2023 Patellofemoral Traveling Fellowship Highlights

Maria Tuca MD, CHILE
Juan Pablo Martinez-Cano MD, MSc, PhD, COLOMBIA

It was an immense privilege for us to be selected as the ISAKOS Patellofemoral Traveling Fellows. It was also a privilege to get to know each other and become friends. We are from two South American countries, Chile and Colombia, six hours by plane apart. We share lots of cultural customs, but we also have similar medical technology and practice, which was very convenient to fully enjoy the experience. Having a partner to share thoughts about a surgery, comment on a case, get lost together in downtown, lose a bag, split a taxi, go out for dinner or laugh at nothing, made a big difference.

Robert Magnussen, MD MPH, UNITED STATES
Marc Tompkins, MD, COLOMBIA

After many years of COVID-related delays, we were finally able to complete our travel for the ISAKOS Patellofemoral Traveling Fellowship. We had several goals in mind as we carefully planned our travels. First, we hoped to gain more exposure to complex patellofemoral surgery – particularly surrounding the diagnosis and treatment of axial plane deformities that can contribute to patellar instability (femoral anteversion and tibial torsion) and different techniques for the treatment of trochlear dysplasia. Second, we hoped to learn more about differences in how patellofemoral problems are approached and treated at different centers. Finally, we hoped to establish and renew contacts around the world for further collaboration in clinical and research endeavors. We believe we were successful in achieving all these goals.

While we planned to begin our travels in the fall of 2020, COVID-19 travel restrictions canceled those plans. We were finally able to initiate travel in the fall of 2021 with a trip to the Hospital for Special Surgery in New York City where we were hosted by Beth Shubin-Stein, Dan Green, Andreas Gomoll, and Sabrina Strickland. We spent three fantastic days in the OR observing tibial tubercle osteotomies, MPFL reconstructions, and guided growth procedures to address valgus knee alignment (Figure 1). In addition, we participated in a cadaveric session with HSS fellows and a morning grand rounds that even allowed John Fulkerson and his team to join us virtually from Connecticut. Highlights of the social program included a delicious meal at a newly reopened Manhattan restaurant (remember when going to a restaurant again was a huge deal??) after showing our vaccine cards at the door! On another evening, we enjoyed a lot of time discussing surgical indications and differences in patient populations around the country, and we learned that Andreas grills a mean steak!

COVID-19 proved to be an even bigger barrier to the international portion of our trip, but finally on the fourth (we think) try, we were able to travel to Europe for the remainder or our fellowship in the Spring of 2023. We planned a busy itinerary through Denmark, Finland, Spain, and Austria and amazingly all travel went smoothly!

Our trip began in Copenhagen, Denmark, where we were hosted by Lars Blønd (Figure 2). We spent three busy days in the OR at both private and public hospitals where we saw multiple derotational osteotomies of the femur and tibia, tibial tubercle osteotomies for multiple indications, and an arthroscopic trochleoplasty. Our learning did not stop there, as we were able to participate in an academic session with his team at Sjaellands University Hospital where we learned about the genetics of trochlear dysplasia in the Faroe Islands. At a delicious dinner with Lars and his family, we learned about the world of e-sports and enjoyed some amazing home cooking. A walking tour of Copenhagen with dinner at the famous Tivoli Garden rounded out a great visit to Denmark.

From Denmark, we traveled by plane to Helsinki and then by car to Tampere, Finland, where we were hosted by Petri Sillanpää (Figure 3). We enjoyed two fantastic days in the OR where we saw multiple trochleoplasties with an innovative technique, tibial tubercle proximalization and quadriceps lengthening, femoral guided growth, and a distal femoral osteotomy. We were able to present our research to the Finnish Knee Society, toured both Tampere and Helsinki, and learned all about the Finnish Sauna Tradition. We shared a fantastic meal with Petri in the Näsinneula Observation Tower with 360 degree views of the Tampere lakes and surrounding area.

From Finland, our trip took us south to Valencia, Spain, where were we hosted by Vicente Sanchís Alfonso (Figure 4). We began our visit with guided tours of the city of Valencia and of course some traditional paella. A highlight was a visit to the kitchen to see the preparation of these traditional dishes. We spent a fantastic afternoon reviewing indications and techniques for derotational osteotomies including meeting and examining some patients with these challenging problems. We then spent a full day in the OR where we observed three different derotation techniques, at the proximal femur, distal femur, and proximal tibia, for complex patellofemoral problems.

Leaving Spain, we traveled to Austria, where we hosted by Gerd Seitlinger in Salzburg and Christian Fink in Innsbruck (Figure 5). We began in Salzburg, where we observed a femoral derotational osteotomy and spent the afternoon touring the old city of Salzburg and exploring the Hohensalzburg Fortress. We then enjoyed the culture of Salzburg with a visit to the Augustiner bräu beer garden and a classical music performance in the hometown of Mozart. The next day we journeyed to Innsbruck where we met up with Christian Fink. We had an excellent cadaveric session where we performed some of the osteotomies we have observed on our trip and discussed and demonstrated different MPFL reconstruction techniques. Finally, in typical Austrian fashion we earned our dinner with a hike up a mountain and were rewarded with outstanding Alpine views and a traditional Austrian dinner with our hosts. The next morning found us on a shuttle to Munich and on flights back home.

We would like to thank ISAKOS and the traveling fellowship selection committee, the Patellofemoral Society, all of our hosts, and everyone at home who made this trip possible.