This Fellowship took place in Switzerland, in three leading centers for orthopaedic surgery: Bern; Lausanne and Zurich. Dr Vittorio Bellotti of Barcelona, Spain and Dr Vahit Emre Ozden of Istanbul, Turkey, present their report…
We started the fellowship at Inselspital in the elegant Bern, the sacred temple of knowledge about hip preservation surgery. On the first day in Bern, we were warmly received by Prof Siebenrock Secretary Miss Karin Haueter that accompanied us to the Hip Surgery Department. We had the honour to meet Prof Klaus Siebenrock in his office, that is a place full of books and history about the Bernese school of hip surgery. Then we moved to the morning conference of his department, where all elective and emergencies cases of the orthopaedic surgery department were discussed with all the staff. We had a tour of the hospital and Prof Siebenrock showed us their new designed emergency department including operating theatres.
In the operating theatre, our first case was undergoing a Bernese Periacetabular Osteotomy in a patient who had an anterior unstable hip after two previous arthroscopies. In another operation room, Prof J Bastian performed a primary THA by trans-gluteal approach for a complex case in a morbid obese patient who had liver transplant. On the second day, we started directly in the operating room. Among others, there was an interesting case of pubic nonunion after PAO. Prof Siebenrock performed osteosynthesis by Stoppa approach. Then we had the opportunity to observe a case of complex femoracetabular impingement treated by surgical hip dislocation and trochanteric osteotomy; Femoroacetabular osteochondroplasty with labral reconstruction was performed by Dr Bastian and Dr Steppacher. At the end of the day Prof Siebenrock hosted us in his house and we had a great typical Swiss dinner with his lovely family and doctor Bastian, Dr Steppacher and Miss Hueter. After dinner we organized a very funny and amazing foosball (soccer table) championship, where on eliminatory bases Dr Ozden won a bottle of Swiss wine!
Our third day started in outpatient clinic, and it was amazing. We had the opportunity to observe and discuss with all the doctors of the staff all the patients admitted to the outpatient clinic. As a reference center, we had a chance to discuss about the diagnosis, clinical examination and treatment options for patients with complex hip pathologies. On the last day of Bern, we had the opportunity to present ourselves and our professional work to all the department during the morning meeting; in the same day we were invited to assist at the Swiss OrthoGeriatric Day, a very good and interesting meeting by Dr Johannes D Bastian.
That same day we travelled by train to our next step: the beautiful Lausanne. Dr Julien Stanovici received us in an interesting meeting in the Olympic Museum of Lausanne, and after that arranged a small welcome party with his young and active team. They really showed a great hospitality starting from the first moment and during all the stay.
In the first day at the CHUV – Centre Hospitalier Universitaire Vaudois – Dr Julian Stanovic performed a complex case of total hip arthroplasty using custom made femoral stem with bikini incision, it was an amazing case and we learned many tips and tricks about anterior direct approach. In the other operating room Dr Alexander Antoniadis performed Hardinge approach in a case with post traumatic arthrosis with implant removal. Then, we had another case with Dr Stanovici, an acetabular component revision by anterior approach in an unstable hip. In the afternoon we moved to another building of the hospital and Dr Julian Favre and Dr Jolles-Haeberli presented us the amazing SwissBioMotion Lab and their investigation projects, including the testing of a robot for primary and revision prosthetic surgery. At the same day we met Prof Dr Julien Wegrzyn, who gave us an interesting and extensive small group conference about dual mobility. At night Prof Brigitte Jolles Haeberli organized for us a fantastic dinner in a very nice restaurant in Bourg-en-Lavaux, with great views of the lake Leman, where we had the chance of tasting a Swiss typical dinner with delicious deer meat.
On the second day at Lausanne, we visited the out-patient clinic and had the opportunity to assist with the patient informative conference, that was scheduled twice a month, where all patients who were going to have a replacement surgery were informed by the team including nurses, orthopedic surgeons, ergo and physiotherapist, and anesthesiologists. Dr Julian Stanovici then took us around the ergo and physical therapy center and talked about their post-operative rehabilitation program. In the afternoon we visited again the Swiss BioMotion Lab with Dr Julian Favre. They gave a talk about the in Vivo 3D analysis cartilage analysis using CT arthrography, and about a novel MRI -based knee cartilage biochemical composition analysis probing OA pathogenesis. We visited then the fully equipped gait analysis laboratory of the CHUV.
The third day started in operating room, where Dr Stanovici performed two total hip arthroplasties by bikini approach, one of them in a case of obese patient. In the same afternoon we moved by train to our third and last stop: the brilliant and modern Zurich.
The first day at Schultess Klinik in Zurich started with the meeting with our genial host: Prof Dr Hannes Rudiger. He was very kind with us and gave us the opportunity to assist in the operating room on all three days in Zurich, where after the morning meeting with all the staff, we moved to the operating room, where he always had scheduled minimum four or five cases of total hip replacement by anterior bikini approach, with several bilateral cases. It was like participating in an intensive total anterior approach hip replacement master course.
One night of the stay in Zurich Prof Rudiger invited us to dinner in a traditional meat restaurant in old town Zurich where they served us a delicious typical sSwiss dinner with a tasting Swiss beer. We had a delicious meal and intimate conversation with a giant of hip and tumours surgery, and a very funny and amazing man.
During our stay in Zurich we had the opportunity to meet and participate in surgery cases with Prof Micheal Leunig, an impressive and elegant surgeon who made us feel comfortable in every moment, and always available to talk about the all cases.
After two weeks it was difficult to leave and realize that the experience was now over.
The fellowship was amazing and unbelievable in every aspect. For those dedicated to hip surgery, Switzerland is a country that means a lot, because much of the old and modern knowledge about hip surgery comes from this beautiful, variegated and mysterious country. A place where diversity is accepted, where the intersection of cultures is perhaps the strong and distinctive point.
Probably they were and will be the landscapes and the mountain air, and the good wine and cheeses, and the chocolate, to stimulate the minds of great surgeons and researchers towards new discoveries and to consolidate the milestones of the knowledge of hip surgery.
We would sincerely like to thank the European Hip Society for this opportunity. We are now richer, in hip knowledge and as persons. And we, the fellows, will be friends forever.
Thanks to Prof Klaus Siebenrock for sharing with us his enormous knowledge and smile, in Bern we learned to observe and consider all the aspects of the hip joint, as in a 4 D vision.
Thanks to Dr Julien Stanovici, to be in the same time a great surgeon and a very close friendly person, and to make us feel at home in Lausanne.
Thanks to Prof Rudiger, for being a genius, and for probably being the fastest and most precise surgeon we have ever met, and to be at the same time so serious and funny. We learned a lot with him.
And finally a special thanks to Mrs Samantha Stokes, our incredible and 24/24 hours available EHS Secretary, that assisted us before, during, and after the fellowship.
