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DAVID DEJOUR

Published in N°010 - March / April 2021
Interview viewed 16 times

DAVID DEJOUR

David Dejour should have finished his mandate as president last May 2020 in Milan, at the Esska congress. He tells us about the highlights of this very popular congress and retraces the main stages of his professional career, which is entirely focused on the knee.

David, tell us about this year’s ESSKA Congress 2020

For the first time, we have organised the congress around a theme: «When fashion meets science». At first glance, the link does not seem obvious, but there are two possible interpretations.

The first, the simplest one: Milan, a fashion mecca, hosts ESSKA, which is a science-providing structure. But we can go further! Haute couture is research based on the history of fabrics, shapes, materials and techniques, which leads to the ready-to-wear clothes that ‘everyone’ will use on a daily basis. We then find this common ground with fundamental research - industry - surgeons with the aim of improving the condition of our patients.

How do you see the link between fashion and orthopaedics?

The parallel between the world of fashion and the world of science is striking: We may think that the practice of our profession is independent of any commercial environment, but this is not entirely true. Indeed, when fundamental research opens up new perspectives, refines theoretical knowledge and thus finds new therapeutic opportunities, our industrial partners will be able to apply instruments, materials and techniques in collaboration with surgeons and researchers. It is our patients who will benefit most from this. Fundamental research is the haute-couture, surgical techniques and the products derived from them are the prêt-à-porter... it is also a nod to this new entity that I wanted in ESSKA "Women in ESSKA" which focuses on the promotion of women in a rather masculine world... you will see it will be a highlight of the congress.

What do you think of these new trends that are taking place?

I find this very positive. With each new «wave» or «fashion» the whole community is questioned again. There are disagreements on this or that subject, and everyone has to prove the correctness of their theory through new studies. This is a great catalyst for research! On the other hand, I think we should always keep a critical attitude towards the constant arrival of new products and techniques.

Does a society like ESSKA have a role in disseminating information?

Yes, this is the essence of a scientific society. Mission number one is to deliver unbiased information to its members. ESSKA pays particular attention to the scientific programme of the biennial congress or its intermediate congress "Speciality Days" to deliver information that is objective and validated by studies with impeccable methodologies. ESSKA likes to give a voice to promoters of different trends. It is in these intelligent and constructive exchanges that our members will make their choice.

What is the mission of a congress?

The dissemination and updating of knowledge at the time of the event. Not everyone reads KSSTA, JEO, or the other top orthopaedic journals regularly. Surgeons unfortunately do not always have the time to keep up to date by reading peer reviewed journals. Instead, they are inundated with information through advertising, social media, video news platforms and the like. This is where scientific societies play their full information role during their congresses by giving an unbiased summary of what is happening in the world. Giving the "pros" and "cons" and all the elements.

Are these controversies important?

They are fundamental and it is a strong feature of the ESSKA congress to compare the past and the present, to look for differences and the most remarkable developments. We can then see that certain trends regularly resurface in a ‘rebranded’ form. This is where we come to fashion with the famous ‘bell-bottoms’ of the 70’s becoming totally outdated, then giving way to slim fitting trousers, but again the ‘bell-bottoms’ come back, in a modernised form. I find it fascinating, these cycles of clothing and scientific fashion!

You mentioned that, in a way, the industry  commercialises the fruits of research. Isn’t that a problem?

No, on the contrary. The industry is an essential partner in our exercise and in our development. It is certain that each one defends its product range with its associated KOL (Key Opinion Leader) panels and sales force. It’s a very stimulating competition for everyone, and we can see it in all areas of economic life, and we are no exception.

How do you manage this balance between science and marketing?

In our congresses we have two areas, the amphitheatres and the conference rooms where all the material presented has been selected by the scientific chairs according to very rigorous criteria. This is where the highlight lectures, keynote lectures, instructional courses, symposia, round tables and free paper sessions are given. The participants can therefore listen to what is "validated". The second area is the technical exhibition area where all companies have their stands, as well as  their workshops which are of high quality but openly oriented towards the brand’s products. In these two areas, everyone will find knowledgeable fulfillment.

In this regard, how does the preparation of an ESSKA congress work?

It’s a lot of work, and requires many steps. You have to define a team of programme chairpersons and the people who are going to implement the programme according to the spaces of the congress centre. This is a huge task. Michael Hirschmann and Kristian Samuelsson are our two ESSKA programme chairs, and Elisavetta Kohn is our local Italian program chair.

This edition in Milan is a bit special as it is the first time we are working with our new PCO (Professional Congress Organizer) KIT.

Did it have a big impact?

Yes, absolutely, and in the right direction. We needed a new and innovative concept. KIT, which is based in Berlin, brought us new technology, especially in the way of submitting symposia and instructional course lectures, as well as abstracts. We wanted it to be more open to our members, more transparent and to reflect what our members want to see covered, or what they are working on. We set up an online platform where we called on all ESSKA members; this is democratic and very open, but it increases the selection work considerably: we received more than 280 proposals for symposia, 2000 for abstracts, and many submissions also for ICLs.

The selection work must have been enormous?

Yes. The task is overwhelming, as this data needs to be evaluated and organised by specialties and even sub-specialties. Then the programme chairs, the new PCO and ESSKA leadership worked closely together to finalize and balance the final program which is going to be amazing!!!

This year we are inaugurating a new lecture in honour of our co-founders. The «Eijar Erickson lecture» will focus on arthroscopy and sport and the new «Werner Müller lecture» will focus on clinical and anatomical issues. You will also discover the real history of ESSKA!

ESSKA fulfils its information mission through its congresses, but it is also very active in the world of publishing, isn’t it?

We have our flagship journal, the Knee Surgery, Sports Traumatology, Arthroscopy (KSSTA) Journal, whose editor-in-chief is Jón Karlsson. It has a good impact factor (3.2) and is one of the major players in orthopaedic scientific publishing.  Jon Karlsson’s policy is to take most of the articles that are submitted to us and make them even more attractive. The aim is not to increase the impact factor at all costs, but to promote the work produced by our members and those who like our journal; that is why the journal is very big, maybe even a little too big, but we still manage to highlight many articles on a wide range of subjects such as sports medicine, all-round arthroscopy, degenerative knees, etc...

But there is another journal attached to ESSKA?

Absolutely. We also created in 2013 the Journal of Orthopaedic Experimentation -JEO- which Henning Madry was in charge of; it was an open access journal focused on basic science. The journal is indexed and should have an impact factor this year. But since basic science is not a broad subject, we ended up with an imperfect balance between the huge KSSTA with a wealth of very good scientific articles and an open mind, and the JEO which was making progress but was struggling to get off the ground. We decided to change the shape of JEO to ‘New JEO’, with a new editor, Stefano Zaffagnini, and a new editorial line.  With Henning Madry leaving to take over the management of Osteoarthritis and Cartilage Open, he has done a remarkable job.

Has the new JEO changed direction?

We have kept basic science, which remains a fundamental element, but we have opened JEO to clinical work such as degenerative and sports knees, shoulders and ankles. The editorial team is made up of associate editors specialised in each field. This provides us with a very high level of expertise, rapid review and high quality. With these changes we hope to restore the balance between KSSTA and JEO.

Publishing is a big job for ESSKA?

Indeed! Between the journals and the books, it is a considerable workload. We also have our newsletter, which went from a biannual print format, to a quarterly digital format, and is now a monthly publication called the ESSKA Times. This has allowed us to increase the volume of scientific articles and to broaden the scope of the content, in a much more timely format. It is an excellent tool for promoting and disseminating information, as it is distributed to the entire ESSKA family, which is about 10,000 people.

We are also extremely happy to be able to benefit from this collaboration that you offer us with MO journal. It is such a positive initiative and I can only be happy to see our former "Maîtrise Orthopédique" taking a European and even international path. Congratulations to you for your editorial quality!

Is it difficult, with all these projects and this big machine that is ESSKA, to keep a certain consistency?

We are working hard to maintain an "ESSKA spirit". This requires men and women who are motivated by a common spirit. The leadership of a company is its quality. First of all, there has to be continuity in the board and in the presidential line so that the work is not started from scratch every two years, with each change of president. Since 2010, we have organised a strategic meeting every two years, which allows us to define lines of action for two, four and six years. The continuity and follow-up of projects is fundamental. I have continued the work of Romain Seil, Jacques Menetrey will continue what I have put in place, and then it will be Roland Becker’s turn... these are not names in front of actions but a group, a team that speaks only for ESSKA. There is no room for individualism.

In terms of education, what are ESSKA’s plans?

The list is long between the biennial congress, the Speciality Days which take place in the year when there is congress and deals with the very specialised subjects of the ESSKA Sections (degenerative knee, arthroscopic ankle and shoulder and sports.)

There are also the books that are published every two years for our participants, the ESSKA academy which is a platform where you can find the main conferences of the congresses and videos of surgical techniques. 

There are also cadaver courses?

Yes, we have reorganised our courses to change the format. We call them "All about..." it’s like an ESSKA trademark. The participants have a day and a half of intensive training on a highly focused topic. If they take part in an "All about ACL", they will know everything about the anterior cruciate from grafting, associated injuries, menisci, osteotomies, etc. This formula is very successful.

What is the model?

It is simple and is done in partnership with the companies who also have this concern for education. The programme and faculty are defined by ESSKA and we go to the companies’ cadaver labs. The business model works well and allows us to have a reduced cost for our participants, and the faculty donates its fees to the ESSKA Foundation. It is also an excellent way for our partners to promote their equipment as we use what they have on the market. We would like to thank them for this win-win partnership.

You also wanted to create an "ESSKA" certification?

The idea was born in our 2016 strategic meeting led by Romain Seil. We asked Martin Lind, our educational secretary, and an external consultant hired by ESSKA, Michael Ross, to work on a methodology to define what a certification is and what criteria are needed in each area to be considered certified. We brought together a group of experts in each area to define these items.

Launched in May 2020, this modular competency-based core curriculum is based on both theoretical and practical knowledge, to define the core competencies required by ESSKA specialists. It consists of 285 Core Competencies, which have been arranged into ESSKA’s six Specialist areas: Knee, Shoulder, Foot & Ankle, Hip, Elbow & Forearm, and Sport & Exercise.

It’s a great project, how long did it take to come to fruition?

The process took over three years. That is the point of these strategic meetings, which handle the medium and long term. In two years, a president cannot complete all the projects, and we have to organise the continuity and transmission of projects from one presidency to the next. This is the great strength of a team that works towards a common goal: ESSKA.
This work is very consistent and strengthens our identity.

Let’s talk about you. You are French and live in Lyon. Does the city have a particular relationship with ESSKA?

Let’s talk about France first. I would be so happy to see more French people in the international congresses. This is probably due to the very good offer produced by our national societies SFA, SOFCOT... but I would encourage our young colleagues to travel, it is so enriching... If you speak English you will make your research shine internationally! This is valid for all countries of course.

Nevertheless the French imprint is strong in ESSKA, very often we find a Frenchman or a Frenchwoman in the most prestigious fellowships of ESSKA because these Frenchmen have a great scientific value (ESSKA-AOSSM ESSKA-APKASS). I believe that there was not an ESSKA-AOSSM travelling fellowshipwhich did not pass in Lyon probably for the orthopaedic surgery but perhaps also for the gastronomy with our famous out three stars restaurant “Bocuse”! But here I am a little too Lyonnais and a little too chauvinistic... shhh.

So why does Lyon have this place in Europe?

Because there is a strong history of orthopaedics in Lyon. For the knee of course, written by Albert Trillat, Henri Dejour, Pierre Chambat, Philippe Neyret, and the generations that followed the list is getting too long. For the shoulder with Gilles Walch but also the prosthetic and arthroscopic hip. Pierre Chambat was president of ESSKA in 2000. So you could say that there is a special relationship between Lyon and ESSKA! More seriously, people are attracted to Lyon because we have developed strong ideas there, and the public and private centres work in great coherence and unity and that is unique! Our “Journées Lyonaises de chirurgie du genou”, created in 1971, are the vector of this sacred union and we are still perceived as a school of knee surgery year after year - the Lyon School of Knee Surgery!

What is your relationship with ESSKA?

My link with ESSKA was written in my DNA in 1996 in Budapest for my first oral presentation at this congress. Since then I have always had a role in the symposia, ICL Keynote lectures. I have always loved this friendly society where I found my unwavering friends like Stefano Zaffagnini. I had the honour of doing the ESSKA-AOSSM travelling fellowship in 2003 with Christian Fink and Fredrik Almquist my godfather being KP Benedeto. It is my heart, it is a little bit my life, I extended to the European level what I had experienced with SFA.

But how did you become president of ESSKA?

Do you want to know how the most beautiful thing in my professional life became reality? It was an incredible adventure, where one day Niek Van Dijk came to interview me during an SFA congress in Bordeaux to see if I could be a candidate for this position. This was an exceptional honour as I was chosen "outside the ESSKA board" which is very rare. In 2016 I was proposed as second vice-president. It was an offer I couldn’t refuse. It was not in my "plan career" because I have never done it. I am not a lobbyist nor a careerist, I take what life gives me and I do it 100%.

What impact does it have to be president of ESSKA?

I would say to have the power to "DO" and to achieve, to get out of one’s personal problematic and to speak only in the "Name of" by eliminating one’s personal affects, to gather the ideas and proposals of all, then to put them in agreement, to be at the centre of a group of high level people (the board) and to fight to obtain a positive and constructive consensus. The role of the president is more attached to the global vision than to an operational role because there is an extremely efficient operational team led by our Executive Director Zhanna Kovalchuk and each member of the board takes on his or her share of operational tasks. It’s a permanent joy. You can understand why politicians fight for power, which is exhilarating. But one must always remain simple and oneself, open-mindedness is a fundamental value.

What about the impact on your personal and professional life?

Yes, this has an impact on the time spent because it takes a lot of real time and also psychological time because you never forget what is going on. It is certain that I have had to withdraw a little from the time I spend with my group of orthopaedic surgeons at Lyon-Ortho-Clinic and from the day-to-day running of the group, but my associates have helped me considerably and our group has never been so strong. Now I believe that the perfect organisation of my secretarial staff and my nurses are there to lighten and make my daily task as an orthopaedic surgeon so much easier. Here too, the strength of the group, of a team focused on a common goal, is the guarantee of success.
I have met and worked with incredible teams in ESSKA, both my old office and the new one, with the strong and efficient staff. The intense interactions, the risky and necessary decision making, the exchanges with our friends from all over the world to agree the programmes of our congresses and scientific societies, ISAKOS, AOSSM, APKASS, SLARD, up to the Pope we visited in November 2019 as part of our charity mission "Cycling for Science"... Everything was and is wonderful.

Thank you to all my friends who have been there on a daily basis in this exercise as President of ESSKA which is an UNIMAGINABLE gift.

I am a happy man.

Published in N°010 - March / April 2021