N°270 - January 2018
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of the year is an event no knee surgeon would want to miss.
We met with François Kelberine, who together with Philippe Landreau founded
this congress more than 10 years ago. He shares with us his passion
for sports and knee surgery and what is so special about this event.
Who had the idea to create the “Knee course” congress?
Philippe Landreau and myself came up with this idea during an office meeting of the SFA (Société Française d’Arthroscopie) in June 2003 in Strasbourg. Given the success of the Val d’Isère Shoulder Course, we thought it would be great to do the same type of event around the knee. Holding work sessions in the mountains has always been something of a tradition in the orthopaedic sector, but there had never been an equivalent for the Knee Course in Europe, apart from a little-known course organized by Erikseon, in Courmayeur, Italy.
Who were the main founders?
We wanted to organize our congress every two years, alternating with the one on the shoulder, but in the same place and the at same dates, to establish a regular pace. The course was intended for orthopaedic surgeons, both for beginners and the more experienced, and dealt only with knee surgery. Specific days were allocated either to sports traumatology, degenerative pathology or traumatology. It wasn’t designed to be a congress for general practitioners: every theme had to be covered in depth from A to Z. It was also open to atypical talks and presentations, rarely seen in conventional congresses. For the organisation, we had to bring a reliable person onto our team and we immediately thought of Corinne Bensimon to deal with the administrative side of things.
When was the first edition?
In 2006. It was a sensitive time then, as it was our first time and we didn’t know what to expect. But it was a big success. We had 120 participants, and all of them were delighted. I must say that we had an outstanding “faculty”: Philippe Beaufils, Ned Amendola, Ramon Cugat, Philippe Lobenhoffer, Pierre Chambat... The scientific content was of high quality, and we were lucky with the fantastic weather. It was the perfect start for a beautiful adventure.
How has the event evolved since its creation?
We made a mistake for the 2nd edition in 2008. The scientific program was too sophisticated, too “Basic Sciences”; it was more of a closed meeting and far from what Philippe and I initially had in mind. We fixed this immediately and went for a model that focused on our daily practices, based on the current state of scientific data and technical subjects. But we made sure to leave room for controversial issues and future trends to keep debates animated and interesting.
The presentations are now short, stimulating, with debates and sessions on clinical cases, so there is plenty of time left for discussions where the participants can get involved. Our goal was, and still is today, to conduct an interesting course for the “standard” surgeon, who, in a few days, wants to get a thorough clarification on specific themes in knee surgery. Since 2010, we’ve expanded and regularly changed the organizing committee around in order to add new blood. And we had the pleasure to be joined by Ian Victor, Romain Seil, Philippe Neyret and Sebastien Parratte among others, and each of them helped to expand our vision for the “Knee Course”.
There must have been some memorable moments ?
One cannot deny that the somewhat unusual setting of a high-altitude ski resort encourages a friendly atmosphere. We have been able to get superstars such as Kurosaka, Oshi, Amendola, Harner to come over, as well as many Europeans. They all become more accessible and human contact is facilitated. I am always pleasantly surprised by the high quality of the exchanges and the fact that everyone - including the participants - feels able to contribute their experiences, particularly in the debates. A discussion we had with a participant during a Knee Course actually led me to change my approach to knee prosthetics, which perfectly reflects the main objective of this course: sharing. There was actually a Polish participant who had been seen more on the ski slopes than at the Congress, and who, on the last day of the congress, came to ask Philippe and myself if we thought the congress was any good, not knowing who we were… I will also never forget the moment when Mike Carmont did his presentation while carrying his one year-old daughter in his arms. It was a unique moment, and one that you would be hard pressed to imagine occurring anywhere else! There was also my ankle fracture that everyone wanted to examine… I tried my hardest to avoid having anyone look at it.
But why Val D’Isère ?
Honestly, can you imagine a more attractive site for a congress in the month of January? When Philippe Landreau and I decided to do this course, Val d’Isère seemed the best place for it: it’s a world-famous winter ski resort. Obviously, it’s not the only place in France with such assets, but the location and the time of the year allowed us to implement a kind of synergy with the shoulder course, which we thought would be good for our image. All these elements allowed those who wanted to enjoy the snow-covered mountains to combine scientific exchanges with leisure time.
So what have you got planned for this year’s congress ?
It’s the 7th edition and we have added 2 new younger members to the organizing committee: Sébastien Lustig and Nicolas Graveleau. To make the congress more interactive, we have created sessions of clinical cases presented by participating surgeons. The cases had been submitted in advance and selected to suit the day’s themes. This year, we have chosen exciting subjects that haven’t been covered for a long time, in order to update them: the more difficult knee prostheses, single compartment arthrosis, cartilage surgery and severe and chronic multiple ligament injuries. The guiding principle will be “technical difficulties and their possible solutions”. Some VIPs have done us the kindness of coming from very far, such as Myles Coolican from Sydney or Willem Van der Merwe from Cape Town, to round off a high-level European faculty.
How did you get into orthopaedic surgery ?
It’s rather atypical. I am in fact somewhat of an abnormality in my family. I come from a family of artists: my father was a musician and my mother a stage actress. Later in life, they had to do other jobs to earn a living. I remember a poster from my childhood that hung in the family lounge showing a drawing of a multi-coloured hand. My mother told me I would be a surgeon. That must have left a mark, because sure enough I started studying hand surgery. In Marseille at the time, pathologies of the hand were treated by plastic surgeons, so I went into general orthopaedics because of my love of sports, which has always been a big part of my life, and sports traumatology.
What is your professional background ?
I did my internship in Marseille. When I made my first choice in ‘81, I my decision was influenced by an event: an intern in his final year, Claude Mailender, was performing a “naked eye” arthroscopy in paediatric orthopaedics. I don’t know why, but I had a feeling that the technique had a bright future. Many other specialties were getting into endoscopic surgery. I was lucky to be caught in the middle of arthroscopy’s development throughout my entire internship. My superiors, Pierre Vroulier and Georges Curvale - who has become a friend of mine - have always encouraged us to develop new techniques when it made sense to do so. As two leading surgeons in Marseille, they really pushed us to develop arthroscopic surgery.
You must have had some epic moments at that time when arthroscopic techniques hadn’t yet been normalised?
I have a great little anecdote involving Jean-Pierre Franceschi – we were in the same department – who was post-resident. We were in the operating room, in 1987 or ‘88, and I was trying very hard to do a cruciate ligament reconstruction under arthroscopy. At that time, without the instrumentation we have now, believe me, it took a long time and it was rather acrobatic. Jean-Pierre stuck his head around the door and said, jokingly of course, “What a waste of time !”. When you think about how successful his career in arthroscopic surgery has been, it was a pretty funny thing to say. The atmosphere there was very innovative and friendly.
So how did you get into knee surgery ?
At that time, arthroscopic surgery was being developed for use on all the joints. I had a special affinity for sports surgery because I did a lot of sports outside of my work. Little by little, I extended my activity to sports traumatology and ipso facto knee surgery. I went to the hospital of Aix-en-Provence to continue to expand my activity, and then after a few years, because of the huge administrative burdens I had to cope with, I went into private practice. My secretary and nurse came with me as well as a number of interns studying arthroscopic surgery. I was able to set up a private sports traumatology centre and pursue scientific activities at the same time. Knee and shoulder are my 2 main activity sectors.
In that respect, what is your implication in the various scientific societies?
As I said before, I believed in arthroscopy from the start and I decided to pay a visit to my different colleagues involved in both surgery and consultation. I travelled around to meet those colleagues. The trips were very rewarding and helped me to develop better relationships. So naturally, I got involved in various societies. Thanks to the support of Philippe Beaufils and Henri Coudane, I got involved in the SFA from very early on – at 34, I was the youngest person on the team – and I was part of it for 12 years, till 2004. I helped with the continued development of the travelling fellowship after André Frank. I was involved in teaching and also a coordinator of the Inter-University degree program in arthroscopy for 6 years. In 2000, I was also in charge of the development of the training centre using anatomical specimens in Strasbourg: the IRCAD, which is now the EITS. I was the course director for more than 10 years. It was and still is today one of the finest arthroscopic training centres in Europe. After the SFA, I got involved in the French Society of Sports Traumatology, where I was a board member for 6 years.
And on an international level ?
I was a board member of the European Federation of Sports Traumatology, of which I also had the honour of being President from 2010 to 2013. This company is now part of the “Sports” division of the ESSKA. In 1995, I witnessed the birth of the ISAKOS in Hong Kong, which is a group I could identify with. I was an active member of the Arthroscopy Committee. Later on I was in charge of the Orthopaedic Sports Medicine Committee for 4 years, and am now involved in the Knee Arthroplasty Committee. Those international societies had a very positive effect on me, but above all they allowed me to establish relationships all over the world, which I am trying to maintain by travelling. Once every 3 to 4 years, I try to participate in a humanitarian mission, even if only by myself. That’s how I ended up going to Nicaragua, Cambodia, Nepal...
Apart from all these clinical and scientific activities, what are your other areas of interest ?
I’ve got 3 hobbies. First of all rugby, a sport that I’ve always played and loved for its strong values of sharing and team spirit. Rugby recently caused me a severe rupture of the long head biceps tendon: an immediate diagnosis, hence the importance of a sound training in sports traumatology! I also love general aviation. Being a pilot allows me to attend congresses regularly. Finally, I’ve always loved the arts and I’m delighted that one of my 4 children, who I’m
extremely proud of, has decided to become an actor.
What advice would you like to give to our young colleagues ?
Many young orthopaedic surgeons are conscientious,focused on an indication, a technique they’ve mastered perfectly. My advice would be to remain open to new ideas. You must be inquisitive and willing to learn from other people’s experiences and know-how. Go and visit other surgeons and watch them work, travel, learn! It’s not always easy for a young surgeon but one must make the effort because it doesn’t get any easier later on. That’s what I have always done since my internship and I still do it regularly. It’s helped me so much, allowed me to meet great people and become the practitioner I am today.
Published in N°270 - January 2018