Marcel Lemaire is with Albert one of the pioneers of the knee surgery and the pathology of the sportsman. Its course is at the very least atypical; the character is enthralling and the man remains impassioned by all that surrounds it. We met it.

 

. : Mr Lemaire, how would you forward yourselves?

. : Today I am an old surgeon. Formerly I was the son of a doctor of Studs. I chose the surgery because being child I had an extraordinary admiration for Rene Toupet who was the surgeon with which my father worked.

. : There was a solid surgical environment around you?

. : Not, I was in an medical environment but I did not want to make medicine because I saw the life of the doctor of near and that I found it infernal. But there was also this strong admiration for Rene Toupet. It was a large surgeon of which I was the intern later. Its extraordinary side was that when it arrived some share he was naturally the owner. It ordered everyone. It had manners which fascinated me. For example, it had a driver. One day, I was 10 years old, I had asked him: “why you do not lead yourself?” He answered me “because the behavior makes tremble the hands then a surgeon should not never lead a car”.

. : It was Mandarin?

. : Not, it was sympathetic nerve and later I found in him the best owner of my boarding school. It was in , and it took its interns with him and made them make operations on fresh corpses. I was at his place of fourth year of boarding school and it made me make major surgery.

. : You made a boarding school of general surgery?

. : I made a boarding school of general surgery directed towards the thorax. I was likely to work with which was not surgeon of the hospitals and which I met at Rene Toupet. which was a remarkable thoraco-abdominal surgeon me truly adopted. I lived during 30 years with him to make esophagi, gastric carcinomata etc… I also passed to to at the same time as . I was also internal of in the night center of traumatology of . was then an emergency hospital for the night. I remember that one reduced the fractures under radioscopy alas. I tell alas because that left me traces in the hands. I was finally internal at .

. : Which was the personality of Jean ?

. : If I tell cold I am in lower part of the truth. It is the kind of owner who made you come in his office and left you there upright. It scraped paper and it showed pretense to you during 5 good minutes.

. : In its book on its boarding school, it however expressed a certain direction of humor…

. : In this book perhaps, but in its service it was not comic.

. : Where did you make your ?

. : With the Hospital at . It had a very great service, which understood all the ground floor of the Hospital. But it was surrounded by many people. was then internal, there was and well others. It was quiet because one was very numerous; there were two assistants, four senior registrars. I do not have the large memory to have learned there thing but at this period I helped already which him, learned to me from the heaps of things. It was the French surgeon most famous for the esophagus. It made me make my thesis on the transfers of the colon for .

. : It appears that during your boarding school you went to Greenland?

. : One beautiful day two ski instructors come to see me has and “You tell me are sportsman, it is necessary that you came with us because we will cross Lapland to ski.” It was very interesting. A voyage m with all the hardware, because there was no supply. It was to see what could do of isolated people. I said agreement and one did it. When I returned of this tour to Paris, I had a telephone call of Paul Emile Victor telling “I learned that you did that, it is necessary to come with me to Greenland! I leave in three months”. I told “good, on the way!”. All that made me take one sabbatical year.

. : What did Paul Emile Victor await you?

. : That I would be doctor of forwarding. I must say that the first gesture that I made over there was not very assured. We were on the edge of the sea with our camp installed and a friend of Victor who was also one of the owners of forwarding had badly with a tooth. I look at and I say perhaps that it would have to be removed because there could be an abscess behind. He answers “good then you remove it to me”. In the hardware that I had there was a box full of forceps. Somebody tells me “you know, to each forceps corresponds a tooth.” I is perplexed “it is a premolar but what it is necessary to make?” Nobody could tell it to me, and me, although my brother is dentist, I had never seen removing a tooth. Everyone laughed. Finally I took forceps which appeared me to be appropriate and… I missed my blow. But with the second test I succeeded in bringing back a tooth which did not hold at all and which one could have left differently.

. : Without anesthesia?

. : Without anesthesia. It was courageous. That known as he had only very serious people there there. Many scientific work were carried out on this occasion for CNRS. One, amongst other things, had spent much time to measure the thickness of the ice.

. : To what did spend you your days?

. : There were heaps of things to make for the scientists but me, I did not have anything to make. I was thus the ideal subject for the scenario writer of forwarding, Jean-Jacques . When the film of forwarding passed in the cinemas I was very noble because I was the main actor. Inevitably, since all the others were busy.

. : All these solicitations come from your reputation of sportsman…

. : I was first “best ”, in 1948. I was in the team of amateur and it was a regional championship. At this time there there was no championship of France amateur.

. : Thus you were brought to occupy you of the sportsmen?

. : Yes. One entrusted the professionals to me to be looked after whereas I was not yet . I was brought to occupy me of the professional team of whereas I did not have any concept of traumatology. I must say that I was qualified better all the same than the preceding doctor who was radiologist. In front of this responsibility, I was indeed obliged to learn something. The chance wanted that the management of Club of Paris is enthusiastic and almost every Monday there was a who arrived from Lyon to play with them and it was . So that I became acquainted with and each time I had a problem it together was discussed. He learned to me enormously from things.

. : It in which year was?

. : From 49 and the Fifties. was already the large Master of the knee of France. It had the reputation and it operated practically all the professional players of France.

. : What did you make at the time when one of your players forwarded a lesion of the crusaders?

. : Crusaders? One should not laugh, in 1949 the pathology of the former crusader was completely ignored, at least in Paris. Some even told that it was a recessive element because often, in the knees , there was no former crusader. The lesions of the meniscuses, it was only one clinical diagnosis because there was not the arthrography… Then a persistent pain on the internal line space and it was the .

. : How did you carry it out?

. : Attention I is innocent, it is which showed me the method. It started by making a comfortable initially vertical channel. It did not cut the side ligament interns and it made an own surgery. Then, its channel initially gradually narrowed. It described a resection not completely total, by leaving the wall meniscal. It was its basic operation and that lasted of the years. I regularly sent the players until the day to him when there is of them one which told me “I do not want to go to see , I want that it is you who operated me”. It had a torn meniscus, it was international, a Morrocan. I had already removed meniscuses at the hospital then I removed his meniscus to him. This day there I put the finger in the gears. After I removed the meniscus to him, the other players came. Especially that I had Roland who played with me in and which was the journalist number one of the sporting page of the Barber. Thus, each time I operated a guy that appeared in the Barber. That was like that until 1958. In ved for the world cup which took place in Sweden and I on the occasion to re-examine it on his arrival in Paris. There, I spoke to him about the cruciates because that trotted me in the head. I found that I saw many broken cruciates.

. : How did you make the diagnosis?

. : Drawer former to 90°. But there is a thing which had struck me much. I had seen several times of the players having an accident on the ground and when I immediately examined them with the cloakroom after the accident, they had a terrible drawer. I put them in the plaster and at the exit of the plaster one month after there was no more drawer. I had concluded stupidly that the immobilization foundation of concrete cured the ruptures of the cruciates. Thus I forwarded this idea with to his return of the world cup. It me a little because it did not admit much which one has of the ideas that it had not had. He told me “the cruciate it is very simple, you take your type you put it sitted a weight of g at the end of the foot and you make him make series of 10 extensions/bendings, and 15 days after he is cured”. That had left me a little. Thereafter, I called to him because I followed a dancer of the Opera to which I had removed a meniscus and which was not well. I showed it to him, by asking to him whether it did not have a rupture of crusader. He told me: “Not it is a laxity of the side ligament interns, you have only to retighten its side ligament to him interns”. What rather worsened the situation. Finally, in front of his drawer which increased more and more, I am allowed to tell me: “but finally the crusader for what that is used?”. I took and it is there that I learned that the major role of the former cruciate is to control internal rotation. I then reflected to know how one could slow down internal rotation, I told myself: “or one applies the brake into antéro-external or one puts it as an postéro-intern”. As an postéro-intern, I will lose myself, and it is there that I had the idea to apply an antéro-external brake. That was worth me to be annoyed with of 1960 to 1978.

.: Why didn't you plan to remake the crusader?

. : Attention, I had done it already. I had made operations of . It was a Anglo-Saxon author who about 1918 had had the idea to remake the former cruciate with the fascia . It passed its taking away of strip through the external condyle and it returned into intra-articular. It had had good performances since it had published, but that was not my case.

. : But why not another intra-articular plastic surgeon?

. : But because it was simpler to make extra-articular, and that at that time to largely open a hinge was a major gesture. One day in the Sixties, I met on the pavement in Paris. I knew it well because we were almost of the same generation. was already in Tours, and he told me “he will be necessary that you come one day to explain us why you see the things with back”. Because this idea of , that the crucial role of the former cruciate was the control of internal rotation, it was the reverse of what one then thought. That can appear odd but the official idea of the time was that the role of the ligament was to control external rotation. It was thought that the ruptures of the former crusader arrived by the external movement valgus-bending-rotation.

. : How you passed from the idea that it is necessary to make an antéro-external control with the plastic surgeon which you described?

. : With the plastic surgeons of I had already handled the scraps of fascia-lata, it was thus not difficult to imagine how to fix a transplant on the face outside of the condyle.

. : You were not concerned with the control of the former drawer?

. : Not. Because when I operated professional football players with my external plastic surgeon, they turned over on the football field content like all. That was enough for me.

. : Since when made you this intervention?

. : Since December 60 but I nevertheless improved it.

. : When did you realize that there was an antéro-external projection in former laxities?

. : I cannot tell you exactly but that was to be towards 62-63. It is a patient who showed it to me, he told me here how that occurs. It locked its right foot and it swivelled. That confirmed what I thought of the ruptures of the former cruciate and I was delighted. I kept it like sign characteristic of the rupture of the cruciate. I published my procedure and this pathognomonic sign of the lesions of the in the Newspaper of Surgery in 1967. which had just created the cards made summarize my item for the Review of csotcina.comedic surgery. A small detail: as opposed to what make many authors in the search for a projection in internal rotation, I do not print a movement of valgus.

. : During all did these Sixties you carry out your plastic surgeon in your corner and the general indifference?

. : Not, not in the indifference but in general reprobation. Until the day when, in 1978, of which I had not had a news since 1960 and who off organized in Lyon the first meeting of International tea , calls to me while telling me: “there is Canadian who wants to come to speak about your operation then he is necessary that you come”. Very nicely it gave me the word before Galway. So that when Galway is installed to the platform it was a little embarrassed, and it told: “it is the new world which has just discovered the old one; I will describe you 200 cases of the intervention which Doctor Lemaire has just described you in connection with 2000 cases”.

. : For were the period when you developed your plastic surgeon there partisans of the intra-articular plastic surgeons?

. : Not much. The least bad of the plastic surgeons intra-articular was that of . But at that time in France csotcina.comedy was directed towards the hip surgery than towards the surgery . That did not interest large world apart from the Lyoneses.

. : Do the Lyoneses in the Seventies, what they think of “Lemaire”?

. : Horrors… Do not ask me what thought.

. : What said ?

. : He did not speak much. He was very extra-articular but in impossible corners.

. : With a 30 years passing, do you think that your plastic surgeon still holds the route?

. : That depends on the operated knee, of what one asks him, of the moment when the intervention was carried out, in short of what the patient wants. The problem is not to satisfy the surgeon but to satisfy the patient. The ideal is to remake the anatomy, everyone is of agreement there above. Only the interventions of the Kenneth-Jones type are heavy operations whose results are dubious and I do not believe that one can propose them with a fifty year old man who wants to go to play tennis.

. : You made of “Lemaire” beyond 50 years?

. : Yes, and even up to 72 years. I remember of a poor woman who had a very unstable knee and which did not dare any more to cross its street. It was reduced to make the turn of its block and fortunately it lived Paris in a district where it could make its races. One day it had enough of it, it came to see me. It goes very well now.

. : But the plastic surgeons Kenneth-Jones type were well simplified and their continuations are not too intricate.

. : It is you who it known as. The continuations are not always happy. I see a quantity of failures of intra-articular reconstruction and if I were not also lazy I would publish them. If one made a study of the subjects which, after an intra-articular reconstruction find their initial sporting level I think that one would be disappointed and it is perhaps for that nobody does it. There are heaps of complications all the same. which is a surgeon that I adhere to much started while making of the intra-articular reconstructions and finally it added systematic the external extra-articular plastic surgeon there.

. : What brought the knee arthroscopy to you?

. : The I did not put itself there by idleness, but it should be said that I am surrounded colleagues who are delighted to do them. I missed the first brought in France. It was Marie-Claude Tesson, who later will create the Daily newspaper of the Doctor, who had brought it from Japan. I was in at this time. But it was a trick which it was necessary to sterilize with formol. I told him: me I will not put in the knees of my patients of the impregnated formol hardware; bring your patients, if you want will operate them here to you.

. : How old are you?

. : 78 years.

. : Until which age one does have to operate?

. : As long as there is pleasure to operate and that does not exhaust you.

. : You operate still much?

. : Yes, I operate as when I was 40 years old.

. : Does the knee surgery still interest you?

. : There are many things which still interest me. Currently, the problems of stability of the ball joint impassion me.

. : Do you have passions, apart from the surgery?

. : I always remained faithful to my physical occupations. I need to slacken me, still now, physically. I ride a horse. I have a horse in my garden and as guard I have a former jockey who installs it when I do not go up. I live in skirt of forest of . I believe that a certain physical-activity should be maintained.