For the past 40 years, the Arago Clinic in Paris has been specialized in orthopedic surgery, in addition to lower and upper limb traumatology. For 2018, the magazine « Le Point » classified this clinic as number one in France for hip and knee prostheses. With modern infrastructures and a team at the forefront of osteoarticular pathologies from lower limbs to the hand, shoulder and spine, the Arago Clinic offers an ideal environment for the development of French and foreign orthopedic surgeons.
Dr Frédéric Sailhan, one of the trainers, told us more about their two-day courses.
INVIVOX: Could you introduce your training?
With doctors Luc Kerboull, Jean-Marie Postel, Philippe Lapresle et Christophe Castelain, we would like to share our techniques and experiences in order to exchange and improve in hip prosthesis surgery. We are going to show what we can do: the direct anterior Hueter approach.
INVIVOX: Could you explain the direct anterior Hueter approach for hip arthroplasty?
Hueter’s technique is not new. It was introduced 40 years ago by Dr Robert Judet. This approach remains secondary in France and in the world. The posterior approach is still the most commonly performed, maybe because Hueter’s requires a longer learning commitment. In the last 5-10 years however, it has made a comeback and is gaining ground particularly among the young generations of surgeons.
The idea of the direct anterior Hueter approach is to pass in front of the hip’s joint (anterior approach). We don’t cut away trochanter tendons which are in the back (as in posterior approach).
Advantages are to preserve the structures around the hip joint: muscles and tendons, articular capsule for certain patients. It’s a direct approach (without any cutting of tissues). We spread the muscles to start the articulation of the hip.
The benefits for patients are to preserve the muscles and tendons (decreasing of the risk of dislocation) and also quicker rehabilitation.
INVIVOX: Who can attend the training?
This training is intended for French or foreign orthopedic surgeons. We also included young surgeons who are just starting off, as well as those who want to learn the anterior approach, or advanced participants who want to develop (with replacing hip prostheses). All courses will be in English. « The spirit of this training is based on exchange. Participants may bring their own clinical cases that we will study together. »
« The spirit of this training is based on exchange. Participants may bring their own clinical cases that we will study together. »
INVIVOX: How many surgeons max. per session?
10/12 participants maximum are split between several surgeons in different operating rooms for a personalized accompaniment and « in situ » training.
INVIVOX: How is a typical training organized (over 2 days)?
Monday is dedicated to the anterior approach for first-line prosthesis. Mornings are devoted to theory and practice with exchanges and discussions. And everybody goes to the operating room in the afternoon: time to practice! We are operating on patients whose cases we have presented during the morning. Monday evening, we have a dinner all together in a famous Paris restaurant. Tuesday is also split between theory and practice but covering the anterior approach for reimplantation of hip prosthesis.
We have chosen Monday and Tuesday thinking of our foreign colleagues who may want to visit Paris the previous weekend.
INVIVOX: What is the most important part of your training?
The high point is definitively the practice in operating room. It will be an opportunity to exchange tips and tricks, advice and experiences. At the same time, we learn from each other.
We will also discuss in great detail all of the options of implants used for anterior approach (straight stem standard, tailor-made and short, cement-less stem and cemented stem).
Practical issues will also be discussed, for example, using different orthopedic tables (Judet’s traction table, Medacta extension).
INVIVOX: What are the main benefits of this training?
We are going to do a “360°” tour of the minimally invasive anterior approach supervised by 5 surgeons who performed the various tasks daily in the referral institution in hip prostheses area. Last but not least, we’ll be sharing a moment of friendship and confraternity. These trainings will help us to meet some foreign colleagues, to get know each other, to develop our network and to continue to remotely interact all together. And why not, visit them in their establishment in the future?
« When surgeons meet, they always learn from each other, it’s a two-way process. When cultures are different, surgical approaches are different too, and it leads to a wave of new ideas and projects. Spending 2 days together is beneficial for all of us. »