In this knee degeneration focused Live clinic, three leading surgeons examine three patients live on stage, demonstrating their clinical examination approach and sharing their step-by-step decision-making process, management strategies, and treatment options:
- Patient 1: The first patient underwent total knee arthroplasty approximately eight years ago but has never been satisfied with the outcome. He now presents with severe pain, persistent swelling, and a limited walking distance. Sébastien Lustig performs a comprehensive clinical assessment, including patient questioning, gait analysis, and targeted physical tests. He also details his imaging strategy to identify the underlying cause of failure. Is patellar resurfacing responsible for the pain? What would be the optimal treatment strategy for this patient?
- Patient 2: The second patient received a right unicompartmental knee arthroplasty nine years ago and now reports pain in the left knee, particularly during activities such as golfing, prolonged walking, or climbing stairs. Sébastien Parratte conducts a detailed, step-by-step physical examination, followed by imaging analysis revealing chronic ACL deficiency and posteromedial osteoarthritis. Considering the patient profile and pathology, what would be the most appropriate treatment strategy? Is UKA still a suitable option?
- Patient 3: The final patient presents with left knee pain lasting over three years, reduced mobility, and an inability to walk long distances. Anders Troelsen identifies a varus morphotype with a correctable deformity. Physical examination reveals functional MCL and LCL and stable ACL, suggesting a bone-to-bone situation. Physical examination shows functional MCL and LCL and a stable ACL, suggesting a bone-on-bone situation. What is Anders Troelsen’s final diagnosis based on imaging, and how would he treat this patient?
I am an orthopedic surgeon specialized in knee surgery. I practice at the University Hospital of Toulouse in the University Sports Clinic located in the Pierre Paul Riquet Hospital.
In addition to teaching at the Faculty of Medicine, I participate in courses for the professional societies to which I belong such as the SFA, ESSKA and SOFCOT.
My clinical activity (more than 800 surgeries per year) is exclusively focused on knee surgery. An important part of my surgeries is related to sports traumatology, in particular anterior cruciate ligament injuries (350+ ACL reconstructions per year).
My research activity is also focused on the knee. I have contributed to more than 110 publications in international journals. I am developing an à la carte approach in order to propose a personalized surgery to the patient. In the context of degenerative activity, the aim is to better analyze the variability of the anatomy in order to be able to propose prostheses adapted to the patient's anatomy. In the context of sports traumatology, it is a question of improving the dismemberment of all the lesions in order to propose an adequate therapy.
Since May 2022, I am a member of the board of ESSKA (European Society of Sports Traumatology Knee Surgery and Arthroscopy) as treasurer.
Dr. Sebastien Parratte (MD, PhD) is a French Orthopaedic surgeon. Internationally recognized leader in his field. After completing his training in France and USA at the world-renowned, Mayo Clinic, he became one of the youngest professors of Orthopaedic Surgery in France.
He completed more than 5000 primary knee and hip arthroplasties and more than 700 revision arthroplasties with complex bone defects. He also specialized in complex cases such as post-traumatic cases, complex deformities as well as arthroplasties in young active patients.
Pr. Parratte has a particular interest on computer-assisted surgery and he is now the only European involved in the design team of a new surgical robot for knee arthroplasty.
On the sport medicine side, Pr. Parratte was the surgeon of the pro Ligue 1 team of Bastia during 4 years, taking care of all the professional football players knee and hip injuries including ACL and meniscal problems.
He invented a new patient-specific custom jig osteotomy system to correct complex deformities or optimize the management of early arthritis of the knee.
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