International Joint Surgery Master, Prof. Pfeil’s Visit to Dongguan Hospital of CM Embraces Its Perfect Closure

On October 21, 2024, the International Joint Surgery Master China Tour 2024 officially commenced at Dongguan Hospital of Guangzhou University of CM (Dongguan TCM Hospital). This academic exchange is honored to invite Prof. Pfeil, Senior Consultant of Joint Surgery from St. Josefs Hospital, Wiesbaden, Germany for academic exchange. Prof. Pfeil has performed surgeries for notable figures, including the German Minister of Defense and the founder of BioNTech. The short stem invented by him for hip joint replacement has been widely acclaimed not only in Germany, but also in Switzerland, the US, Australia, Japan, and other countries, and this is making him a model of innovation in the medical field. Prof. Pfeil's visit to Dongguan Hospital of Guangzhou University of CM (Dongguan TCM Hospital), armed with his extensive clinical experience in joint surgery, exceptional innovative capabilities, and systematic German orthopedic education philosophy will promote the development of Joint Surgery Department of the hospital and help it keep pace with advancements in Joint Surgery both domestic wise and international wise. Moreover, the new building of Ortho-Trauma Center of Dongguan Hospital of Guangzhou University of CM will be put into use at the end of 2025. Prof. Pfeil's engagement in this exchange is expected to significantly enhance the clinical skills and educational training of the Joint Surgery Departments in the Ortho-Trauma Center.

During the welcome ceremony in the first morning of the visiting week, President DENG Weijun of Dongguan Hospital of Guangzhou University of CM (Dongguan TCM Hospital), Director LU Guoliang of the Orthopedics Department, Directors DENG Huaidong and TAN Zhichao of the Joint Surgery Departments (Orthopedics Ward I and Ward II), and key members of the joint surgery team held a welcoming ceremony for Prof. Pfeil. Both sides introduced their hospitals and discussed collaborative development. Following this, Director TAN's team accompanied Prof. Pfeil on a tour of the hospital's Chinese Medicine Hall, TCM outpatient clinic, and TCM treatment sections to understand the kernel of TCM treatment. This academic exchange involving Prof. Pfeil and the doctors of the hospital will be realized through expert consultations, ward rounds, case discussions, surgical guidance, departmental management training, and master open classes. These activities aim to ensure the breadth and depth of clinical diagnosis, treatment, and academic exchanges, effectively improving the academic and diagnostic standards of the Joint Surgery Department in the hospital.

The second day of the International Joint Surgery Master 2024 China Tour began with a discussion on several difficult cases. Director TAN Zhichao's team from the Orthopedics Ward II prepared four cases involving the hip and knee joints to explore treatment concepts with Prof. Pfeil. These cases included options for hip preservation or hip joint replacement in patients with femoral head necrosis, key considerations for hip joint replacement in patients with DDH, strategies to avoid post-op early  loosening of the hip prosthesis, and discussions on posterior tilting of the tibial component after UKA or THA.

Subsequently, Prof. Pfeil and key members of the Department analyzed the medical history of the patients scheduled for surgery and discussed relevant surgical plans. After confirming the plans, Prof. Pfeil proceeded with surgical guidance. During a case of TKA, Prof. Pfeil shared a simple method for measuring the alignment from anterior superior iliac spine to the midpoint of the ankle with Director TAN's team, and he advised that flexing the knee during the application of the tourniquet could facilitate better muscular treatment during the surgery.

During the morning surgical guidance, Prof. Pfeil provided precise and in-depth instruction for one TKA and teo cases of two THA, allowing Director TAN Zhichao's team to benefit from the refined and standardized surgical techniques.

In the afternoon academic exchange session, Prof. Pfeil conducted lectures and discussions with Director TAN's team. He presented on two topics related to hip joint entitled Bilateral Simultaneous Hip Replacement and The Impact of Hip Joint on Knee Joint. The joint center where Prof. Pfeil works is a key center for surgical traning of joint replacement in Germany. He possesses unique insights into perioperative management, post-op pain management, and rapid rehab in hip and knee joint replacement. The lecture and discussion also focused on perioperative management, prevention of (deep vein thrombosis) DVT, and surgical pain management in hip and knee joint replacement, aiming to help Dongguan Hospital of Guangzhou University of CM (Dongguan TCM Hospital) enhance its perioperative management, alleviate patient pain, and prevent DVT.

On the morning of October 23, Prof. Pfeil delivered a lecture to the major research team of the Joint Surgery Department. Clinical research enhances treatment outcomes, develops surgeons' critical thinking and research skills, and provides young doctors with opportunities for growth and academic advancement.

In his lecture, Prof. Pfeil drew on his decades of clinical research experience to systematically guide the department members through various research approaches. He covered topics such as the definition and significance of Orthopedic clinical research, enhancing treatment efficacy and surgical techniques, promoting evidence-based practices, the roles of clinicians and researchers, and the mutual integration of clinical practice and research.

Prof. Pfeil further noted that he had observed cases of early loosening after UKA, which were induced by the lack of built-in posterior slope adjustment on the tibial plateau of the specific prothesis system, leading to posterior tilting of the tibial component postoperatively. The research of his team on this reveals that the design of the prosthetic system inherently lacks slope adjustment, and he then reminded the team that they would have to adjust the slope manually during operation to prevent tilting. Knee-preserving surgery is becoming increasingly prevalent in China, and UKA, among them, is gaining popularity. The retrospective clinical research of his team offers significant guidance for improving post-op outcomes and enhancing patient satisfaction in UKA.

In the afternoon, Prof. Pfeil compared various approaches to hip joint replacement in his lecture. The Joint Center of St. Josefs Hospital, Wiesbaden, Germany, which he led, employs the anterior lateral (AL) approach for hip replacement. They are also using the Optimys short stem designed by Prof. Pfeil paired with the titanium-coated, high cross-linked PE acetabular cup prosthesis system, which is commonly used in Europe, and with the AL apporoach and the prothesis system, they could finish a case of THA within 35 minutes.

Prof. Pfeil then worked with Director TAN Zhichao's team in surgery. After providing guidance on a case of fix-bearing UKA, he personally demonstrated an AL approach THA. Director TAN then took over to complete the placement of Tri Lock prosthesis on the femoral part.

On October 24th, the Sports Medicine Committee of Dongguan Medical Association's Annual Meeting & the Sino-German Orthopedic Seminar was grandly open. This seminar benefited from the visit of the renowned German joint expert Prof. Pfeil, coinciding with the live surgery demonstration of Prof. ZHANG Jin, together with a team of Orthopaedic surgeons and Joint surgeons from Dongguan People's Hospital, Dongguan No. 8 People's Hospital and other hospitals in Dongguan.

After Director TAN Zhichao delivered the welcome speech, the seminar officially commenced. Prof. Pfeil initiated with presentations on State-of-the-Art Hip Joint Replacement and Surgical Video Demonstration and The Application of Rapid Rehab Concepts in Knee Joint Replacement.

Prof. Pfeil shared his insights on the perioperative management of THA, focusing on Hip Stop+, a self-management manual for perioperative patients that he spearheaded. He engaged in discussions with his colleagues from various hospitals in Dongguan about how surgeons and patients can collaborate to ensure quick surgical access, facilitate rapid rehab, and reduce pain.

In his lecture on State-of-the-Art Hip Joint Replacement and Surgical Video Demonstration, Prof. Pfeil emphasized the surgical techniques as the most easily improvable aspect of perioperative management for THA. He provided a detailed breakdown of the surgical demonstration using an AL approach to place the titanium-coated, highly cross-linked PE acetabular cup paired with the calcar-guided Optimys short stem.

Afterward, following the live-surgery broadcast of an artificial ACL reconstruction led by Prof. ZHANG Jin, Prof. Pfeil collaborated with Director TAN Zhichao’s team for a live demonstration of hip joint replacement using an AL approach with the Tri-Lock prosthesis. During the surgery, Prof. Pfeil demonstrated how to access the joint capsule through the interval between the gluteus medius and the tensor fasciae latae after incising the fascia lata. He then removed the visible joint capsule, took out the femoral head, and used a retractor to expose the acetabulum. Director TAN assisted in placing the Tri Lock prosthesis, and the surgery was successfully completed.

AL approach for hip arthroplasty not only boasts adequate exposure of the acetabulum, direct view for femoral head osteotomy, and easy placement of the femoral stem, the removal of the joint capsule also allows for improved post-op movement of the hip joint, and there is no worry of posterior subluxation of the prosthesis.

At this Sports Medicine Committee of Dongguan Medical Association's Annual Meeting & the Sino-German Orthopedic Seminar, Prof. Pfeil’s lectures and surgical demonstrations showcased the deep integration of modern joint replacement techniques with the concept of rapid rehab, offering new insights and reflections for clinical practice. Through such exchanges, we hope to boost the innovation and application of surgical techniques in Joint Surgery so that more patients can be benefited.On October 24th, we celebrated the final day of the International Joint Surgery Master 2024 China Exchange Week. Prof. Pfeil started the day with a case discussion with the department team to assess the post-op recovery outcomes from the week’s surgical cases. Patients who underwent THA via AL approach recovered well from the surgery and their joint mobility improved greatly. These encouraging results are attributed to the effective surgical demonstrations and guidance provided by Prof. Pfeil throughout the event.

In the end, Prof. Pfeil emphasized that during clinical examinations of patients presenting with knee pain, it is essential to assess hip joint function and observe their walking gait. This is because some patients with knee pain often have underlying issues such as degenerative changes in the hip joint or DDH. In such cases, performing a hip joint replacement is necessary to fundamentally alleviate knee pain and correct deformities.

The successful conclusion of this academic exchange week left the Joint Surgery Department at Dongguan Hospital of Guangzhou University of CM (Dongguan TCM Hospital) with abundant academic fruits. Prof. Pfeil shared advanced techniques for hip and knee joint replacement through surgical demonstrations and guidance, particularly highlighting the skills related to the AL approach THA. This has helped the joint surgery team optimize surgical processes, improve precision, and enhance postoperative outcomes. Prof. Pfeil also imparted strategies and management experiences for rapid rehab in the perioperative period, covering aspects such as patient self-management, pain control, and the prevention of DVT. This will assist the hospital in further improving its comprehensive management of the perioperative period, facilitating faster rehab for patients. Through specialized lectures, Prof. Pfeil encouraged backbones of the department to prioritize clinical research, exploring research topics derived from diagnostic and therapeutic practices to promote the mutual advancement of clinical care and research, thereby enhancing the overall academic level and innovative capabilities of the department.