and for this
able to run when he went on and for this guy so it took a little bit of right
guy so it took a little bit of right
guy so it took a little bit of right it was his first race and it was four
it was his first race and it was four
it was his first race and it was four months after the surgery it was a trail
months after the surgery it was a trail
months after the surgery it was a trail around 13 kilometers so going back to
around 13 kilometers so going back to
around 13 kilometers so going back to sports activities after arthroplasty is
sports activities after arthroplasty is
sports activities after arthroplasty is not only a dream
not only a dream
not only a dream it’s for us reality and we have to deal
it’s for us reality and we have to deal
it’s for us reality and we have to deal with that every day and it’s also very
with that every day and it’s also very
with that every day and it’s also very interesting for us because it’s also a
interesting for us because it’s also a
interesting for us because it’s also a challenge and when you are getting old
challenge and when you are getting old
challenge and when you are getting old and you are not able to have good
and you are not able to have good
and you are not able to have good results in sports you try to a bit in
results in sports you try to a bit in
results in sports you try to a bit in surgery and I hope we are breaking new
surgery and I hope we are breaking new
surgery and I hope we are breaking new ground in speed of recovery so we have
ground in speed of recovery so we have
ground in speed of recovery so we have changed a lot of things on the patient
changed a lot of things on the patient
changed a lot of things on the patient I’ve also changed our mind and I hope
I’ve also changed our mind and I hope
I’ve also changed our mind and I hope we’ll be able to influence medical
we’ll be able to influence medical
we’ll be able to influence medical practices in other part of the world
practices in other part of the world
practices in other part of the world thank you
thank you
thank you [Applause]
”
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