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动态
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。
精彩回顾
戳视频 抢先看
1、您是何时决定从医的呢？又为什么专攻运动医学、创伤外科尤其是膝关节外科呢？
这是一个好问题。我18岁的时候是德国国家滑雪队越野滑雪和跳台滑雪运动员。当时我的膝关节受了重伤，内侧副韧带断裂了，花了大概一年的时间才康复。从那时起我开始考虑学习医学，并且我有预感这将会非常有意思。并且我萌生了专攻创伤外科领域的想法，因为我对创伤很感兴趣。
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.
2、您的早年经历如何塑造你的成就？
在我还是个学生和年轻医生时有幸遇见了很多好老师。他们对我诊断和治疗患者影响深远。时至今日，这段时期的经历还深刻地影响着我的日常实践。
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.
3、您职业生涯中是否有对您来说很重要的导师，他们教会您什么，是如何启发您的呢？
很难说出具体哪一位对我的影响最大。有好几位对我来说都很重要的导师。有一位是我在美国北科罗拉多州Steadman Hawkins医院学习时的导师，当时我是一名实习医生，这位导师深刻影响了我治疗病人的方式，也激发了我对膝关节损伤的浓厚兴趣。
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.
4、从您自身经验出发，对于一名医生来说，到不同医院或者不同国家访问的重要性？
我认为到不同的国家了解不同的医疗系统是非常重要的，这会启发我们的创新思维。了解不同的治疗理念是非常有趣的，也让我们有机会从众多治疗理念中挑选出最好的。同时我们也能从科学的角度测评出最好的医疗系统和治疗理念。
因此（访问）打开了我们的思路，至少让我们意识到世界上还有很多不同的理念和方式，可以给患者带来好的疗效，帮助我们成为一名更好的外科医生。
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.
5、您是中德骨科与创伤外科交流学会（DCGOU）候任主席，您认为国际学会间的合作对学科发展有什么重要意义？
我认为这不仅会推动骨科和创伤外科的发展，也是国家间交流的纽带。我觉得这是一个非常重要的政治信号，鼓励国家之间特定学科的紧密合作。
对我来说，（成为候任主席）是我能做的小小贡献。我们与中国达成共识，可以与中德两国经验丰富的外科专家共享经验。所以，在我看来这不仅带动了骨科与创伤外科的学科发展，也是连接两国的纽带。
在中国有很多经验丰富的外科医生，他们非常具有创新精神。当然德国在骨科和创伤外科领域也是极具创新性。所以我认为这是一个非常完美的衔接。大家一起创新、相互学习，互相评价对方的创新成果，也许讨论很激烈，充满批判性，但是彼此开诚布公、畅所欲言。
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.
6、您于2020年起任BG创伤外科医院汉堡分院院长，恭喜您。这家医院是全球知名的创伤外科专科医院，也是德国最大的创伤中心之一。能否请您给我们分享您接下来几年的计划？
创伤外科医院汉堡分院是一家由德国法定事故保险协会运营的创伤专科医院。我供职的另一家医院-汉堡大学埃彭多夫医院的创伤科规模也非常大。两家医院在汉堡市的同一个区域。因此我有把这两家医院资源整合起来的想法，让两家医院紧密合作。两家医院的行政管理是独立的，但是在创伤病人的治疗上合作非常紧密。
因为我不仅是BG创伤外科医院汉堡分院的院长、创伤外科主任，还是汉堡大学埃彭多夫医院创伤外科主任。我的想法是两家医院合作，在汉堡市构建一个完善的创伤救治体系，让病人无论在BG创伤外科医院还是在大学医院都能接受到最好的治疗。实现这个想法主要靠专家。无论病人在哪家医院，都有最好的专家在病人身边。所以我们组建了一支同时在两家医院工作的专家团队。
正因为我同时管理着两家医疗机构，计划实施起来非常得心应手。相对而言，我为BG创伤医院设立的目标更多。一方面是病人的康复，大学医院是无法提供康复治疗的。因此，创伤病人尤其是受了工伤的病人，会选择到BG创伤医院进行康复治疗。另一方面，从事故现场的急救到康复后病人重返社会，我们希望每一个环节都能为病人提供最好的治疗并形成良好闭环。
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.
7、您同时也是汉堡大学埃彭多夫医院骨科与创伤外科主任及创伤外科系主任，您如何平衡在两家医院间的行政、临床、科研、教学工作及个人生活？
好问题。平心而论，同时供职于两家如此大的医院真的非常劳神费力。但是我很幸运，两家医院的团队成员都非常配合我。我在BG创伤外科医院（汉堡分院）的团队非常优秀，在汉堡大学埃彭多夫医院的团队也非常出色，能与这样的团队共事，我倍感荣幸。他们给予我全方位的支持，如行政工作、临床工作、科研活动等。我们在汉堡大学创伤外科有独立的科研团队，在BG创伤外科医院（汉堡分院）也有独立的科研团队。因此，团队对我的支持是我能平衡众多职务的主要原因。
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.
8、您对如何培养年轻医生有好的建议吗？
很难给出太具体的建议，我只能从我的经验出发分享我的看法。2018年以前，我一直供职于汉堡另一家大型创伤中心，不是大学医院，是Asklepios医院集团圣乔治分院。在那里我培养了自己的团队，这个团队的成员后来都跟随我到汉堡大学和BG创伤外科医院（汉堡分院）工作。
我非常幸运，多年来建立了自己的团队并且大家也愿意跟随我到新的单位工作。这两家医院原有的团队也非常出色。我带着我的团队、理念、创新带到了新的医院，我的团队和原有的团队配合得也很好。因此，我通过团队的融合把我的理念和创新带到新的工作医院。我非常幸运，两家医院原有的团队很乐于接受我带来的新理念。
我认为管理团队成功的关键是：公开透明、敢做敢言、打破隔阂。整个团队要勇于讨论新的技术和理念。成员间的和谐相处也很重要，唯有这样才能带领团队的进步。如果团队内部有斗争，这就非常棘手。我在两家医院的团队都非常优秀，互相之间紧密合作。这对我来说弥足珍贵。
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.
9、您活跃于多个专业学会，是德国膝关节学会前任主席、德语国家关节镜与关节外科学会创伤委员会前任主席、AO Trauma德国区学科发展官，您认为这些学会对学科和医生有何重要意义？
学会是非常重要的。我认为即使是大型创伤中心的主任，也非常有必要积极投身于各大学会。举个例子，AO（国际内固定研究学会）是全球领先的骨折治疗学会，这是一个非常著名且规模庞大的学会。多年来我一直是AO Trauma德国区学科发展官，我倍感荣幸。
同时我是德国膝关节学会的创始人之一。作为德国膝关节学会的前任主席，我非常荣幸也非常自豪能看到学会的茁壮成长，尤其是在复杂膝关节手术领域，德国膝关节学会是非常权威的。
至于AGA（德语国家关节镜与关节外科学会），这是一个历史悠久，在关节镜领域非常著名的学会。关节镜手术也是我的专攻领域之一。于我而言，在很多病例甚至是复杂关节损伤的治疗上，关节镜是一个很重要的工具。AGA在德国也是骨科与创伤外科领域最大的学会之一，对本学科来说非常重要。
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.
10、您认为科研对一个临床医生有何重要意义？
对于外科医生来说，投身于科学研究非常重要，我的从医理念是成为一名学术型外科医生。也就是说，我对我做的每台手术的科学依据都了然于心，我很清楚我的科研水平和我的科研成果。所以我在治疗病人的时候，我对自己在科研领域的定位也是非常清楚的。我认为对病人进行临床研究的同时也是评估和控制自己的医疗质量。当我们要应用某种新疗法，尤其是要用在病人身上时，我们一定要对疗法、疗效，以及自己的水平进行评估。对我而言，一名学术型外科医生需要通过科研来评估、约束自己。
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.
11、您是一位非常有创新精神的外科医生。您开发的Frosch入路在全球广泛应用，对此您有什么想法？
其实看到我开发的入路被其他人应用我感到很自豪。我知道Frosch入路在中国挺热门的。我真的引以为豪。但你要知道Frosch入路是我在2007年开发的。我认为作为一名学术型医生不能对自己的成就太自满。对于已开展的入路要持续评估和改进。因此，多年来我们对这个入路进行了多次改良。我认为在提高自身技术的同时，还需要持续评估入路的利弊并加以改良。我现在的Frosch入路和2007年的原版也不一样。我现在还在使用这个入路，不过是经过改良的，因此基于经验对其进行改良很重要。
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.
12、您在国际上知名度很高，至今您最自豪的职业成就是什么，为什么？
我最自豪的是我培养了一支极高水平的年轻手术团队。我非常自豪可以跟一群极有天分的人才共事，能够带领大家在膝关节外科和创伤外科领域勇攀高峰，这是我个人职业生涯排行第一的成就。
其次，是我有机会能跟这支优秀的团队一起开发各种新的手术技术。比如您刚提到的Frosch入路，多年来我们精益求精，一步步地对其进行改良。同时，我们应该是世界上首个完成关节镜下膝关节后外侧角重建术的团队。在关节镜下，我们成功重建了膝关节后外侧角。全球范围内能在关节镜下重建膝关节后外侧角的团队并不多，我们对这项技术非常得心应手。对于膝关节复杂损伤的治疗，我在两家医院的团队都已经达到了非常高的水平，我对此也十分自豪。
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.
13、新冠肺炎疫情现在是医疗领域最大挑战之一，您认为这对您所在领域有何影响？
这是一个非常复杂的问题。疫情对骨科与创伤外科领域具有多重影响。其中一个影响就是，疫情令治疗变得更加困难，比如很难在最佳时间进行手术。因为医院很多医护人员，尤其是护士，都被抽调到ICU去照顾新冠病人。手术室人手不足，无法像疫情前一样高效运转。
另一方面，许多肌肉骨骼系统出现问题的病人，尤其是老年病人，不愿意到医院看病。因为他们认为在医院感染新冠的风险很高，但其实不是这样的。
不仅如此，全球科学界的同道们失去了面对面交流的机会。线上会议跟线下会议始终还是不一样的。所以我觉得我们的学术会议缺失了一部分，尤其是会后的活动。结束会议后，来自不同国家不同文化背景的同道一起小酌两杯聊聊天，这些都是线上会议无法取代的。
还有一个可能是比较正面的影响。很多平时专注于临床工作的创伤医生，由于疫情不得不被隔离，或者由于手术室的关闭无法工作，所以他们得以投入更多时间来写文章。过去几年我们在文章和科研上的产出有所提高。但我认为，要有新的想法和创新，最好还是面对面交流。需要举行线下会议，而不是用线上会议来代替，但是很可惜现在做不到。我相信在过去的两年，假如我们的各种学术会议可以线下举行，而不是仅凭线上交流的话，我们会有更多创新。单纯的线上交流无法推动学科的创新和科研成就。科研创新还是需要面对面的交流。
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.
14、假如您不从医的话，您会从事什么行业？
这问题不好回答，但是在我决定学习医学前，我曾经想过读工程学。对于我来说成为一名工程师也是非常有意思的。对于骨科医生来说，学习力学和生物力学也是非常有必要的。因此，如果不从医的话我可能会成为一名工程师。
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.
15、您有什么兴趣爱好？
为了放松身心，我平时喜欢慢跑、骑山地自行车或者越野滑雪。这是我真正的兴趣所在，运动并不只是为了强身健体更是为了放松心情。运动对我而言非常重要，是我能够在高压环境下工作的良药，我无法想象没有运动的生活。
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
汉堡大学附属埃彭多夫医院创伤外科与骨科主任、创伤外科系系主任
BG创伤外科医院汉堡分院院长
相关经历
● BG创伤外科医院汉堡分院院长（自2020年）
● 汉堡大学附属埃彭多夫医院创伤外科与骨科主任、创伤外科系系主任（自2018年）
● Asklepios集团医院圣乔治分院创伤外科中心主任、急诊与重建外科主任（2010年-2018年）
所获荣誉
● FOCUS杂志最佳创伤外科医生
● FOCUS杂志最佳运动医学医生
● FOCUS杂志最佳膝关节医生
● FOCUS杂志最佳膝关节（十字韧带、半月板）医生
成员身份
● 中德骨科与创伤外科交流学会（DCGOU）候任主席（自2020年）
● 德国膝关节学会（DKG）主席（2016年-2017年）
● 关节镜与关节外科学会（AGA）创伤外科委员会主席（2014年-2017年）
● 德国创伤外科学会（DGU）项目委员会副主席（2014年-2017年）
● AO Trauma 德国区学科发展官（自2014年）
● 关节镜与关节外科学会（AGA）讲师（自2010年）
● 德国骨科与创伤外科学会（DGOU）临时咨询委员会成员（2009年-2013年）
