本期仁医医疗特别邀请到国际著名膝关节外科专家Prof. Frosch做专题访问。Prof. Frosch现任汉堡大学附属埃彭多夫医院创伤外科与骨科主任、BG创伤外科医院汉堡分院的院长，也是中德骨科与创伤外科交流学会（DCGOU）候任主席。作为两家大型创伤中心的灵魂人物，Prof. Frosch计划建立更紧密的创伤救治体系，实现资源互通惠泽患者。
Prof. Frosch是国际上为数不多的、可以仅通过关节镜手术微创治疗后斜韧带损伤的专家之一。Prof. Frosch团队开发、改良了多种手术技术和入路，如Frosch入路、膝关节后外侧角关节镜下重建术等。
Interesting question. In former times, when I was 18, I was in the German national team for cross-country skiing and ski jumping. And I had a serious knee injury when I ruptured my medial collateral ligament and it took me out for almost 1 year. This was the time when I was thinking about studying medicine because I had the feeling that this is very interesting. And also there comes the idea to go in the trauma surgery area because I was very interested in injuries.
I had the chance to have very good teachers as a student, also as a young doctor. And they influenced me highly in how I realize and diagnose problems and how I proceed to treat patients. And this experience in my former times as a student, as well as a young doctor, influenced me until today in my daily practice.
随后，正如我所提到的一样，我有幸在几位非常好的导师手下学习。尤其是我在哥廷根大学工作时，Prof. Stanković 给予我非常大的帮助，并且对我影响深刻。他教导我如何做手术、如何治疗病人。还有我在哥廷根工作时的主任Prof. Stürmer，他在治疗复杂损伤方面对我影响非常大。
It is difficult to speak about one greatest influence. I would say I had a couple of great influences. One was when I was in Vail, Colorado in the Steadman Hawkins Clinic where I was a student there, and this experience highly influenced me in my way to treat patients and also brought up my high interest in knee injuries. And then in later times, I had very good teachers, as I already mentioned, especially during my time in Göttingen, I had really excellent teacher Prof. Stanković who helped me and influenced me very much. He taught me in doing surgeries and treating patients. But there were also other colleagues like my former Chief Prof. Stürmer, who also influenced me highly in treating complex injuries and how to proceed with these injuries.
I think it's very important to see different medical systems in different countries because it opens your mind to innovation. And it's very interesting to see different treatment concepts which gives us the chance to decide which treatment concept is the best. And also, on a scientific basis, we can evaluate, which systems and which treatment concepts are the best. So it opens the mind, and at least, brings us to our mind that there are different concepts and different ways, which sometimes are very successful to treat patients, and that helps us to be better doctors and better surgeons.
It's not only the development of orthopedic trauma and orthopedics surgery, it's also a very important political signal to connect countries and to work together in a specific field. It's only a small contribution for me, and also political agreement to see China on the same level from eye to eye, exchanging experiences with these really experienced surgeons in China and also very experienced surgeons in Germany. So for me, I would say it's not only the way to bring forward orthopedics and trauma surgery, it's also a thing to connect countries.
There are a lot of experienced surgeons in China, who are very innovative. And I think we, in Germany, are also very innovative in orthopedics and trauma surgery. It's a really perfect connection to be together innovative and to see and learn from each other, and to evaluate innovations, maybe in a discussing and critical, but very honest way.
The BG which is run by the Workers’ Compensation Insurance is a special trauma hospital for workers. The university hospital also has a big trauma department, and both of them are located in the same town in Hamburg. So it came up that it would make sense to bring these two hospitals together and that it's a kind of a connection or a very deep collaboration. They are still separated from the administration, but they collaborate in the field of trauma surgery very closely.
Since I'm the Medical Director of the BG Trauma Center and the Head of the Trauma Department, and also the Head of the Trauma Department in the University Medical Center, my idea is to bring these two centers even more together and create a system for trauma patients here in Hamburg, which enables every patient to get the best treatment from the best specialist in this field, either in the University Medical Center or in the BG Trauma Center. The best doctor comes to the patient no matter the patient is in BG Trauma Center or in the University Medical Center. So we have teams which work in both hospitals, which is, for me, very important. I am the head of both institutions and that even makes it easier for me to collaborate and to bring both groups together.
The BG Trauma Hospital has some more goals, one of which is to rehabilitate patients, which is not possible in the University Medical Center. So, for rehabilitation, people, usually especially the workers, come to the BG Trauma Hospital. And it is also very important to get the chain from rescue from the accident scene till the complete rehabilitation, we want to have a closed chain for these people that they get the best treatment.
That's a good question. It's very demanding, to be honest, to be in two very big hospitals. But I have the really great situation that I have really excellent collaborators in both clinics. I have a really excellent team here in the BG Trauma Hospital. And I also have a really great team in the University Medical Center of Hamburg-Eppendorf. It's really a great honor for me to work with such a team who supports me in every area where I have tasks, like administration, like clinical practice, like research activities - we have a research team at the university in the trauma department, and we also have a research team at the BG hospital. This is what enables me to manage these different tasks.
It's very difficult to give really good advice. I just can speak from my own experience. Four years ago, I had the chance to be, here also in Hamburg, in a big trauma hospital, which was not a university hospital but Asklepios Klinik St. Georg. There, I built up my team, and many people of this team went with me to the university clinic and another group went to BG trauma hospital. And I had, additionally, the great situation that in both hospitals there are already really excellent teams. So we supported these teams which were in the hospitals already with my own team, which bloom my ideas and my innovations. So I had the chance to bring my ideas and innovations to both hospitals through the teams. And I had the great situation that the former teams in the hospital accepted these innovations and treatment. The very important key to success is to be transparent, to speak about new innovations, and to bring down walls. It's very important to open the innovations and the ideas for the whole team and to bring a kind of harmony in a team, then you have the chance to bring the whole team forward. If there are fights in your team, it can be very demanding and difficult. And I have the great situation that I have really two great teams which work very closely together.
The societies are very important, and even if you are the head of a big trauma center, it's very important to be politically engaged in some of these societies. AO is probably the world leading society for fracture care and treatment. It's a very famous and a very big society, and it's a big honor for me to be over years as the Development Officer of AO Trauma Germany. I was one of the Co-founders of the German Knee Society, so for me, it's also a really big honor to be a former President of the German Knee Society, which is developing really great. And especially in the field of complex knee surgery, it's a very powerful and very honorable society. The AGA is a very old and famous society, especially for arthroscopy which is also a very important tool for me for treatment of patients and even of complex joint injuries. The AGA also, here in Germany, is one of the most famous and biggest societies for trauma and in the field of orthopedics and trauma surgery.
Being in scientific research is very important for a surgeon. My concept is being an academic surgeon. That means that for every kind of surgery I perform, I know exactly what the level of research or the answers of research of my treatment. And I think to do clinical research with patients is also to control your own doing and to have a assessment of your own quality. When there is any innovation in the field of surgery and if you use this innovation, especially in patients, it's very important to evaluate them, to evaluate your results and to see how good you are in this field. So for me, being an academic surgeon is to always control yourself by research and studies.
Well, it makes me kind of proud to see that other people use my ideas or, in this case, my approach. And I know it's popular in China to use the Frosch approach, which makes me proud. That is absolutely clear.
But the Frosch Approach was developed in 2007. And I think it's very important, as an academic surgeon, not to be too proud of yourself. It's very important to evaluate and to further develop the approach. So, by time, we developed improvements in this approach. And I think it is very, very important, to become better and better, to evaluate the pros and cons of such an approach and to improve it by time. I would not say the Frosch Approach from 2007 in the original version is the same that I do now. I still do it, but in most of the cases, in a modification.
It is that I built up a young team, which is now at a really high level, especially in surgery. It is one of the proudest things my career to get the chance to work with highly talented people and to bring them to such a high level, especially in knee surgery and in trauma surgery. This is clearly No.1 in my personal career achievements. And No.2 maybe is that I had the chance to develop new operation techniques with this team. For example, as you already mentioned, the Frosch Approach, which we modified and improved even more step by step over the last years. And that we were probably the first group in the world who did arthroscopic posterolateral reconstruction of the knee. There are not many groups in the world who are able to do this in an arthroscopic way, and we are very successful in this arthroscopic treatment. And also in treating other complex injuries in the knee, I think we have reached a very high level in both departments and that makes me proud.
It's a very complex question. It has multiple impacts in the field of orthopedics and trauma surgery.
One impact is that it makes it even more difficult to treat the patients probably and also in a perfect time to do the surgeries, because a lot of members of the staff here in the hospital, especially nurses, are at the intensive care units to treat the Covid-19 patients there. We miss them in the operation room and do not have the capacity in the operating room that we are used to have.
The second aspect is that many people with musculoskeletal problems, especially elder people, don't come to the hospital, because they have the feeling that it might be dangerous, which is not.
The third aspect is that the whole scientific world has not the chance to meet. The online meeting is always different than a personal meeting. So I think there is something missing, especially the talks behind the curtain, after the symposium, going together to the bar and having a drink together with people from different countries and different cultures. These are completely missing and are not reflected in online meetings.
One more aspect, which might be a positive one is that a lot of young trauma surgeons who usually were in the clinic, they had to be in quarantine or they have not the chance to work because operating rooms are closed, so they have the chance to write papers, for example. So our output on papers and scientific was increased, but I think for ideas, for innovations, it's very important to have personal contact and a chance to meet people on a congress instead online, and that is missing.We probably would have much more innovations in the last 2 years if the congresses were not only online, but even more in a personal setting. I'm absolutely sure that this is not improving innovations and research. For innovation research, it is very important to meet personally.
Difficult question. Before I wanted to study medicine, I had plans to study engineering. Engineering is also something interesting for me. To think about mechanics and biomechanics is also necessary in the field of orthopedics surgery. And if I would not be a medical doctor, I think I would be an engineer.
To get my head free, I go jogging, mountain biking, or cross-country skiing. Yeah, this is what I really like, and doing sports is not just for the body, it's also for relaxing my mind and my brain. I think sports, for me, is very important, which enables me to do this job as I do it with a lot of stress, high pressure. That helps me a lot and I could not imagine not doing sports.
Prof. Dr. med. Karl-Heinz Frosch
● AO Trauma 德国区学科发展官（自2014年）