Last September in Lyon the 12èmes Lyons Journées were held of Knee surgery. Among the many personalities of the knee surgery, the presence of Pr LU of Beijing was particularly remarkable. We went to his meeting in S where it received us with much heat.

 

. : How does one become surgeon in China?

. : Initially it is necessary to make studies of medicine in a medical university and the input in medicine is difficult. From my time, I am 61 years old and I passed the entrance exams to 18 years, he had there only one place for 100 applicants. After 6 or 8 years of studies you become doctors. Then, that depends on the hospital in which you work. In what relates to me, 98% of my comrades of promotion left the hospital of origin to become either general doctors, or to specialize in another hospital. But whatever the speciality that you wish to make, it is the hospital employer which in the final analysis decides your guideline. If the hospital needs a neurologist you will be neurologist. In what relates to me, I had the possibility of remaining and to make my speciality of surgery. Probably because I worked much, that I took in core my responsabilities and that I was very devoted towards my patients. The surgery contained many departments and I had to spend 3 years to make the turn of it.

. : Why did you choose csotcina.comedy?

. : Many people responsible for department wished that I remain in their speciality but the chief of the department of csotcina.comedy the instructor wanted absolutely to keep me and as he was the Director of the hospital I did not have the choice so much! The cardiovascular surgery had however rained me much. My owner sent to me to become to one six-month period in plastic surgery in the father of the plastic surgeon to China the instructor . Afterwards, I made six months in hand surgery in the famous instructor . Then, I made surgical part of the team sent in the area of the great earthquake of 1973 to . I had on this occasion, the chance to work and learn much near csotcina.comedists come from all the areas from China. Then, I returned as chief resident in my hospital. At that time, it was in full Cultural revolution, there was no more large world in the hospitals and in particular more young people. I thus remained, for lack of payroll, chief resident during ten years. I did many interventions the every day and often after nights guard where I was disturbed several times. That was one period very in charge of my career.

. : Did you have a family life?

. : Not really. My wife was cardiovascular surgeon when we married. Fifteen years after, because of my schedule, I asked him to change and it deals now with body extra circulations. She is also instructor.

. : You speak English well…

. : I started to learn English around 38 years. I was born in the Northern area Is of China and in this area the second school language was Russian whom I still speak. But in this language, I had evil to find literature surgical and in addition the level of Russian medicine was very low. After the surgical revolution, I asked my hospital to become “”. My owner asked me why and I told him that I wanted on the one hand to acquire a diploma of PhD and on the other hand to learn English correctly. I could read of English but I was unable to speak it correctly. My owner made fun nicely of me because I said “sergeant” instead of “sucker”. I was thus sent during one year in a school of language to Pékin. I returned in second year and I did not understand anything with the first exchange rates. I had much evil at the beginning. After this year of study of English, in 1984, I could travel to the USA to Phoenix in Arizona. I was “” during 2 years at Anthony . He worked for on hip prosthese and of knee. There was also Dr. Joseph Dupont; He had belonged to the first workshop of . After first half of the year, I could take part in interventions and I learned much near them.

. : Was the American surgical practice then very different from that of China?

. : There was no prosthetic surgery in China in particular for the knee. China was then 20 years old of surgical delay. There had been some episodical cases of hip prosthese. Our csotcina.comedic surgical formation had been based primarily on the surgery of the ostéo-articular after-effects of the poliomyelitis. At the time there was only one department of csotcina.comedy which dealt of traumatology and polio, whereas today there are four of them: , prosthesis, tumor and rachis.

. : Which was your field of search in Phoenix?

. : The hydroxyapatite.

. : How did your return occur?

. : I left the USA with the great astonishment of my colleagues who told me that the majority of people in my situation remained on the spot. Me I wanted to turn over to China to on the spot practice all that I had learned and to be able to help all the people in China who required this surgery. But the return was not easy. No the car, not of telephone, not even of warm water for my shower! With my return, I asked to have eight beds for my patients in order to make articular prosthetic replacement, but the hospital did not want. They found me too young and especially they did not believe at all in the good performances of the prosthetic joint replacement. I however could operate a case of bilateral polyarthritis (PR) on a completely disabled patient and my Master, Pr , which had close to 70ans, after having seen the result, then said me that my knowledge to make was very important because nobody in China could have discussed this patient correctly. He helped me to find in Pékin another hospital who would like to entrust beds well to me. It was not easy because I was completely unknown and that nobody wanted on me. Finally, I found place at the Hospital for the Rehabilitation of the Workers. They gave me all the beds which I wanted because they had few patients. I have outward journey to make free consultations and conferences in the centers of rheumatology to find patients one by one. The first year I could make nee prostheses. Second year 16, third 34. Therefore, I increased my recruitment step by step. In 1994, a surgeon of the knee of France, Dr. , made a “workshop” with Pékin or he said that if nee prostheses a year are not made, one could not claim oneself qualified on the matter. I was very annoyed because this year there, I had made only 56 of them! But they was very difficult cases.

. : I.e.?

. : There were cases of PR, , arthritis of the psoriasis and some osteoarthritides. But they was always severe cases, very advanced with attacks particularly difficult to operate. I were brought to operate in the same time of the attacks of the hip and the knee and even of the cases of attacks of hip, knee and ankle. That requires a sophisticated surgical strategy. Gradually, I was brought to set up a multi-field approach of these patients with a rheumatologist, a kinesitherapist, a psychologist and even a specialist in Chinese traditional medicine.

. : At the beginning, did you have prostheses easily?

. : That was not easy. The company that I contacted on my return in China on the spot did not have a market. She asked me, if I wanted to have prostheses, to make buy by the hospital all the as well as inventories of prostheses. Fortunately that the Director of the hospital supported me because the first batch contained 15 prostheses and at that time they were particularly expensive.

. : How is currently made the financial assumption of responsibility of operated?

. : If you work for a company or the government you have a medical hedging. If not, if you do not work or if you are farmer, you do not have any assumption of responsibility and you must pay for your care. For example, if a peasant is made reverse by a car, it is the insurance of the vehicle which will have to take the care in charge.

. : Let us return at your beginnings as regards knee prostheses…

. : I had only the most difficult cases, those of which nobody wanted to occupy himself. And into postoperative I did myself the rehabilitation of operated. It was necessary however that these cases of knees ankyloses lead to good performances if I wanted to prove reliable. I think that my training in plastic surgeon and hand surgery helped me much to deal with the major problems of the soft parties which these interventions posed. At the end of three years of effort and good performances, a particularly difficult case helped me to obtain beds in my hospital of origin. Indeed, the patient of the Hospital for the Rehabilitation of the Workers was shown on television and the management explained what it could do in these cases considered as despaired, but without never quoting my name. The Director of my hospital of origin to which I was always attached and in which I worked part-time, was then very dissatisfied that one did not refer any to my name and my source and it decided to give me on the field of the beds.

. : Which was your wages then?

. : In this time there, before leaving to the USA, with two wages of surgeon and only one dependant child, we did not have that the equivalent of 40 euros in bank. At the house, television was in #07645A and white. Once we had ensured our fuel supply it remained nothing any more.

. : But finally your competence was recognized…

. : Indeed, I ended up having many patients, of students, pupils. I started to make “” on the arthroplasty of the knee and I start again each year; I am with 11th. It is most important of China as regards prosthesis of the knee and I have 400 listeners. I also wrote a book on the prosthetic surgery. It is the first published in China. Then, I translated into Chinese the book of on the knee surgery. I was also brought to travel in all China and I have to make a score of symposium. I have now forty doctors who work on research programs in pathology . I am very careful with search because I really want that China goes from the front one.

. : When did you become instructor?

. : In 1991 to 46 years. I profited during every year preceding my appointment by the support by my family and in particular by my wife which was enormously devoted for my career. On the scientific level, Pr helped me much, not only on the medical level but also on strategic planning. He encouraged me to go from front, he suggested me transforming what was a department in an Institute of the Rheumatic diseases. He was an excellent Master.

Instructor and Instructor Lu

. : Did you can travel abroad?

. : Especially as from 1997. In 1993 however I could go with the to Séoul where one of my communications had been accepted. I passed after the famous German csotcina.comedist . It had a conference with 7:00 of the morning on the difficulties of the prosthetic surgery of hip and of the knee in PR and there was nobody. At the end of a score of minutes, there was to be 10 people. At the end of his conference, I put some questions and it was reported that I knew the subject. It came towards me at the end from my presentation to congratulate me for my work and it told me: “Formerly we had difficult cases as those which you exposed but we did not have the good techniques nor the good implants. Now, we have good techniques and excellent implants but we do not see any more these cases! ”. It cordially tightened me the hand. Then, it invited me in its service. In 1994, I went in to Germany and it very received me. In 1996, Goodman de the USA came to visit me, he saw my patients and we badly did not discuss. It invited me to make a presentation in 1997 in . Then, I went with the in 1998 to make a presentation on my cases of knees ankyloses.

. : And how did you come to Lyon?

. : Last year, of the French surgeons were present at a congress of csotcina.comedy in . I myself was invited to forward my series of knees and French asked me to make my presentation in Lyon in 2006.

. : Do you have now Chinese prostheses?

. : Yes and I have my own knee prosthesis. It is the second generation. In fact after my first ordering of prostheses, the company was withdrawn from the market and I had the without the implants. Thus implants should have been manufactured on the spot and does that of it was the first generation of Chinese prostheses. One started with a company which manufactured components for aviation. I was brought to make manufacture several successive models. With regard to materials there was no difficulty on the spot for alloys. Only polyethylene was to be imported.  In 2004, we manufactured an original model based on studies scanner of our patient population.

. : There are biometric differences?

. : It is especially in the small sizes that varies. Today, the young generation is much larger but the people of about sixty who suffer from their knees have, as a whole, moreover small sizes that those of the Western implants. We start to export towards Japan.

. : You cement the knees?

. : Yes, all implants. We have very good manufacturing plants of surgical cement.

. : Do you make another thing that prostheses in the knee?

. :  Not, for the other surgical disciplines of the knee I entrust to my younger collaborators who each one are specialized in their field. I have an expertise in the ankyloses of the knee and of the hip by and I have 43 cases. These cases are rare and come from all China. For the remainder it is about osteoarthritis by knowing that in China it relates to especially the knees. 

. : And on the hips?

. : In general, we cement the stems, especially in the elderly. In the young people, I use the prosthesis without cement of because it gives me good long-term results. Today, the position of the manufacturers and distributers of implants changed. They are very numerous and very present around the surgeons. It is far time when I was to beg to have implants.

. : Does there exist a liberal csotcina.comedic practice?

. : Not yet but one speaks about it. It is question of letting surgeons settle as a liberal. I could, perhaps, with my nearest retreat to plan to work for my account but I would not do it. What I wish, it is to withdraw themselves completely and to devote themselves to the fisheries and my family.