belongs to the new generation of the Belgian university csotcina.comedists. He exerts at the Catholic University of Leuwen where he devotes himself to the pathology of the knee. He informs us of his experiment of expert and designer as regards prosthetic arthroplasty of the knee.

 

MO. : Of which area of Belgium are you?

. : I come from the catholic university of Leuwen. This city is located at the center of Belgium, a little more in north that Brussels. It is the largest university of the country, with more than 92 280 students who live and work downtown. It is a true university town.

MO. : Which is the specificity of the Belgian Catholic University?

. : Especially “catholic” character of administrative management. We are the second older university catholic of the world. There is an ancestral tradition, in the university departments, all strongly influenced by Catholicism.

MO. : Does that want to say that there is also a “catholic” tradition surgical?

. : Yes, certainly. In the plan of ethics, we are rather strict in Leuwen. There is also a great rigor in the selection of the students and medical staff. However, that does not want to say that one will ask to the candidates which is their religion or if they are practitioners, but there nevertheless remains still a philosophical influence in the selections. However, all that is much less sensitive than there are 10 or 20 years, but this heritage remains always perceptible.

MO. : In addition you have the duality Flemish and Walloon, to manage…,

. : We are of #9CF9EF pit foot in the Belgian policy. Indeed, our university was literally cut into two in the Sixties where the French-speaking people separated from the Flemish party. We have two entities now. There are 2 catholic universities of Leuwen, Flemish and Walloon.

MO. : In which party do exert you?

. : I am Flemish party what has as a corollary a close relationship with Northern Europe, but especially with the United States. On the other hand, the French-speaking party approaches more of the south to Europe, and in particular France.

MO. : Which angle of attack on the surgical activity?

. : One often jokes between us of this separation. On our premises, Flemish side, one works harder and longer than in the French-speaking party, but that, it is a joke. However, in the purely csotcina.comedic plan, there is a rather significant difference in surgical philosophy and the knee surgery in particular. We are very influenced by the English and American Schools. The surgeons of the knee of the French-speaking university are them very close to the French School.

MO. : Do you hold common or meetings with the French-speaking surgeons?

. : It of organized there nothing in a formal way but one very frequently meets. People who specialize in the knee have had very friendly relations and very close relations for a few years, which was not always the case in the Eighties/90.

MO. : Is the knee your speciality?

. : It is exact, I operate only knees although from time to time, I make a in a footballer because in my department one is in charge of sports traumatology. But normally apart from these exceptional cases, I make only knee. But I make all the knee surgery. The only thing which is changing, it is the assumption of responsibility of the cartilaginous lesions where one starts to think of the Clerc's Offices and with the . My surgical team will strengthen itself with a collaborator for what one calls of the “biological” interventions.

MO. : Do you have a “biological” splitting in your university?

. : It is not really a splitting, but we have a unity depending on the university, managed jointly by the biologists, the rheumatologists and the surgeons of the knee. We created a department of study and of focusing of technologies of before guard, we are well placed on the ground of “biotechnologies”.

MO. : How is organized on your premise the interface between the hospital and the university?

. : It is a complex diagram of organization. To simplify let us say that the surgical private clinic is under the dependence of the university. What means in fact that nothing can occur in the csotcina.comedic department without the express permission from the university.

MO. : Then how are the procedures and the choice of the implants decided?

. : We have fortunately a total freedom for this type of decision. I speak rather about the selection of medical staff and the general strategy of the hospital. For example, the interrelationship between my private sector and my university activity. The surgical strategy always belongs to the surgeon.

. : Do you have a private activity?

. : Yes, I have an activity deprived like all the instructors of Leuwen. We have the right to carry on an activity deprived in the same structure, during the same work hours. But for that, there is a price to pay, and we must transfer a rather important percentage of our fees at the university. In practice, after tax, one can hope to keep 35% more of our fees.

MO. : Is this to say that these private customers are strongly remunerative for the university?

. : It is interesting for the two parties. It as should be remembered as we are paid monthly on a statute of instructor of the universities. One can increase our remuneration by making more the private one. The university perceiving a great percentage of the private fees, it is very interested de facto by this activity and does not seek of anything to restrict us. Thus there is with final interest for the two parties.

MO. : Are the liberal sector, purely deprived and not academic, developed in Belgium?

. : The exclusive private activity practically does not exist in Belgium. We have a system where the consultations and the operations are refunded to 90% by the government, the patient has a small share to pay. It is the general system. In addition to that, the majority of the surgeons have a liberal practice, during one or two days per week and there, they can implement a multiplying mailman of the agreed price. They is 2,5 times the basic tariff on average. In Belgium, there are only two or three surgeons who exert exclusively into private.

MO. : Which is the person who initiated your taste for csotcina.comedy?

. : Actually, nobody. As much of surgeons become csotcina.comedists, I was a medical student especially interested by mechanics. In fact I was interested more by mechanics than by the chemicals or pure physiology. Then, with a profile of this type and I believe that it is the case for many of our colleagues, you slip automatically towards csotcina.comedy.

MO. : In do your course have is made traumatology?

. : Yes, like everyone, I learned the csotcina.comedic gestures via traumatology. And thereafter, I passed quickly from traumatology to “cold” csotcina.comedy then to the exclusive surgery of the knee.

MO. : What made you choose such a specialized surgery?

. : I believe that the majority of the assistants senior registrars are very interested by the knee because it is at the same time an accessible hinge “visual” and that there is a rather mysterious aspect around the mechanics of the knee. It is a hinge difficult to discuss, they are very prestigious for somebody in the course of formation to operate knees. This speciality remains then very gravitational for the experienced surgeons. It is a speciality in the csotcina.comedy which is very protected and for a surgeon beginning, it is not always easy to adapt the knees because there are not many opportunities left by the elder ones. I had much chance for my part because of a very specific situation of my hospital where a surgeon of the very famous knee exerted. It was the Instructor who occupied himself, the first in Europe, of the footballers and the knee of the sportsman. He became universally recognized and by chance he was in the hospital where I began.

MO. : It is thus him which appointed you?

. : Not completely… The department head of the csotcina.comedic private clinic left to the retreat. It was necessary to choose a successor and the Instructor was the logical candidate for this post, but it is the Instructor Fabry, very known in the world of the infantile csotcina.comedy, which was selected. Into some days all changed, resigned and chose the deprived exclusive one. Very of a blow, there was a vacant post. It was necessary to allot this post in urgency. Doctor Victor who had been in the service for a few years, had to manage one period of transition and only transition, because Victor wanted since always leaving into private. Fabry become department head of csotcina.comedy contacted me during my fourth year of assistantship with like proposal becoming the future chief of the Department of knee surgery and the sporting lesions, under the condition which I was to guarantee by contract which I would remain during at least 5 to 10 years in the university, without leaving for the private one. All that was matched in no-claims bonus of a freehand for my formation “knee”.

MO. : You were finally done a “gold bridge”?

. : Completely. During my third year, I had the possibility of choosing my mode of formation, with the certainty to become the future chief of the Department knee. Because of that, I redefined my priorities and the three last years of my course, were exclusively reserved for the knee surgery during voyages to the United States and in England.

MO. : Which are the common points between the surgery of the young sportsman and osteoarthritis at the stage of prosthesis?

. : Almost nothing. The common point it is that there are 2 sick people of the knee. Both are interested to have an optimum result for a very specific problem. The only thing which account is to have a good performance: the reduction of the pain and functional restoration. In practice and technically, there is nothing commun run. The only mailman which imports really it is the experiment of the surgeon and his “vision” of the knee.

MO. : For the surgery of the knee, how do you follow operated?

. : All the patients are re-examined regularly. We have a good system of clinical follow-up and not only on our premises, in the csotcina.comedic private clinic, but everywhere in Belgium. There exists a tradition in our country it is that to remain faithful to its surgeon. One does not see, as in the United States or in France, the patients to flicker from one surgeon to another, to take multiple opinions and finally to disperse the surgical results which can become uninterpretable.

MO. : Do you see many osteoarthritides after knee?

. : I see many osteoarthritides after the meniscectomies which were made there is 15 or 20 years, especially total meniscectomies with open sky. At that time, in Belgium, we were not very advanced in the rebuildings . We did not start that 10 years ago to carry out internal . One already starts to see after-effects among these patients. But these osteoarthritides occur especially when a meniscectomy because in Belgium coexists, we continued a long time to make total meniscectomies by .

MO. : Which are the results of the meniscectomies?

. : My impression is that there are notable differences. I do not have unfortunately figures on this subject. Today, I make much more total prostheses after meniscectomy
“open” that after partial meniscectomies by channel. It can exist bone necroses after partial meniscectomy but these cases are discussed and the figures are almost virtual.

MO. : Is there a place for the prosthesis ?

. : There is one of them…. To give figures, in my service one operates 450 to 500 total prostheses a year and one makes only 20 prostheses . I know that comparatively with France this proportion is surprising. But they are my statistics and I cannot change them. From time to time, I am frustrated a little by this low number
“of plain”. I do not know for which reason I do not manage to increase this percentage. Perhaps this is a defect of indication. I do not know.

MO. : Does that mean that you the osteotomy compared to the prosthesis ?

. : I make also osteotomies of or for beginner. I make of them 30 to 40 a year, which is a little more than my figure of , I believe that it is a question preferably. There are an indication for the osteotomy and another for the …

MO. : The indication that you prefer with final is the total prosthesis by far…

. : Let us say that if I hesitate, if I, I doubt will always pose a total prosthesis.

MO. : Which security brings a total prosthesis to you?

. : The first security is to discuss the compartments which de facto by plain and which are likely to wear quickly and this for many reasons. Secondly my impression, and it is something which is not well described in the literature, is that I see much “plain” which is symptomatic, in particular on the level operated compartment. If I appear what I see with the consultation with the literature, I could say that my impression of “plain. ” is not always so favorable only what is commonly allowed. I see many which was loosened quickly or which remains painful without apparent reason. Thirdly, I too often see wears or degradations of the external prosthesis especially in .

MO. : In is your experiment, which the percentage of total prostheses which have unexplained pains?

. : It is a good question, here as much more as what one finds in the publications. If one analyzes the literature, one with the impression that 95% of the prostheses are impeccable and function perfectly. It is not at all my feeling. It is perhaps because I am still rather young and that I foresaw only the results of the first series of total prostheses of the knee which were obviously still worse than than one sees today. In my practice, only 60 to 70% of the patients carrying are really content, which wants to say that there is still a significant margin of progress to make.

MO. : What is this for you that a good performance of total prosthesis of knee?

. : A good performance after total prosthesis means that the patient, after one year, returns to control and can do what he wants, pain-free, with a result which will be stable in time, i.e. for at least 10 to 15 years. That, it is a good performance. Again, I still insist: if 70% of the knees evolve/move thus, I will have a great job satisfaction.

MO. : From how long do you think that the result of a total prosthesis can be evaluated as being stable?

. : I always refer to this subject in consultation. I tell the patients that their result will be final starting from one year and half, two years.

MO. : Which are the mailmen which explain why a prosthesis can improve beyond the first nths?

. : In very first place, development of the cicatrice and especially the progressive easing of the capsular cicatrice which is formed around the prosthesis. Secondly, there is the phenomenon “of biological osteoplasty” the osseous cuts generate a traumatism. And all that takes also time to recover. That takes at least a year, one year and half.

MO. : Therefore, there should be a difference in recovery between a cemented prosthesis and a prosthesis without cement?

. : Yes, indeed. I made my “PhD” on the modes of fixing of the femoral components and tibial of the total prostheses knee. There is, obviously, a “biological” difference osseous with the interface and . With a cemented prosthesis, one obtains an almost immediate union . Of course, there exists a prolonged reaction of the bone around the components. On the other hand, around an uncemented implant, it develops an healing process and of incorporation which, with the beginning, is very unstable, evolutionary, and which takes much time before being stabilized.

MO. : Which mode of fixing do you use?

. : Now, all my prostheses are cemented. Previously I was very influenced by the techniques of and I used his system without cement at the beginning. After a few years, I preferred to turn towards the same cemented prosthesis but.

MO. : Are your failures of prosthesis without cement rather on the femoral slope or rather on the tibial slope?

. : Both, but very limited. One recently re-examined the uncemented long-term outcomes of the “” and one noted a “survival” from 97,5% to 8 years, which is finally very well.

MO: With such results, why to have evolved to cemented?

: Unsealing is not in question. The problem, for me, it is rather the post-operative initial interface of the uncemented prostheses, the patients have much more badly: at the beginning rehabilitation is more difficult than if the prosthesis is sealed. It is this development and not the end result which made me prefer there is a few years cement.

MO. : Which is the mailman which influences the inflammatory reaction around a prosthesis without cement?

. : I believe that there are multiple mailmen. First of all, is needed a stable primary fixing. More stable is this initial fixing, more favorable will be the process of osseointegration, faster will be functional recovery. Should be obtained a very rigid initial stabilization. Secondly, it is necessary to try to obtain a very intimate contact . If possible less than 1,m what, with the conventional instruments one has today, is not always acquired. It is especially on the level of the femur and the chamfers that this space is irregular.

MO. : Do you think that these prostheses without cement are likely to give ?

. : I am on, but again it is something which one does not find in the literature. , it is a question about which he is necessary to lean because the biologic response can induce an internal cicatrice hypertrophic or at least too important with final inextensible fibrosis.

MO. : Does it sometimes happen to you to use prostheses with mobile plate?

. : Yes, from time to time. 5 years ago, I used much more the prostheses with mobile plate because I believed that the mobile prostheses were a solution to the few problems which one had to solve at this time. It was the time when one had imagined more congruent prostheses in order to reduce the stress and wear polyethylene. But with final, the results were bad because one saw a loss of mobility, a loss of bending, in comparison with the systems with flat insert like theGallant one or the PCA. This moment, I believed that the mobile plates were the solution to this problem of wear of the EP but the congruent ultra side deteriorated the end result of these knees which did not fold well.

MO. : Thus currently, you reduce your indications of mobile plates?

. : Yes, because we noted meanwhile, with the studies kinematics whom we have make, which there is no gain to use mobile plates.

MO. : Is the search for a “ bending” thus fundamental for you?

. : I will not say that it is “very” important, but I believe that it is necessary to take account of the aspirations of the patients, the lack of bending is one of the most frequent complaints: “… there is something, doctor, who poses a problem to me, it is the bending; I cannot fold as before…”. I believe that we, surgeons, should not occult the need for bending of the patient. One with the air in the congresses to minimize this request and to think that is not important. With a radical cure like a , one must try to restore the native articular situation and that wants to say maximum bending.

MO. : How to increase the bending of a knee?

. : It is a discussion which can last several days. To be short, today one does not know it with certainty. It is known that there are artifices which can help, but we did not find yet of magic formula. One of the most important things, for me, to gain in bending, it is to have a stabilized system which causes the “”. The studies kinematics which we have make, show that by increasing the “”, one increases the bending. The value is of 1,4 degree for m of “”. But in the very major bending, one notes a kind of stand-off or loss of contact between the cam and the system of stabilization. But that occurs only in hyperflection at the time when one has already the maximum . I believe that the system of stabilization is useful only for the beginning of the bending up to 15 103°, there it remains a contact between the EP stabilized and the cam. Beyond that, the system opens as a book without there being no more contact .

MO. : Is this to say that one needs an aircraft bungee cord and a ball joint of very good quality to obtain a good bending?

. : Yes, especially an aircraft bungee cord of good quality. Because one sees that in so major bendings, the ball joint does nothing but re-enter in contact with the femur in a very partial way, it is especially the area of the tendon which is in contact with the femoral trochlea.

MO. : Did you study these prostheses stabilized in fluoroscopy?

. : Yes, we did many studies with at the time when Dennis made its studies which were besides more success than our work. Approximately, we showed at the same time as Dennis that there are certain paradoxical phenomena.

MO. : I.e.?

. : Knee prostheses which we posed between the Seventies and 90 do not reproduce absolutely a normal movement. The articular kinetics remains paradoxical. The femur moves forwards during the bending what is strictly the reverse from what occurs with a normal knee. There are other functional defects such aberrant and nonforeseeable fémoro-tibial rotation during the movements of /extension bending associated with phenomena of in the frontal plane.

MO. : In your studies by fluoroscopy, did you find a difference when there is an excessive ?

. : We did not make a factorial study . It is a little damage, but it as should be realized as these studies are very elaborate and take much time. One must pose the indications well. We especially examined total prostheses of knee which function well, among patients who are well. We wanted to do that to define exactly what one can still improve at a patient who is well. Currently, that' it is passed-T? We have improved patients but who tell us “I am content, but my knee does not function like a normal knee”. It is this type of patients which interested us. It is exactly where we noted that these prosthetic knees do not function at all like normal knees but rather like mechanical hinges equipped with an unforeseeable kinematics. Here is the problem to be solved in the future.

MO. : You are designing a prosthesis of last generation. Did these studies have to influence the kinematics which you want to give to your new knee?

. : Yes, and we are not only. Many groups dealing of the development and the design of the total prostheses of knee, are working on the prosthesis of 3rd generation. And all these surgeons have like common point to know with precision these paradoxical movements, irregular, not very reproducible, that we noted during the hundreds of fluoroscopies that we realized. The final aim is to harmonize the prosthetic function.

MO. : How do you hope to solve part of these problems with a new implant?

. : It became very clearly that everyone tends to seek a system able to reproduce the kinematics of a normal knee. That means asymmetrical with a contact point in the plate interns relatively stable, and little posterior displacement. Contrary, the external plate shows a which can reach 15 to m what as well reproduces the normal internal rotation of the tibia in bending as external rotation in extension. One calls this mechanism “ home”. Everyone works on a system which can reproduce such a movement. The majority of the factories protect their results and the disclosure of these developments remains very confidential, one knows really only the mode of study of these paradoxical movements.

MO. : I.e. there is a differential rotation of the two condyles?

. : Yes, in this type of prosthesis the concept is obligatorily an asymmetrical system with condyles which are as much as possible anatomical, physiological. The condylar design is completely different between the internal and external compartment. That wants to as say as one needs a antéro-posterior system of stabilization. We have some now because we noted, in these fluoroscopic studies, that the fact of the is probably one of the significant factors of the absence of reproducibility of a normal kinematics of the knee prosthesis.

MO. : You thus have also an amendment of the tibial plateau?

. : Yes, of course. The tibial base plate was to be completely different to agree to the asymmetrical condyles. Then, the system of stabilization imposes a former and posterior stabilization, by keeping the two cruciates. Lastly, the prosthesis is of patching type i.e. one remains very economic on the cuts.

MO. : Does your prosthesis hold account of the tibial slope?

. : Yes, but not only of the tibial slope. If one evolves to a so physiological and so anatomical prosthesis, it is almost automatically necessary to reproduce the tibial epiphyseal of 3 degrees.

MO. : What wants to say that you create an oblique line space?

. : Not, because they would be too dangerous. An error in the tibial cuts is always possible today with the available. The option that we chose is to put the tibial base plate at 90° and to incline the polyethylene of 3° as in a conventional hinge.

MO. : Aren't you afraid that with such an anatomical prosthesis there are errors of installation by little experienced surgeons of the knee?

. : It is a very good remark and therefore such a prosthesis must authorize a margin of error without which one is likely to arrive at a catastrophic result. That wants to say that we worked so that the prosthesis tolerates an acceptable error in antéro-posterior positioning, rotational and three-dimensional.

MO. : Is this to say that it would be necessary to consider, with this type of prosthesis, a surgical navigation ?

. : Not inevitably, we return here in discussion of a philosophical type. It is clearly today that a trading company never will not develop a system which would be plantable only using one computerized navigation. This new implant does not have to be navigate to be posed correctly.

MO. : Summers you favorable or unfavourable with navigation?

. : I use it from time to time, that interests me in the scientific plan. Today, my opinion is very clear. The systems available today increase the precision of installation, especially for surgeons who operate little or who have limited experience. The utility is much less for operators who have an great experience of the knee surgery. We made a study in this direction and we will publish it in a few months. I do not believe that the systems are user-friendly enough for a today generalized use. That takes too much time, that is too expensive to recommend to use navigation systematically. For this reason, I repeat that it would not be acceptable to develop a prosthesis which one can establish only using one navigation. If one developed a prosthesis whose installation would be so precise to obtain a good performance, it would not be a good prosthesis.

MO. : For your new prosthesis you use a femoral component of the type…

. : Yes, but I already use for all my patients a zirconium component.

MO. : About what is it?

. : The condylar block is manufactured out of zirconium alloy which, in the course of manufacture is put in contact with oxygen. The oxidation of surface is then very progressive. The tribological characteristic of this implant is that of a ceramics on metal basis, included in the mass.

MO. : I.e. do we deal not with a ceramics, but with a metal alloy?

. : It is exact. The advantage it is that it has all the characteristics of ceramics but without the disadvantages. The condylar block is very resistant. The zirconium oxide is a metal much more reliable than a component chromium plates cobalt in term of rigidity of it, hardness, of fatigue strength and to the abrasive forces.

MO. : How much condyles of this type did you pose?

. : We began the implantations about a year ago and half, that made approximately 500 or 600, I do not have the exact figures. The figure of ust be rightest. The femoral component is always sealed. The tibial component is not yet available out of zirconium oxide. We are working on a complete system, but apparently the realization is not so easy.

MO. : Which gains do you wait of this type of condyle?

. : You know that certain American teams published results showing a faster rehabilitation with zirconium. Personally, I am not convinced that it is the greatest benefit of this implant. On the contrary, I believe that the aspects concerning rigidity, the reduction of the wear of polyethylene, tribological qualities make the force of this prosthesis. It is necessary to also insist on the biocompatibility among patients who have an over-sensitiveness or an allergy to nickel. We noted that in the components cobalt chromium plates, the quantity of nickel is not negligible, in the same way in the titanium components. In zirconium oxide, the quantity of nickel is almost equal to zero.

MO. : Did you have to take again prostheses of this type?

. : Yes, I removed some for infection and one without cement for unsealing. With the whole beginning, components without cement were available. In Belgium, one established two uncemented components which are not built-in and I had to remove one from them.

MO. : Were there remains articular or of the ?

. : Nothing. There was neither , nor inflammatory granuloma.

MO. : Don't you think that the weak element of this system remains polyethylene and which alternative solutions could you propose?

. : Yes, it is clearly the polyethylene which remains the weak point of knee prostheses. However, problems due
with polyethylene are much less important than there are 10 or 20 years and, personally, I have the impression at the present time that the problem of the prosthesis of the knee today is a problem of function and not a problem of wear.

MO. : How will be called your new prosthesis?

. : It will be called “”.

MO. : After all these studies on the knee surgery, don't you regret a little the hip?

. : The hip, I know of it too little to appreciate it with his fair value!! Even if I am perhaps too young to be also specialized I see there with final only advantages.

MO. : Do you deal prosthetic overhauls with the knee?

. : Yes, and more and more.

MO. : Which is the number of prostheses which would have to be made a year to be authorized to carry out overhauls of prostheses?

. : It is a difficult question. I have an opinion on this subject, but the answer is delicate because one lives in a world where if a precise writing is made, it is known that immediately, a lawyer will be able to use it against the colleagues. Then, I will say it very prudently. I believe that if one makes more than nee prostheses a year, one is probably able to solve a difficult problem of overhaul. If one makes some less than 50, I believe that one must study the case well to be taken again. I will not say that it is an error to do it but I believe that it is something which, in our trade must be an individual decision according to its competences and of its practices.

MO. : As regards overhaul, which type of implant do you prefer?

. : I prefer a modular system where one, , with stems available to the femur as with the tibia, these stems must exist in all the faces, but I can interchange needs also distal and posterior femoral blocks, tibial blocks.

MO. : Finally you want all the extensions possible?

. : Yes, I want a system absolutely complete.

MO. : Don't you think that it is preferable to use a prosthesis with hinge, or pivot-hinge?

. : It is a field which remains very discussed. I am rather defender of the systems with hinge, in any case much more than somebody could not consider it who is influenced by the English and American standards.

MO. : According to you, do there exist indications of prostheses with hinge in first intention?

. : Yes, for example, in the event of very severe valgus at an old patient, with an instability . It is for me an obvious indication, but there are others of them too. For example, patients carrying a neuropathy, patients with a system defective or irrevocable bungee cord.

MO. : Do you have specific techniques of repair of the aircraft bungee cord?

. : It is a question which becomes more and more of topicality because one sees more and more problems of aircraft bungee cord, after 3 or 4 overhauls where the ball joint often is very degraded. I believe that a surgeon who does many overhauls must control all the techniques of repair which are available, i.e. taking away leg , taking away by of the to rebuild the tendon or even to descend the tendon from the rectus to rebuild the patellar tendon. It is also necessary to be in connection with a tissue bank of bone to profit from of the patellar tendon or combined tendon/ball joint quadriceps… It is necessary here also to be complete. It is an example of complementarity between the surgery and prosthetic.

MO. : To return to the sport, it seems that you a past of candidate of veil…

. : Yes, it is true. In my youth, I sailed with my brother in one 470 and we were very well classified with the national plan, but also with the international plan. An example: We made the Olympic Games in the Belgian team in 1992, in Barcelona.

MO. : Where a Belgian team involved is to make center-board?

. : In the seaports of North or in the south of France. Each year there were training courses of drive in and Cannes. But also in or the La Rochelle.

MO. : Do the conditions of navigation make it possible to make center-board in these North Sea removed?

. : It is difficult, but these conditions make you a man.

MO. : The competition you At' it helped in your professional practice?

. : Yes, certainly because in the veil one must fight not only with the weather conditions but also with the competitors. To arrive there, one must do the utmost and at the same time one must keep a humility towards nature and the mailmen which one cannot always control as it is wanted.

MO. : Finally do the modular surgery of the knee and the handling of the multihulls have common points?

. : Yes, they are two “ performance”.