Orthopedic surgeon Professor Dr Michael Hirschmann has already received numerous national and international awards in recognition of his research and achievements in the field of knee arthroplasty. As Head of the Knee Surgery and Sports Orthopedics Team and Senior Consultant in Orthopedics and Traumatology at the Cantonal Hospital of Baselland, he has not only ensured that Basel has a firm place on the global map of orthopedics. As an experienced knee specialist, Prof. Hirschmann has also gained an international reputation, particularly in the field of revision arthroplasty. In addition to science and research, Prof. Hirschmann is deeply committed to passing on his specialist knowledge to young doctors and medical colleagues.
Leading Medicine Guide: Prof. Hirschmann, in your youth you competed in the decathlon at national level. Did that period shape you?
Prof. Dr Michael Hirschmann: I think so. In this type of competition, you have to juggle different disciplines, and you simply can’t be equally good at all sports – that’s just not possible. So you’re forced to develop a certain tolerance toward yourself. At the same time, I learnt that nothing works without hard work. And I learnt to persevere through strenuous, demanding and arduous phases.
Leading Medicine Guide: It is also unusual that you have gained experience all over the world in your specialist orthopedic field of knee joints.
Prof. Dr Michael Hirschmann: Yes, I’ve taken part in many exchanges, seen a lot internationally, and that too has left its mark. I think it’s very important to step outside your familiar surroundings and get to know other things. The same issue is tackled differently in every country. That’s where you learn the underlying principle. I also started taking part in research exchanges early on. I spent a year working in London, which broadened my horizons considerably. There, you see clinical presentations that we simply don’t encounter here anymore. People there have to wait months for a specialist appointment; it’s a completely different healthcare system. The different approaches to the same issue – those were important experiences. In other countries, for example, robotic surgery was adopted much earlier than here.
Leading Medicine Guide: Of the countless prizes and awards you have received, which ones mean the most to you?
Prof. Dr Michael Hirschmann: The award from the American Academy of Orthopedic Surgeons (AAOS) – that means a great deal to me. Because hardly any European has received this honor before. My team and I received the Award of Excellence for our scientific work on the topic of ‘Diagnosis and treatment of painful knee replacements’. I have been working on the issue of painful knee replacements for a long time – looking at how to better identify the cause and what can then be done. However, with all the awards I have received, it is also important to me that the whole team is recognized and that my young assistants can gain experience and prove themselves.
Leading Medicine Guide: Together with PD Dr. Dr. Andrej Nowakowski, you co-head the Department of Orthopedics and Traumatology at the Cantonal Hospital of Baselland. You both complement each other perfectly; PD Dr Nowakowski is a specialist in hip arthroplasty, while your area of expertise is the knee. PD Dr Nowakowski researches and works on innovations in hip implants – where does your focus lie?
Prof. Dr Michael Hirschmann: Alongside clinical research, passing on knowledge is very important to me. I pass on my knowledge to my assistants and students in my daily work, and to other colleagues at conferences and meetings. I have also written a number of books on the treatment of knee problems, particularly knee replacement surgery. The thickest book deals with the topic of ‘painful knee replacements’. I also sit on committees or serve on the executive boards of many national and international professional societies to actively advance the field. Conferences are always excellent opportunities to exchange and share knowledge.
For us, teaching also includes practical guidance. We have an arthroscopy simulator at our clinic, which young doctors can use to practice handling the instruments and techniques. We strive to be very innovative in our training. For example, we have set up a Surgical Skills and Training Lab, as young doctors must undergo training in the techniques before they are allowed to operate on patients under supervision. This is always difficult to integrate into training, and this is where the training sessions help. This is a project very close to my heart.
Leading Medicine Guide: You have gained an excellent international reputation in revision or replacement arthroplasty. Could you explain to us what this involves?
Prof. Dr Michael Hirschmann: The knee presents a particular challenge even for experienced endoprosthetists. Knee prosthetics are complex for many reasons. In the knee, we find a complex interplay of ligaments, tendons and muscles. Statics and dynamics are defined by individual anatomy, which varies slightly from person to person. The quality of prosthetics can be further optimized. We know that around twenty per cent of all patients are not satisfied and/or pain-free following a knee replacement. In such cases, an expert is needed who can treat these patients with competence and experience. The trick is to identify the causes of the symptoms and then tackle them specifically. We have developed a standardized assessment protocol and specialized treatments for these patients. Word of this has spread both nationally and internationally, and our patients therefore come from all over Europe.
Leading Medicine Guide: That must be very rewarding and satisfying work, mustn’t it?
Prof. Dr Michael Hirschmann: Yes, I really do feel very privileged to do this work. I am very grateful for that. It is always wonderful to see the patients, their joy at being pain-free, and their gratitude for their new mobility. That is what makes my job so rewarding; I am grateful to have a profession like this.
Leading Medicine Guide: Let’s talk briefly about joint-preserving surgery. What new methods are available in this area?
Prof. Hirschmann: Preserving the knee joint is always our primary goal. Today, there are a wide variety of different treatment options that make it possible to preserve the patient’s own knee joint for as long as possible. Because we can offer all forms of cartilage repair, e.g. cartilage cell transplantation, cartilage-bone transfer, meniscus preservation such as meniscus suturing, meniscus replacement, and ligament reconstructions – for example, of the anterior and posterior cruciate ligaments, and the medial and lateral collateral ligaments – as well as leg alignment corrections, it is possible to preserve the knee for a long time and only recommend a knee replacement when it is necessary.
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That really sounds like a complex field of work where there is still a long way to go. Thank you very much for the interview, Professor Hirschmann!
For further questions or to contact him directly, Professor Hirschmann can be reached via his profile page on the Leading Medicine Guide.
