International Sports Medicine expert Prof. Mueller's Visit Review to Guangdong Hospital of Chinese Medicine

On the morning of September 23rd, 2024, the academic exchange week of the International Sports Medicine Master China Tour 2024 kicked off at the Guangdong Provincial Hospital of CM. This academic event invited Prof. Müller, Deputy Clinic Director of Orthopaedics (Musculoskeletal Center), Head of Knee and Sports Department at LMU Klinikum, to visit the Department of Sports Medicine for a week of academic exchange and surgical guidance. Prof. CHEN Haiyun, Vice President of the Specialized Hospital of Orthopaedics and Traumatology, Prof. YANG Weiyi, Director of the Department of Sports Medicine, Head Nurse CHEN Hongyun, and other key members of the department held a welcoming ceremony for Prof. Müller, introducing the development situations of both hospitals and departments to lay a solid foundation for further in-depth communication. During the welcoming ceremony, the Sino-German Communication Centre for Sports Medicine was officially established at the Department of Sports Medicine of Guangdong Provincial Hospital of CM, marking a new international collaborative development platform for the Sports Medicine department of the hospital in the diagnosis and treatment of shoulder and knee joints (including conservative and surgical treatments), particularly in the concepts of knee preservation and arthroscopic shoulder surgery.

After the welcoming ceremony, Prof. Müller, accompanied by the team of Department of Sports Medicine, toured the hospital to understand its basic situation. Head Nurse CHEN Hongyun introduced the department's post-op rehabilitation concepts and the combined traditional Chinese and Western medicine standards for thrombosis prevention and treatment. Prof. Müller engaged in discussions with Head Nurse CHEN on the algorithm of rapid rehabilitation and thrombosis prevention and control, exploring the standards and pros and cons from both Eastern and Western perspectives.

During the afternoon's difficult case discussion, Prof. Müller engaged with the team to explore the treatment of several challenging disorders, with the topics of acute fresh dislocation of the shoulder joint, controlling low-grade infections in the shoulder,  post-op rapid rehab concepts, and the indications and patient selection principles for UKA and HTO involved. Following this, Prof. Müller delivered a lecture on The repair of rotator cuff tears induced by sports, covering key diagnostic and treatment standards such as anatomical analysis of the rotator cuff footprint, causes of rotator cuff tears, conservative treatment methods and standards, surgical treatment methods and standards, comparisons between arthroscopic and open surgery, the impact of surgical techniques on the efficacy of rotator cuff repair, and a demonstration of the steps involved in arthroscopic rotator cuff repair. In this lecture, Prof. Müller systematically introduced the anatomical characteristics and treatment techniques for rotator cuff tears, comparing the efficacy of various surgical techniques based on literature review, providing valuable references and insights for the diagnosis and treatment of rotator cuff tears at the Department of Sports Medicine of Guangdong Provincial Hospital of CM.

On the second day of the International Sports Medicine Master China Tour 2024, on the morning of September 24th, Prof. Müller participated in the morning shift meeting at the Department to understand its management and daily operations. He subsequently discussed the diagnosis and treatment of new patients admitted the previous day with the department members, reviewing their medical histories and images while discussing treatment plans. In the following surgical guidance session, Prof. Müller provided advice to Director YANG's team during a UKA surgery. Both sides discussed the amount of tibial and femoral osteotomy, as well as the osteotomy techniques. Prof. Müller also shared the standardized surgical procedures for UKA and demonstrated the key points and considerations for performing arthroscopic repair of rotator cuff tears for the team.

During the afternoon case discussion, Prof. Müller collaborated with department members to review complex cases, focusing on the extent of valgus correction and osteotomy for UKA, the degree of valgus to be remained postoperatively, and the critical aspects of preoperative planning, including the calculation and restoration of the joint line and the alignment during surgery. Following this discussion, Prof. Müller delivered a lecture on The Athlete’s Shoulder Joints (including Shoulder Instability). With extensive experience in treating sports injuries, he used a visually engaging approach to share insights on the two main causes of athlete injuries (traumatic injuries and overuse injuries), the primary types of injuries commonly seen in athletes, and their corresponding treatment methods. This lecture provided the department members with comprehensive diagnostic and treatment recommendations for shoulder-related sports injuries.

The third day of the International Sports Medicine Master China Tour 2024 began with ward rounds engaged by Prof. Müller. In the morning, Prof. Müller and Director YANG Weiyi's team focused on reviewing the recovery status of patients who had undergone surgery the previous day, discussing key points related to post-op care and pain management. Following this, Prof. Müller proceeded to the OR with Director YANG's team to provide guidance on the day’s surgeries. On that day, the cases of TKA guided by Prof. Müller (focusing on the management of flexion and extension gaps) and the arthroscopic repair of rotator cuff tears were thoroughly examined the previous day during a case review session, where Prof. Müller and the department team analyzed the medical history, basic examination indicators, indications, prosthesis selections, and key surgical techniques discussion.

In the afternoon, the highlight of this academic exchange—the Academic Salon conducted by the Sports Medicine Department, Guangdong Provincial Hospital of     CM —officially commenced. The meeting was hosted by Prof. CHEN Bolai, Vice President of the Orthopaedic and Traumatology Specialized Hospital of Guangdong Provincial Hospital of CM, with Prof. Müller as the keynote speaker. The event attracted sports medicine experts and young doctors from several hospitals in Guangzhou. Prof. Müller began the academic salon with a lecture on Knee Joint Preservation Strategies in Cases of Cartilage Defects. He first revealed the causes of cartilage defects and the prevalence of such injuries among athletes. He then introduced the historical evolution of cartilage treatment, the indications for conservative treatment, and the gradated approach to treatment. He then presented mainstream cartilage therapies, including OCT, posterior condyle relocation/Mega-OATS, microfracture, autologous chondrocyte implantation, and minced cartilage. He outlined the operational techniques for each therapy and shared comparative studies on their short- and long-term outcomes, along with his personal experiences and an analysis of the advantages and disadvantages of each method. Following this, Prof. Müller delivered another lecture on Medial Osteoarthritis of the Knee: UKA - HTO - TKA, covering topics such as the selection of fixed-bearing and mobile-bearing prostheses for UKA and the indications and patient selection criteria for UKA and HTO. The indications for HTO and UKA are often not so distinctive so that surgeons are confused in such cases. Drawing on his 20 years of experience with knee arthroplasty, Prof. Müller distilled key points on how attendees should choose appropriate indications for HTO and UKA. During this master class, participants engaged in in-depth discussions on cartilage therapies and knee preservation surgeries, marking a vibrant academic exchange that infused new energy into the concepts of knee preservation treatment and surgery in the Guangdong Provincial Hospital of CM and in Guangzhou city at large.

On the morning of September 26, 2024, Prof. Müller proceeded to the OR with Director YANG's team to provide guidance on the day’s surgeries. The cases scheduled for surgery that day had been thoroughly reviewed during the previous day's case discussion, where Prof. Müller and the team checked the patients' medical histories, basic examination indicators, indications for surgery, prosthesis selection, and key surgical techniques. During the TKA and UKA performed that day, Prof. Müller suggested Director YANG's team to deepen their understanding of the previously taught surgical techniques, with a particular focus on the details of tourniquet application, intraoperative local anesthesia, and pain management. The surgical guidance was highly successful.

Later that afternoon, Prof. Müller returned to the department to begin a lecture session with the team, sharing his insights on Modern Concepts in Reverse Shoulder Arthroplasty. He reviewed the selection of prostheses and the surgical procedures for modern shoulder arthroplasty, with a particular focus on complications such as instability, loosening, and periprosthetic fractures, offering recommendations for avoiding these problems. The professor then discussed the revolutionary advancements brought about by advanced 3D preoperative planning, PSI prostheses, and intraoperative navigation systems in reverse shoulder arthroplasty.

September 27, 2024, marked the concluding day of the International Sports Medicine Master China Tour 2024. The morning activities commenced with surgical guidance by Prof. Müller, focusing on UKA, HTO, and ACL reconstruction. During the surgical guidance, the professor meticulously reviewed the team's surgical practices, providing valuable feedback and instruction. In the afternoon, Prof. Müller returned to the department for a discussion on challenging cases with the team. He then delivered a lecture on Sports-Induced ACL Tears (Risk Factors - Treatment - Recovery - Do ACL Tears Lead to Career Termination?). Upon concluding the lecture, the International Sports Medicine Master China Tour 2024 came to a successful closure. This Sino-German academic exchange in Sports Medicine not only brings new technical concepts to the Sports Medicine Department of Guangdong Provincial Hospital of CM but also laid a solid foundation for future clinical and research collaboration between the two sides. The exchange is expected to further help the Sports Medicine (Joint Sports Injury) Department of the hospital in advancing knee preservation techniques and shoulder joint injury repair, promoting the development of sports medicine in South China. Additionally, collaboration with internationally renowned experts will enhance the academic influence of the Sports Medicine (Joint Sports Injury) Department of the hospital on the international stage.