Jean-François made all his professional path with de . He was among the first csotcina.comedists to be devoted to the surgery of the sportsman. Although not academic, it knew to give to his service a label of formation. Its discrete, rigorous and effective exercise make a model of surgical wisdom of it. Of its fresh retreat, it takes to us stock of 30 years of trade.

 

 

. : It is pleasant to be with the retreat?

: It is perfect! It is one of the best moments of the life because finally one is free. The first advantage of this freedom, it is to have time to make things, to do them and not to be late as of Monday morning. That wants to tell for example to take its time for reading and that goes simply from the newspapers until more the big books which one can really impregnate oneself, which it is difficult to make for its working life. The second advantage of the retreat, it is to be released of this feeling of responsibility sometimes crushing, the anguish, the word is not too strong, of this trade which one does not demolish oneself. On the contrary, more one ages more one has this concern to try to make well, to overcome well the proof which each intervention represents. Because so for us it is the hundredth time, for the patient it is always the first and of this concern not to fail, one never demolishes oneself any. That made two years that I stopped and he does not have a day there when I tell myself only today, there will be no problem for a patient to operate or already operated. Thus this concept of peace of mind is something of so essential that at any time I did not regret not consulting any more nor to operate. And then, finally, one should not forget all the problems arising from under permanent payroll of medical staff, source of difficulties always repeated for the departmental manager.

 

. : Didn't you fear the trouble?

: If. My concern was that at the end of 12 work hours a made life daily newspaper including the weekends, I do not tell myself one morning: “what will I well be able to make today? ”. In practice for two years it has absolutely not been the case, because I can make a heap of things which I did not make front. I nevertheless kept a contact with the profession because the colleagues have the kindness to ask me to take part in meetings in France or abroad what enables me to be busy to prepare them quietly, while having much free time in addition.

 

. : Did you have the impression that your last years were particularly difficult?

. : Without any doubt and that for several reasons. The first it is that administrative heavinesses worsened considerably as well as the relationship with the managements. When I was young, it was the department head who had convened the Director of the establishment in his office but for a few years, it is the Director who convenes you in his office; that clarifies a little the difference of the relations. All the #53B0A6 tape, all that preceded the accreditation… I was chairman of the COVERING JOINT, I was chairman of the consulting of block, that also represents additional stresses. The problem it is that for administrative that belonged to its work, but for a surgeon that is added with his work what is considerable. The second reason of painfulness, it was the rarefaction of the interns in csotcina.comedy. It was necessary each six-month period to fight to recover making functions of intern. I had the chance to have very positive ratios with certain foreign countries, following many congresses or conferences of teaching that it is in South America (Argentinian), in North Africa (Morocco) or with the Middle-East (Lebanon), which enabled me to have at the end of the formation, but each end of six-month period, it was a concern. Finally the third reason they is incontestably the relationship with the patients who changed much compared to what I knew he there 20 or 30 years. I do not dispute, of course, the need for patient safety but the obligation to try to do its work well, the obligation of results replaced. And I add here still the shortage of nurses and of aid-looking after which made only be accentuated these last years, for all the reasons which one knows well. I really make a point of paying a very specific homage to them They helped me, and supported, under difficult conditions, until the end of my activities. I have for them a very major attachment which also goes to my secretary so present and effective. I do not forget either my colleagues, doctor and surgeons. Fortunately that all all and were there to make these last years bearable.

 

. : If one can understand the increase in the level standard, how to explain that in 10 years the surgeons accepted such a level of administrative stress without any counterpart?

. : That holds especially, in my opinion, the basis even of the medical profession, i.e. our individualism. Our frame of mind does not lead us to federate us. Incontestably it misses a union that it is within the medical profession in general or surgical. In a hospital, each service has its specific concerns and one was not able, in not more than elsewhere, to federate to be able to oppose an united front to the supervisions or our Managements. Those of my generation did not know, or did not can, to do it. Perhaps, young people, in a society which changed well, any more the same things will not accept that us and will manage to affect the decisions.

 

. : Which is the characteristic of the hospital compared to the other hospital structures of the Paris region?

. : I was internal in in years 66-67, and then the structure of this hospital had appeared me to represent the ideal. An hospital structure comparable with that of the hospitals of the Public assistance, with all the specialities, including at the time the pediatric surgery, and a large technical plate. And all that with a private clinic spirit, i.e. each expert had his patient whom he consulted, which he operated and which he followed and this while benefitting from the discussions in the service and the consultings that one could obtain from the other specialists. For me it was the advantage of the liberal exercise with all that represents of relation personalized with the patient, while having behind oneself the infrastructure of a hospital. In addition for reasons which are perhaps debatable, I had never wanted that my work is related to a direct remuneration on behalf of the patient. It is a thing which always obstructed me that a patient pays directly to be neat, therefore the fact of being a remunerated hospital surgeon was a situation which appeared ideal to me.

 

. : Who financed this so specific structure?

. : had been built before the war to look after people of average conditions free with at the beginning a Franco-American foundation. But this way of looking after free proved to be a financial fiasco. The war arrived, which was perhaps not more badly for the future of the hospital in the sense that successively the French Armies, German, American invested the hospital. After the war during one moment the hospital was taken again by the Public assistance of Paris, since Mr Merle of was during one year department head in before going in . Then, the SNCF wished to have a hospital to look after its railwaymen. Thus the SNCF became not owner, because the hospital is the property of a private foundation, but administrative by a contract renewed every 5 years. In years 95, the SNCF considered that it was not any more its interest and disengaged itself. The Foundation, owner of its walls, sought a new manager. There were several candidates like or Reciprocity. Finally it was directed towards a management ensured by a Board of directors specific to the hospital which understands the Town hall of , the General advice, etc…. It is always a hospital deprived with this difference close since the Nineties we are a private hospital taking part in the hospital public service.

 

. : Thus ensuring the urgencies?

. : From this moment, we were compelled with the global budget, then secondarily compelled at the department of emergency as . What completely changed the structure of the services. All that made that the hospital changed much between what I knew when I entered there in 1969 and at my exit in 2002. Another characteristic of it is that formerly the new experts were chosen by co-optation and the progression was done towards the of service. Maintaining when a post of head of service is released, the post is opened with everyone. It in oneself a bad thing, but that is not done to lose a cohesion which was one of the strong points of our hospital.

 

. : How was your service organized?

. : Not being university, although having been placed on the short list into 76, I did not have a senior registrar. I had with me four assistants, Doctor , , Hassan and , four interns and a doctor , Doctor . When I started we had 12 external who disappeared since good a long time. I twice made the inspection per week in all the service, we had each morning a minicomputer-staff for the urgencies and a weekly staff, but we kept this same concept as each surgeon who had seen his patient in consultation, operated it and followed it. Even if between we are discussed with staff to arrive to a joint position on the way of discussing the patient, for the patient it had only his surgeon like interlocutor.

 

. : Which was the speciality of the service?

. : It was a department of csotcina.comedic surgery general when I arrived and that remained until the end. But inevitably by the force of the things, by recruitment, some were directed more towards the hip prosthese or of knee, others towards the spine surgery and me in fact more towards the surgery related to the sport. But we kept despite everything this training of general surgeon. It sometimes happened to me to operate rachis for example, because I was trained like that, but it is obvious that it is one completed period.

 

. : Why did you make surgery of the sportsman?

. : Personally, I was always impassioned of sport. When I arrived at , I was likely to be in the same hospital as two doctors with whom I must much and which worked in the service of functional rehabilitation and readjustment of Mr : Alain and Jacques . Both were very directed towards sports traumatology, that they largely developed, if not created, in France. They had the same age as me about, and there was no surgeon in the service which is interested in the sport at the time. We were made to understand us and here how my surgical guideline started towards the sport. Alas! Doctor died there are about fifteen years, but I have always kept with Doctor the same relations for more than 30 years Fidélité, confidence and true friendship even did nothing but develop with the rate/rhythm of congress, seminars and lesson that it is within the diploma of sports traumatology of Paris VI or in various foreign countries. This interest that I had for sports traumatology me led to initiate the French company of Sports traumatology and I was pleased to be appointed about it the first Chairman by my colleagues. Our society counts now more than embers, doctors of the sport, radiologists and surgeons.

 

 

 

. : It was especially the beginning of the surgery knee. As an intern and a senior registrar I had never seen surgery knee. Thus I learned it while going to see various Masters like in Lyon and Lemaire in Paris which learned to me much. At the time, indeed, the knee was the main pole of interest and, for example, we operated all the fresh distorsions of the knee and after the knee that was the shoulder, ankle and all the surgery. What I liked in the surgery of the sport it is that interested at the same time many hinges and a large range of pathologies.

 

: Did you develop specific techniques?

. : The objective of was to rebuild the central pivot of the knee and for Lemaire was to fight against the symptom of the projection. From the start, not being neither of nor other school, I told myself that the two things had to be made at the same time. I thus associated these two techniques. According to the times in various ways, initially by the technique of Kenneth-Jones, according to his princeps description, then of associated with Lemaire, then that was the technique of Mac which made the same thing with only one transplant and finally the transplant bone-tendon-bone by making an external gesture independently. What struck me it is that formerly, we see patients with very advanced chronic laxities, and one made this surgery of the central pivot plus the , but by also adding very often internal or postéro-external plastic surgeons. It is undeniable that during these 10 last years, I did not see any more these great chronic laxities of formerly because the patients came to consult much more early.

 

. : Why this approach of the surgery of knee?

. : well, Mr spoke about “the extension in oil spot of the lesions”. I.e. that starting from a lesion of the former cruciate, the other parties of the hinge more or less come to release in turn and to distend. As from a certain moment, the only repair of the initial lesion is not sufficient any more to stabilize the knee. When one sees a patient who has just broken his former cruciate the only anatomical repair is sufficient, but if one sees the patient later with an important projection that wants to say that there is already a distension in addition and that the only anatomical repair is not sufficient any more. It seems well that after a whole recent period where one preached the repair isolated from the central pivot, much from surgeons return to the association of a time of plastic surgeon anti-projection. I do not see why both would not be associated and it is not to make belt and straps but well because they are two different things.

 

. : Does that give what afterwards 20 years?

. : 20 years after, them to have largely re-examined, it is excellent at least in the field of stability. I will not say as much the late development of it towards osteoarthritis! I was the other day, to accompany an Argentinian colleague, to re-examine surgeons to operate ligaments of knee and I saw that the majority of them added an external time which is not called any more the plastic surgeon of Lemaire but who keeps the same principle of this plastic surgeon anti-projection. I must say that this observation pleased enough to me!

 

. : It was what your favorite repair of pivot?

. : Me, it was the . In the service, we made some but on a little selected people, less sporting. For us the ideal remained the but I am ready on top to change opinion, because now, according to what I could read, fixings of the improved much. The problem of the before was not the transplant itself, it was its fixing.

 

. : On the external level today the plastic surgeon that you would propose would be that of Lemaire still?

. : Yes, but I believe that one can make simpler. One can simply keep the first party of Lemaire i.e. the strip of fascia latums inserted on the tuber of which is fixed on the external condyle, by a screw of interference for example, without making all the loop.

 

. : Not need to return?

. : I think that it is not necessary to make all the loop. It is nevertheless an intervention a little more important with a larger cicatrice and it is probably not essential. What counts it is the limitation of internal rotation. Of course some will tell you that you limit tibial internal rotation. The experiment proves that it is not true except fixing this external plastic surgeon in great external rotation. But in discrete external rotation one does not limit to a significant degree internal rotation and I do not think that it is a disadvantage.

 

. : And shoulders it?

. : In the same way that for the knee, there were formerly two designs. Schematically, that of and Patte which preached the repair of the cap and that of which abolished the conflict. For my part, I thought that these two approaches were not contradictory and I was always inclined to associate the two techniques. Concerning repeating luxations former, I always remained very faithful to . I made my small contribution to the surgical treatment of repeating luxations and posterior instabilities by describing an original technique: the panel pedicle with a scrap and fixed on the posterior edge of , thus associating the negotiable instruments of a stop, but quite vascularized, with those of a share of centring thanks to the scrap , without counting that one could also carry out in same time a of the posterior capsule according to .

 

. : And ankle it?

. : Ankle, it should be recalled that I am of a generation which operated much the recent distorsions of ankle.

 

. : Why operated them to you in urgency?

. : I did not can tell, one thought that was better to suture the torn ligament. What proved completely false obviously. Now, everyone is of agreement to say that it is not necessary to operate the pure lesions . It is necessary to make the difference between the pure lesion and the lesion associated with a fracture with the dome . It is known well now that the peripheral ligaments heal although it is the internal plan of the knee or the external plan of ankle. The consensus appears now acquired.

 

. : What made on the tears of the ligaments of ankle themselves?

: LI was seldom operated because the pure distorsions of LI are exceptional but they exist. It was sutured. It was technically easy, which perhaps made the success of this intervention. With regard to chronic laxities, I was always a partisan of the anatomical repair and not of the plastic surgeons to short peroneal side. These plastic surgeons have for me the disadvantage of being caught some with the stabilizing muscles of ankle. I made external anatomical rebuildings according to a a little original technique which is that so made by in the United States and which derives in fact from the technique that Blanchet had described there is a score of years. Strainer then had described an about identical technique which I amended a little. The idea of Strainer was of the cicatricial party and to suture the ligament. improved it by making the reintegration, then me I a little amended it by making a reintegration plus a joining out of cardigan with possibly a reinforcement so necessary by a scrap periosteum for example, which in my experiment was seldom necessary.

 

 

 

. : In the repair of chronic laxities, according to the technique which I used, it was not necessary to go to thus approach the peroneal tendons I did not do it. On the other hand, there are the symptomatologies directly been dependant on the peroneal tendons and that the imagery made it possible to show well now. It is a specific symptomatology, but which can be associated with a chronic laxity because it is known well that crackings of peroneal are in fact the consequence of a laxity of ankle, or of a first distorsion of ankle. Symptomatology is retro-malléolaire that they are pains, a tumefaction, slappings, in short of the retro-malléolaires signs whereas chronic laxity is limited to the repeating distorsion. I did not invent anything: that was described by in particular, but I on the occasion to see some not badly by sporting recruitment. To return from there to the hinge itself, which has me particularly interested with Jacques they are the lesions dome because it was a pathology ignored in particular the chronic slope as the lesions of necroses partial, dystrophies, or intraosseous cysts. We worked this question much not to limit ourselves so that the Anglo-Saxons told and all to call ankle. There are very specific executives . In particular, the fracture , always of the external dome , consequence of the initial distorsion and which is for me a formal operational indication of the distorsion of ankle recent.

 

. : How do you operate them?

: Usually one makes the ablation of the fragment and in same time one sutures the ligaments since one is on the spot. Beside the fractures of the dome there are all the other lesions that it is the true of the adolescent who is internal and not external, that they are the dystrophic lesions with images under with lesion of the joint cartilage or which in fact the intraosseous cysts probably due to an initial lesion but develop in the form of a single under . These frameworks are completely different at the same time in the field of the imagery and the processing. Certain lesions must be discussed under but of others must discuss itself by access for rebuilding. Last times of my exercise I made not badly rebuilding with cartilaginous autografts in mosaic which I took on the knee, since in France one cannot make of Clerc's Office of corpse. I took them on the party of the internal trochlea. My departure with fact that unfortunately I do not have long retreats, but the short-term appeared satisfactory.

 

 

. : Which type of channel initially?

. : The internal injuries are almost always posterior and require the osteotomy of the internal malleolus unfortunately. If a Clerc's Office in mosaic is made it is the only way of posing the perfectly directed grafts. Previously I made a rebuilding with cancellous bone which I took on the lower tibial epiphysis and then generally by putting the foot into large equine, one managed to fill the loss of substance without making osteotomy.

 

. : Is the cartilage of the knee sufficient thickness to rebuild that of the slope?

. : Not! Incontestably it is not the same cartilage, and the ideal would be to be able to make fresh core taken on a to have same morphology. Now isn't an autograft of the knee biologically preferable?

 

. : But in could the fractures of the dome, one remove the fragment under a few days after the distorsion?

. : The problem, it is that they are not very good to inflate ankle with fluid right after the rupture . What could perhaps be made is to discuss ankle functionally and to remove the fragment afterwards one month but I do not think that it is the good solution because the rehabilitation of ankle will not be done inevitably very well.

 

. : And then there is the …

. : Yes, there was all the surgery of the Achilles' tendons that it is the surgery of the ruptures or the surgery of the chronic injuries. The ruptures, there too it is a thing which interested me well. There is not far from 30 years, I sought what I could do like study in the service of my Master and I had re-examined the operated patients of rupture because at the time one started to speak about the csotcina.comedic processing, in particular J. . I had come from there, like him, to think that the csotcina.comedic processing was at least equivalent to the surgical treatment. Then, some ten years ago, I took note of work of with his percutaneous joining and I saw there the advantage of an effective surgical treatment but as the way of avoiding the complications as alas everyone knows more or less after surgery. I made much of percutaneous joining of the Achilles' tendon at one time when it was not very known and one published like that our the first 50 consecutive cases and all re-examined . Taking into account the completely satisfactory results, I continued.

 

. : You do not find that it is a masked csotcina.comedic processing?

. : at all! But like any percutaneous surgery that requires much care. It is not enough to pass a thing in three seconds and it is finished! It is necessary to endeavor to pass in the proximal end, the rupture, the distal end and to arise at the good place. Then, to make sure that holds by the harpoons. It is necessary to go up sufficiently high in the proximal part to be on being out of about healthy tissue. This is why one cannot use it when the rupture is too high. Too much low it is excluded, but in the average rupture I think that indeed one has a mechanical negotiable instrument of setting in contact with the ends and that one has a hold which is more effective than with the csotcina.comedic processing. The csotcina.comedic processing allows the same thing but with eight weeks of plaster. at least. Whereas with one can do without this immobilization strict foundation of concrete except the 10 or the first 15 days until obtaining what I call the primary cal. Then I placed operated in removable orthotic device allowing a partial support and I made begin a certain mobilization of ankle, leaving there still the principle which should not be left immobilized people because they is bad for tissue vascularization.

 

. : What made you on the chronic ?

: There I did not invent anything. I made of it not badly with simply this concept that all does not answer the same technique. I.e. there are indications for the ablation of a fibrous cicatrice or a cyst and that there are indications for the combing. All the chronic should not be combed. There is a good number where a core or a pseudo cyst can be removed, then the reconstituted tendon, without making this combing which despite everything…

 

. : With disadvantages?

. : That can have disadvantages. That strongly enlarges the tendon what is not inevitably necessary. Just as the ablation of all the sheath. It should not be forgotten that all the vascularization of the Achilles' tendon comes by before and that the ablation of the sheath the . In a general way, I think that there is not a truth and that there is not a technique which adapts to all. Perhaps I owe this critical mentality, namely that each technique has its advantages and its disadvantages, with my Masters and . I do not think that all must be combed. I saw, unfortunately in second hand, much of of Achilles which had been combed. What is a nonsense because makes some that had done nothing but weaken the more, and cause secondary . What necessitates completely lifting rebuildings.

 

. : What did you study on the level of the hip?

. : My only original participation was the former projection of hip. It is Alain who addressed our first case to me. It was a of Rugby which had a projection on the side of the foot which pursued. Something vaguely was felt but we did not know what it was. This type was very embarrassed and thus I operated it. I released the tendon of the to the capsule and I dissected the area then I closed again. It was clearly improved. Not cured because its projection persisted from time to time, but it did not have badly any more and it could take again the sport. From there, I considered the question. I read the little of things which had been published on top in a parsimonious way and I went to medical faculty to study that a little near. What arose from the literature it was that it was the which probably jumped on ilio-pectinate eminence. With the lecture theater I precisely saw the local anatomy, the best way of approaching the area and the means of putting an end to the projection if one slackened the by dividing his posterior blade on the level of the former edge of the mining area.

 

. : Which is the mechanism?

. : When the hip is in extension, the tendon jumps on pectinate eminence . Now it is not any more one mystery and one sees it very well in echography. To make it cease, it is enough to slacken the tendon a little. However it is not the only cause of former projection. There is the tendon of the former right, there are the femoral ligaments which can jump on the femoral head. Now it is known that there are intra-articular projections dependant on a synovial fold with the image of the of the knee. Finally, I on the occasion to operate some not badly and the former projection of hip had become a characteristic of the service. Thanks to an anesthetist, Doctor , we made the intervention under sensitive anesthesia . The patient did not feel, but kept a motricity. This technique made it possible to approach, divide the posterior blade of the and to see whether the projection disappeared or not and if the projection did not disappear that wanted to say that had to be made a more complete browsing. But, to remain in the “soft parties”, one could also speak about the high of the common tendon about ischio-leg or of the syndromes of cabin of effort of leg or about before arm.

 

 

. : You left your claw on an hip prosthese…

. : Prosthesis ! On the basis of the principle that everyone was of agreement to discuss the fractures moved by prosthesis I told myself why not implement the same principle to the fractures very old subject in order to make it walk immediately. At the time, there was neither , nor , even less gamma nail and one was still with the nail plates with setting in discharge etc… In same time, I had on the occasion to see a tumor of the upper end of the femur and one had a prosthesis of rebuilding which one called . I had told myself that one could adapt this technique to the fractures. At the time, I worked with society SEM and I take down my telephone to inform them of my idea. My interlocutor answers me: “it is funny these times Ci I have three other surgeons who made me the same proposal: , and . ” Of or the name , which sounded well. One thus made a prosthesis with trochanteric support plus a series of base plates increasing thickness which one could add according to the loss of substance. Thus in the service we with satisfaction did not discuss any more the fractures old people but by one arthroplasty from the start because we put them upright as for a usual femoral prosthesis.

 

. : As regards did prosthesis you defend the prosthesis of ankle?

. : For the prosthesis of ankle, I must also much with my Master who had authorized me to put the first in his service. It was a prosthesis which one called : Thomas-Parkridge-Richards. I thus put one of them, then some others with satisfactory results on retreats of 7-8 years. Thus I continued to put this prosthesis until the day or it was done more. Then I wandered with other models which did not give satisfaction. With my friend Jean François we developed a prosthesis answering so that we wish i.e. parallelism, congruence between the two implants. The cut was done with the same guide of cut on the level of the tibia and the by removing very little osseous hardware on each side. We worked on this prosthesis during several years. We posed it about fifteen with results which were debatable, We were completely conscious that there were improvements to make on this prosthesis. But the house to which we had entrusted the manufacture of this prosthesis decided to stop purely and simply. This prosthesis is not done any more, but we always have the patent. That was a great disappointment because we had worked much above.

 

. : What did it have like characteristic?

. : What one had wanted it is that the cuts are done with the same guide of cut to be on congruence of the two implants. The patent rested on this concept of the cut with the same guide of cut for the and the tibia. Moreover, the two implants were posed in same time thanks to a removable adapter It had three components: two metal components, tibial and and between the two a polyethylene insert which in the tibial plateau but by keeping a possibility of rotation. We had drawn it so that there is a rotation but it did not have the complete mobility of Pappas Moreover we do not wish that it be posed by removing cortical former tibia. It was cemented but I think that the prosthesis of ankle should not be cemented. There was still to work above but unfortunately the things stopped brutally.

 

. : Were your indications primarily traumatic?

. : Indeed, because of the recruitment of the service. The ideal indication is ankle posttraumatic without too much .

 

. : You were content with the result?

. : Of our prosthesis fairly because there were still things to make. But, for the prostheses of ankle in general yes, since the indication is well posed i.e. with ankle centered sufficiently well, with a bone of good quality and a preserved mobility because the prosthesis of ankle does not give mobility. But it is certain that developments are still to make. I was accustomed to telling, when I spoke about the prostheses about ankle: “That didn't one say knee prostheses to my beginnings, there are 30 or 35 years? ”

 

. : Let us speak about your formation…

. : My formation, it is double. On a side I was trained by the Merle school of not by Mr Merle of itself but by his direct pupils who were and . In my Master, I was very marked by his rigor, his discipline, his very great severity, his requirement and, inter alia much of other things, accustomed to “No-touch” and not to put the fingers, it is a thing which I kept all my life. I was high like that. Other side there was Mr who showed me much private clinic, much reflection, a very meticulous procedure, regulated like music paper. It was somebody who could operate and who had learned the surgery from formerly but with a large open-mindedness! It left me for example set up, for the first time in the service, a prosthesis of there is more than thirty years. It was of agreement to test since valid arguments were forwarded to him. Thus I have this double formation and I must say that I am also very critical which pushes me to discuss the things and to have my idea all alone. Since always, I thought that there was never but only one truth. Modesty and humility should be the master words of our profession, but they are not unfortunately most widespread. I never sought when I was internal or senior registrar to be operated much, I preferred to help much to see how one makes, writing, I still have at home the written techniques when I was internal, lira, reflecting to be able after being alone. I did not like much that one tells me you make Ci, you do that.

 

. : Other influences?

. : I did not forget the assistant of which became then my departmental manager, Jean Jacques , who infinitely learned to me discussion physical exam. It was really a large Master, in the field of the examination. It did many poliomyelitis and of . He learned to me much on the operational care. It was a Mr who operated slowly but which never left before it is as perfect as that could the being. He taught me not to be in a hurry to operate, to take time that it was necessary without counting. He also taught me the spine surgery. He did much scoliosis. I was trained by these people on the surgical level, but I do not forget either my medical education near Mr and of his team.

 

. : You knew all these beautiful people with ?

. : I knew them in where I had arrived as senior registrar. I remained senior registrar two years, one year at Mr , one year at Mr . At the end of my , a post of assistant was released and it was proposed to me. I accepted readily because it was my dream to remain in . What also formed me much it is that I was during 13 years chief consultant of a center of rehabilitation.

 

. : You cumulated the two functions?

. : One had asked me to be a chief consultant in Saint-Cloud. I was one afternoon per week there, and an of Saturday morning party. And there I learned, which the surgeon misses much, i.e. the operational continuations, the beginnings of the mobilization, the reactions of the patients… I learned that the surgery did not stop with the operating room far from there and it is not enough to say that with so many days one will do this or that. For example, two patients having the same surgery knee will not have the same continuations inevitably. On the whole, I can say that I have much reconnaissance for my Masters surgeons, but also for my physical friends, doctors, , and all the others which I cannot quote, like for the kinesitherapists of and Saint.

 

 

. : What think of the label “surgery of the sport”?

. : I will say that it is a square pulse since there are more and more people who have an sports activity, that it is regular or which it is specific. It became also a form of publicity, as that was at one time for the doctors who displayed “Diseases of the women and the children”. The was not there for little, making think that all became easy. Whereas the is only one vote initially. As regards knee, for example, the essential problem is especially well to place its transplant!

 

 

. : Is this a different surgery? Should a high level sportsman be operated differently?

. : Differently I do not think, I would tell rather than the indications can be different. The professional sportsman has obviously other requests, in particular as regards time, that a sportsman of leisure. It is very different. A professional sportsman who breaks the former crusader if it is not operated, therefore it should be operated immediately. If Mr everyone is made a crusader former to the ski one will rehabilitate it and one will see whether it should be operated secondarily. One can give oneself time to supervise it and see whether the intervention is essential, but before it is too late!

 

. : Did you can make another thing that surgery?

. : Not, not much unfortunately! In my life of surgeon there was hardly another thing but csotcina.comedy by the exercise even of the trade, the responsibilities for department head to which are added the participations in the congresses, the preparation of the communications and the publications for reviews or books, various and all the activities of teaching. I had thus the occasion, and the pleasure, of pitch badly to move me in France and abroad. I am rather lazy and as all those which are believed, or tell myself, lazy I worked all my life much. I thus did not can devote me to all that I would have liked to do. What interests me particularly it is painting, the sculpture, the voyages and the history in general with a predilection for prehistory, archeology, and the medieval history. If I had been informed at 18 years of the various trades, I would perhaps not have chosen the surgery but archeology.

 

. : Did you described crackings of peroneal side, you meet much of it?

 

. : With did your beginnings, that consist of what the surgery of the sport?