Jean died out one year ago. With him one disappears from the large French pioneers of the prosthetic joint replacement. Maîtrise csotcina.comédique had had the privilege to meet it little time before its death and it very had then pleasantly referred to its memories of heroic times and the passage to modern csotcina.comedy.

 

. : Which are the roots of the family?

. : At the beginning it is a country family of the Hollow one. One of my grandfathers was farmer. It was certainly a man of great span since without specific instruction, it had succeeded in being an General adviser and Delegate of his district. Especially it had made give an instruction to its four sons, which at the time, whereas it did not have fortune, was difficult. All his/her friends told him: you are insane, you do not know what can . And he answered . That finally went very well since my father made the very beautiful csotcina.comedic career which one knows. He was intern, Science Doctor, etc… The oldest son remained to work with the farm to gain a little money, the second boy made the central school where it was received first blow but it had to give up because it made a tuberculosis. In the other connects, on the side of my mother, my grandfather was migrant. The migrants were people who because of poverty, left to them to go to Paris. With foot first years, then by the railroad. My grandfather worked in the ship and it had succeeded well from the material point of view. It had several buildings in Paris and starting from this state of migrant it had succeeded in making a true small fortune.

 

. : Which was the professional route of your father?

. : My father made his medicine and see, I never had the curiosity to ask him why him, wire of peasant, had made this choice. He made his medicine under the conditions of a poor student. He lived with 100 F per month what all the same at the time to place themselves, nourish themselves, dress themselves in Paris was very little. He worked enormously and very quickly. He was one of the first to see that csotcina.comedy was a specific discipline and that it was necessary to be detached from the remainder of the surgery. He thus devoted himself to the bone surgery. He had very difficult beginnings with the financial point of view and little by little customers and a fame came to him. He initially was at the hospital where he was the assistant of , then after in liberal surgery. He had very beautiful customers but he was always haunted by work. Its Treaty of the fractures of the members was extremely widespread and later, when I was called in South America to make conferences, I saw in the library of American of the south which at that time spoke French, this famous Treaty of the fractures of the members.

 

. : When did yours father can build his private clinic?

. : Before the war it had a friend who told him: your private clinic you will be on your premise, more especially as your sons are Because indeed, its two Jean sons and Robert had started to make medicine and csotcina.comedy. Then it decided to build a private clinic. It did not have much money and it made loans. It had a friend architect who made him the plans. One settled Square , close to the old cycle-racing track of winter. At this place were forwarded many victims of the sport and one worked enormously. There were 40 beds what proved very quickly insufficient, as well as a consultation and an aircraft of radiography. Then the war arrived. We were very patriotic and a little unconscious because we had on the spot installed a true first-aid post for the resistant ones who arrived of everywhere. The miracle it is that with our 40 employees, nobody gave a telephone call to to denounce us. There was a permanent procession of casualties. Once however, Robert was taken by which had nevertheless smelled something.

 

. : How old was Robert at this time there?

. : It was 30 years old. They came to seek it and took it along. Me I was at the Saint-Louis Hospital where I directed the department of csotcina.comaedics and one called to me to say took along your brother! >> I said myself is there, one will not re-examine it . The evening, Robert returned and he told me was very hard. I was questioned all the day but they did not maltreat me. The first interrogative one was very hard, an old cow, the second a little more flexible and the third seemed to be shoved some a little. When it was finished, this third individual who had a little old air told me you leave free; there are not many people who left from here . It was street of the Willow plantations. Robert who had a fantastic cheek answered him: made me lose you my day; I had operated and many patients to see, made me bring back by car. Extraordinary thing, the type checked that there remained still a driver in the court and Robert returned in a car of . There was much chance.

 

. : Which was the speciality of your father?

. : csotcina.comedy and traumatology. It dealt with fractures, of pseudarthroses… We helped it when we were intern. It made osteosyntheses, it operated many osteomyelitides. Bone pathology was neglected and as it was interested in it, the patients came from everywhere. It was a disciple of which was the first to make osteosyntheses. There were the plates, but not yet the nails. The nails arrived at the time of the war. Beside osteosyntheses there were the continuous extensions and many people were plastered.

 

. : Did work in which hospital?

. : . There is a history which you will not tell because it is embarrassing, but which enchanted my father. had a great vitality. One day in the afternoon it feels an impulse then it goes in the street and it challenges a which had good appearance and brings it to the staff waiting room. , the lady also and it realizes whereas it was covered with crab-louses. But the share was too engaged: it then takes the daily newspaper of the time, it makes a hole inside and ahead!

 

. : Speak to us about your beginnings, your boarding school…

. : I was internal of Mr at the hospital. At this time, I was already worked by more or less new ideas and with Robert we had seen that a Belgian appointed made an external fixer. Then one launched out in the external fixer which at that time was not at all in vogue. People did not want any. One made publications, even in time that interns, and Mr forwarded our publications to the Academy of Surgery. We were also interested in the anesthesia which had been created by German and who had fallen in disuse. We made 40 of them that Mr forwarded to the Academy Surgery then we gave up because we were not anesthetists, but that went very well. There to tell the truth, Mr was a little anxious to see us launching us in these businesses, and he asked his supervising old woman is well these Sirs? >> And she answered: he did not have stories there! >>.

 

. : As of your beginnings, you undertake original work. Is this during the that you acquired this experiment?

. : Yes one had seen things, one had read. The external one was then a Mr more important than today. But there was beautiful Internat. I was also at Mr who had taken to me in friendship. I was at , the brother of the writer. It was a remarkable spirit but a rather poor operator, he had to be helped. But it was always late. It started to operate at midday and the pavillon of anatomy started at one o'clock in the afternoon; then one was unhappy. Towards the end of the boarding school, I was in Richard with then afterwards in Saint-Louis. Richard was an extraordinary personality. He was large, he was beautiful and he had many women who would run to him afterwards. He operated remarkably but he was very optimistic. I remember an operated patient of the shoulder to which it required to raise the arm and which expressed a poor abduction. He raises the hand to him and tells me: , abduction, 90*>>. Then he asks to him whether he resumed his work. The patient answers: stays metal turner I cannot make any more my trade and I am now guard in a . Richard tells me : resumption of the .

 

. : During didn't your boarding school, he have there joint prostheses?

. : Not that did not exist.

 

. : What did you make then for the fractures of the neck?

. : One often gave up them with the bed. Sometimes a small plaster was put, but it was very badly tolerated, sometimes one installed a traction sometimes finally one did not put anything. One can admit that beyond 60 years that which was reached of a fracture of the neck had a chance on two to pass there. There were complications urinary, pulmonary, etc…

 

. : Was Robert always with you?

. : Robert was a little younger than me and it was appointed three years after me. But we sought to be together. As we were not characters very crafty ones we were often going to the same owners instead of us to separate to attend a large range of owner.

 

. : How did you discover femoral prosthesis?

. : Here how that occurred. It was into 45, just after the war. I had a friend who spoke to me about an extraordinary substance, tolerated well, the methyl with which it remade the nasal edges and the orbital arcades. I told myself that to solve all our problems with the fractures of the neck, Robert and me could replace them by acrylic resin heads. We knew very well Mr who directed the laboratory of the Pasteur institute and one told him: you want to make well on animals of the tests of tolerance of the . The experimentation was favorable then one launched out. One went Belleville where one had indicated a metal turner to us, in a court absolutely dripping. But this type was a skilful turner and it made us with the millimetre close to the acrylic resin heads with a pivot which was to cross the neck of the femur. I remember that one did not have a car yet, then one went up to bicycle to Belleville. It is incredible.

 

. : Then, this first prosthesis, it was an acrylic resin ball with a stem?

. : Yes. One found blocks of acrylic resin in the trade. One nevertheless solicited industrialists to carry out tests of wear and mechanical resistance. One needed a minimum of precautions because it was a little breeches to establish these balls, like that. We were well involved from the operational point of view because we had made repetitions on the corpse with the amphitheater of Clamart. The first implantation, in May 1946, were done on a wine merchant of Boulogne which forwarded an hip osteoarthritis very invalidating. At the eighth day he sauntered without pains and celebrated this success by drinkings of Beaujolais wine. The second implantation relates to an old patient of the Hospital. One day, one of my friends on the spot tells me: heard of a trick that you prepare for the fractures of the neck; I have of them one in my service, you can come . I arrive in his service and I see an old woman with a fracture of the neck and which was rather badly in point. He tells me: old one does not risk anything, because if one leaves it like that, it is . Then one is lance, one operated it with Robert. We took the channel initially of , we removed the head and placed our implant in the coll.

. : Did that hold?

. : The fifth day this woman walked. Miracle! That made a terrible noise. Everyone precipitated and one put acrylic prostheses in quantity. The method thrived in an extraordinary way and one was invited to expose our work to the United States. It is only at the end of the Fifties that had the idea to put an adhesive paste to fix the femoral implant and to seal a prosthetic . On our side, we had seen well that it was necessary to protect and we had tried joint replacements . We had tested preserved skin, then included a plastic , but we did not have adhesive.

 

. : This adhesive of , it was methyl methacrylate, i.e. in different form, the same matter as that of your prosthesis.

. : Yes but we had not had Robert and me the idea to use it. It was under our eyes and we did not see it.

 

.: Between your first experiment and , there was nevertheless the prosthesis of Moore. At which time it did appear?

. : I did not can say it with precision, but not very a long time afterwards.

 

. : When did you report yourselves that there were complications?

. : At the end of three or four years. There were mobilizations of prostheses and wears of . But there are of them some which still hold. I see some from time to time which returns in consultation.
But, generally they did not finish wearing. You know, a hip, that carries extremely. Then it was seen that it was necessary to change. At this time we had made a prosthesis rather close to the prosthesis of metal Moore. It was not badly, but it was always the protection which gave us many concern and for which us had not found a good solution. I had carried out a trick which one called the cap of jockey. It was a plastic cup with a visor which one screwed in top. But it was not very solid.

 

. : But you were not far from modern screwed …

. : Thereafter, vis-a-vis the troubles of cement, we made with Robert of the rough parts intended to be included in force. We posed 5.000 of these prostheses without cement. The request was incredible and we were mad. At the beginning they was marvellous, because that held well but for reasons of bad metallurgy there were not badly secondary problems of mobilizations of the implants.

 

. : In this process of innovation which you two had the ideas?

. : There was each one of it. Robert had a very believed language. When I had an idea and that I exposed it, he told: is completely . One did not speak about it any more but the following day he told me reflected there would be perhaps nevertheless something to see with your . It was a very fraternal mode of reflection.

 

. : But it is together that you very invented?

. : Together yes. For example for the artificial hinges, it is me which had the idea but Robert developed them and implemented, etc… For the prostheses without cement, it is Robert who had the idea. He told one should make a porous metal prosthesis which one would insert in force. That held but one was betrayed by the metallurgy. For the release of the quadriceps in the stiffnesses of the aircraft bungee cord it is me which had the idea. That had a vogue also. It is one of the only tricks which they still call the operation of .

 

. : How did it come to you?

. : In a curious way. It was after a conference in Special of New York. The conference had gone well and I was over-excited. While walking me in the corridor after this conference and while thinking of all the stiffnesses that we see, I told myself why not all the quadriceps. At the time one did not do much osteosynthesis and one had more stiffness than now. One tried well to lengthen the quadriceps but they was very bad. As of my return, one of my first patients was a Breton racing cyclist who made brilliant beginnings but which following an accident had the stiff knee. He tells me I can fold the knee, one offers a work to me because I can deliver the . Then I told myself: goes . I speak about it in Robert and both it is operated, one the quadriceps and one obtains 90*. We could have better done but it was the first. One was content and the patient could deliver his newspapers.

 

. : You worked with the Ill children?

. : Yes, I directed the infantile department of csotcina.comedic surgery in the service of Mr Fèvre. But my activity was mixed. The morning I was at the hospital and after midday in private clinic.

 

. : When did you leave the hospital?

. : When I had the retirement age. I continued in private clinic and I did not stop operating that two years ago. One moment ago when it is necessary to be withdrawn.

 

. : During the years when you were in and Robert with , the competition with the school of Blackbird of was wild?

. : Me I was very buddy with and . People enjoyed to create us a competition with Merle of , but it was exaggerated; he dined at home but it is true that he was of a difficult access. In the congresses, Robert who had a very fast spirit arrived from time to time to it making him touch the shoulders with ground and Merle did not like that.

 

. : What a are the ideas which did not succeed!

. : I will make you a confidence: we made 30 interventions of strip to the knee which one will call thereafter the operation of Lemaire, and which we never published! We quite simply sought something to stabilize the unstable knees and we found our method very banal! Yes we had many ideas. In the scolioses, we carried out many xenografts successfully.

 

. : What do you graft?

. : Bone of skid was taken. So that the grafts are sterile, we take at the slaughter-houses, of the fetuses of skid on gravid mares. One brought whole egg as an operating-room, one passed it to iodine and one left a skid with splendid bones. One cut our grafts in the femurs and one put cold at -30. Ca went well but it was longer than the autograft. It was necessary to count the double of time for the merger. But that took and we had only one rejection out of 80 files.

 

. : Why didn't you continue?

. : Because it was very long, and because so that the taking away are aseptic it was necessary to find a mare gravid intended for the slaughter-houses…

. : How do you reduce the scolioses?

. : I reduced them with a sterile cable and hooks. I fired on the system and I obtained a reduction thus. Then I hamper my grafts. But it was not a very good method and I gave up it as soon as the stems of were available.
To tell the truth we did too many things and we were always in overpressure. We could have better done, but we did what we could.