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Blog posts tagged in Traveling Fellowship
Fellow Laurie A. Hiemstra, MD
Banff Sports Medicine, Banff, Canada
Fellow Shital N Parikh, MD
Cincinnati Children’s Hospital, Cincinnati, USA

Lyon, France (Oct 6-Oct 8, 2014) 


Our traveling fellowship started in Lyon, France’s second-largest city which is immersed in rich historical and cultural tradition. On Oct 6 morning, Dr. David Dejour picked us up from the hotel and we headed straight to the operating room. The day was packed with 8 surgeries, back and forth between 2 operating rooms and 2 very efficient surgical teams. The surgical cases included patellofemoral arthroplasty, salvage trochleoplasty, MPFL reconstruction and tibial tubercle distalization. The sad part was that there was no time for lunch. The evening dinner was hosted by Dr. Dejour at Brasserie Leon de Lyon with Professor Elvire Servien, Dr. Guillaume Demey and a visiting fellow. On Oct 7, we visited the Albert Trillat Center at University Hospital, where we were greeted by Professor Philippe Neyret and Professor Servien. It was wonderful for Professor Servien to present the ‘History of French Orthopaedics’ with brief introduction of the pioneers of patellofemoral surgery. The morning session ended with case discussions. That afternoon gave us some free time to hike up the ‘Fourviere’ and the ‘Roman ruins’. The morning of Oct 8 was again spent with Dr. Dejour in the operating room where we had chance to discuss some cases, interact with him and get more surgical perspective on the patellofemoral joint. 

At the May 2013 meeting of ISAKOS in Toronto, Drs Shital Parikh and Laurie Hiemstra were awarded the 2013-14 ISAKOS/PFF traveling fellowship.

In June, 2012, Dr Ashraf Abdelkafy of Egypt and Dr Geraldo Schuck of Brazil completed the US part of their ISAKOS Patellofemoral Traveling Fellowship, sponsored by the Patellofemoral Foundation. They visited with Drs Grelsamer, Fulkerson, Arendt and Dye. Click here for a report of their visit. In September, they visited Drs Simon Donell and Andrew Amis in the United Kingdom, as well as Drs Philippe Neyret, David Dejour, and Elvire Servien (former PF Traveling fellow) in Lyon, France. Click here for a report of the European portion of the their Fellowship.

 Dinner in Connecticut with Dr. John Fulkerson With Dr. Arendt in Minneapolis

With Dr. Scott Dye in San Francisco With Dr. Ronald Grelsamer in New York City


Among the things we had the opportunity to see and discuss during the Patellofemoral Traveling Fellowship, I would like to highlight some of them. We who are knee surgeons are familiar with the vast majority of procedures related to Patellofemoral surgery, but my attention was pointed to procedures on the lateral retinaculum, both, repair procedures (in cases of excessive previous release) and lengthening. I had never seen them before, they were very interesting, and new to me. 

I think we still need to study more about MPFL isometry and on the its points of insertion; I realized that some surgeons are more concerned with the femoral insertion while others with the patellar insertion, I couldn´t see a consensus. I also think there is still need for understanding in relation Patellofemoral arthroplasties; we have different models and techniques and also different moments of indications and positioning.

We had very rich discussions about the differences between patient’s complaints that come from instability or arthritis, and how we can use this to decide the best treatment option, as well as non-surgical approach to these conditions. Understanding the biology, tissue homeostasis, and adaptability of tissues, is a fertile field to be studied and we have them in mind as we think in femoropatellar joint disorders.


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