August 11, 2025 • 70 mins
Join us on the AHF Podcast Live as we welcome Dr. Francisco J. Gómez Torres, an orthopedic surgeon and innovator from Mexico. Despite a recent earthquake, Dr. Torres shares his journey from founding Osteofit in Mexico City to advancing the field of orthopedics through mentorship and global collaboration. Learn about his inspiration to pursue orthopedics, his experiences with anterior hip surgery, and his thoughts on bringing advanced medical practices to Latin America. Engage with our host Joe Schwab and hear insightful questions from our live audience. Don't miss this enlightening discussion!
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Episode Transcript
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Joseph M. Schwab (00:23):
Hello and welcome again to the A HF
Podcast Live.
Today on the Anterior HipFoundation podcast, we're gonna
be joined by Francisco GomezTorres, an orthopedic surgeon
and innovator, and a passionatevoice for Latin American
orthopedics.
And interestingly enough, therewas an earthquake today, not too
(00:47):
long ago in Mexico, and thatcaused a little bit of our delay
to the broadcast.
So we're happy to know that, uh,Dr.
Gomez Torres is safe.
That he's gonna be joining ushere momentarily.
Dr.
Torres from founding Osteo FITTin Mexico City to shaping the
next generation throughmentorship and global
(01:08):
collaboration, he's redefiningwhat it means to lead with both
skill and heart.
Whether in the or behind apodcast, Mike or climbing a
mountain, he's on a mission torestore movement, inspire
others, and elevate equity insurgery worldwide.
(01:29):
Dr.
Torres, welcome.
I hope you're okay.
Is everything okay in Mexicowhere you're at?
Francisco Gomez Torres (01:37):
Hello.
Yo, it is really nice to hearfrom you I'm so sorry to be this
late, but guess what?
Welcome to Mexico City.
There was just, an earthquakeand the whole hospital was um,
downstairs.
We are up here right now.
It's so good to, uh, greet you,again.
Thank you, again for invitation.
(01:59):
How are you?
Joseph M. Schwab (01:59):
I, I'm, well, I'm just happy to hear that you,
are safe and, and well, and, uh,hopefully your, your patients
and your staff and, and yourfamily are safe as well.
So, thank you for joining me
Francisco Gomez Torres (02:12):
I, thanks to you Joe.
I would like to start just, um,telling you, do you, don't you
miss these kind of experiencesback in Switzerland?
Joseph M. Schwab (02:28):
It's been a while since we felt an
earthquake here.
Yeah, no.
Um, but I really wanna
Francisco Gomez Torres (02:35):
you, you are missing it.
Joseph M. Schwab (02:36):
yeah, yeah.
I'm sure.
I, I'm really interested inhearing, we had a chance to talk
briefly at the a HF meeting inNashville in June.
And, um, but I'm interested foryou to, to, kind of tell me
about and share with ouraudience a little bit about what
inspired you, um, to pursueorthopedics and specifically how
(02:58):
did you end up, uh, gettinginvolved in hip surgery and in
anterior hip surgery?
We, we learned it's quiteuncommon in Mexico.
Francisco Gomez Torres (03:09):
Yeah.
Yeah, you're totally right.
Well, I would like to start, um,telling you that since I was a
kid, well, I was really exposedto medicine because both of my
parents are doctors.
So my, my mother is a familydoctor and my father was a
surgeon.
Uh, since there, I do rememberto be the whole time with them,
(03:32):
I was raised with another twobrothers who are not at all
doctors.
They see blood and they getdizzy.
So I was the one, they were justsmuggles.
So after, after I, uh, wasexposed to this, I kind of like
(03:52):
it.
Um, I studied medicine back inMexico State.
I even, um, got, um, this, I waslike the president of my, um,
class.
So I, I was always.
Pursuing, um, this kind ofliving.
Um, and from there, when I wason the, on my internship, I had
(04:18):
the chance to have theserotations, uh, through general
surgery, orthopedics, internalmedicine, pediatrics and stuff.
And I saw that orthopedics waslike the most, um, how you say
it decisive.
You, you, you perform, somebodygot broken, you perform a
(04:40):
surgery and it's healed a monthlater, which is something like,
for example, internal medicinedoesn't have to, you know, you
know how to treat, uh, diabetic.
Maybe you can control theirissues, but it'll take years.
Well, I mean, it's not even, uh,there's not even a treatment
(05:03):
right now.
No, maybe soon.
But that, that was the way Ichoose orthopedics.
And then I got a doctor who, ona vacation, he told me, you
should come to me, uh, to the,to the surgery room.
We can see if you like it.
(05:23):
And damn, I saw, uh, uh, hipsurgery that day.
I say, yes, this is the thing.
So I studied for my, um,specialty exam.
I was the number 16th of thewhole country.
So I
Joseph M. Schwab (05:42):
Oh wow.
Francisco Gomez Torres (05:42):
the chance to choose.
And after that, well, the restis history.
I studied in a, in, um, ims,which is like the biggest public
service in Mexico.
I'm from there.
After COVID, I started, um, tocreate these kind of congresses
for, uh, students and to joinsome leading voices about
(06:07):
orthopedics.
And a doctor, Dr.
Victoria Manuel, I was one of myguests.
He was delighted because of theeffort, and I think that's, that
was the way he invite me to joinhis team as a fellow surgeon at
(06:28):
the national, uh, rehabilitationInstitute here in Mexico, where
I learned hip and kneereconstruction surgery with him.
He's like a mentor to me, and I,I do appreciate the way he
taught, uh, teach taught us, uh,on that time.
(06:48):
But, um, as.
Here is where the story starts.
Uh, uh, some, some months ago Iwas reading, um, this, this book
Dr.
Ma signed for us at Nashville,and I saw that he, yeah, yeah, I
(07:08):
saw, I saw he have a mentor ofhim, of his, who was performing
surgeries, uh, in a posteriorway or maybe a lateral approach.
And when he decided that thiswasn't the most natural way, uh,
it was because he have thechance to hear fromelles, you
(07:31):
know,
Joseph M. Schwab (07:31):
Mm-hmm.
Francisco Gomez Torres (07:32):
he, he.
Writes on his book that thefirst time he saw him, it was
because Dr.
Letell was doing, uh, a tabularfracture through a anterior
approach.
But then he decided to join himin Paris, where Dr.
Letell was performing, um,anterior approaches to, for hip
(07:55):
prosthetics, and that he evenhad, uh, a table for it.
So it was like for me, maybe 30years later, but it's the, the
same history here in Mexico.
I don't know if it's a culturalmatter, but the anterior
(08:15):
approach is, might be, it mightbe not the most, um, acceptable,
um, approach for the leadingsurgeons today.
I
Joseph M. Schwab (08:29):
In Mexico specifically.
yeah, And we'll get into alittle bit about, uh, I'm gonna
wanna learn a little bit aboutwhy you think that is and how
you think that might change, butwe'll get to that.
Francisco Gomez Torres (08:41):
Sure, sure.
I, I'm your guest today, so I'mso happy to answer your
questions as well.
I do have some questions for you
Joseph M. Schwab (08:51):
Yeah, of course.
Francisco Gomez Torres (08:52):
I, I can, I can see you as, as a
mentor also.
I, I think I do have a lot of,um, to learn from you and the
whole a HF uh, uh, crew.
Joseph M. Schwab (09:07):
Yeah.
Well, I think the a HF itself isa community of learning, so we
all learn from each other andthere's, there's a lot that we
can learn by having these sortsof conversations, both locally,
nationally, and, andinternationally.
Yeah.
Francisco Gomez Torres (09:22):
Yeah.
For, for example, I would liketo know if the anterior approach
was all, uh, the beginning foryou or if you have to.
Make this switch betweenapproaches when you first
started.
Joseph M. Schwab (09:37):
Well, most of my, uh, residency training was
in posterior approach and directlateral approach.
And, um, I first saw anteriorapproach at a course when I was,
uh, later in my residency years.
And I thought it was veryinteresting.
I got to meet Dr.
Matta, he taught the course.
And, um, uh, when I came backinto practice after doing my
(10:02):
fellowship in Switzerland, whereI saw some anterior approach
towards the end, um, I decidedthat I wanted to start my
practice doing all anteriorapproach.
So when I began my practice, Ijust started doing anterior
approach right away from the getgo.
So my training was, uh, a littlehaphazard.
(10:23):
It's different than it was, thanit is nowadays, uh, for sure.
Um, but uh, but we, we made itthere.
So that's, that's how I ended upwith anterior approach.
But that leads me to a question.
Was there, you talked about howyou, uh, kind of found a mentor
in, in hip and kneereconstruction surgery.
was, there A particular case orpatient or conversation that you
(10:49):
had during that training thatmade you feel, this is exactly
where I'm supposed to be, thisis what I'm supposed to be
doing, and that confirmed thedecision you had made?
Francisco Gomez Torres (11:00):
For sure.
I must say that, for example, inthis, in this practice I had as
a fellow surgeon, it's always inthe very same.
Now you, you can't change theapproach because you want to,
you have to follow strict rulesbecause this is the school we
teach in, in this institute.
(11:23):
Or for example, as I told youbefore, I was, um.
A couple of months ago, I wastrying to, uh, I was working in
a, in IMS where they do havetheir own school.
They do, uh, hips laterally,mainly, mainly, and I heard from
(11:45):
this colleague, a doctor whohave learned the interior way,
um, in the us He was performinghis cases, uh, under the water,
as we say here, because hewasn't allowed to, well, this
doctor even got punished.
He, they took his consultationand he was changed, uh, to
(12:09):
another service.
So I think this, uh, the, theway I have been in touch with
the anterior approach is mostlywith colleagues of mine, friends
who, which I do perform hipsurgeries, but in.
Our own.
We have our own patients, ourprivate, private patients, and
(12:33):
we gather, you know, we gather adoctor from Central Mexico City,
a doctor for, from Bolivia, whonow works here in Mex, Mexico
City.
And I myself, and we do performthe entire hip surgery in on, on
in our own way.
You know, as the way we learned.
One of my friends learned at theHip Institute with Dr.
(12:56):
Uh Dom, for example, and thisother friend of mine learned in
Magdalena De La Salinas, whichis a hospital here in Mexico
City, and I did my own thinglearning through them.
And through you, for example,and you know, like this, like
drop water drops.
(13:18):
I have been learning on my own,as you said before, I'm kind of
an entrepreneur, but I'm lookingfor my practice everywhere.
I even went to Switzerland, uh,at Pass Basil where I had the
chance to perform with Dr.
Carl Stoffel, which I do, Iadmire a lot.
(13:38):
He taught me some tips.
I went to the AO courses, uh, attables at Luer.
So it's all kind of a mix.
You have to look for your ownway and more than look for it.
Create it in some, some way.
Yeah.
Joseph M. Schwab (13:56):
It.
Give me a little bit of an ideaof what the, what's the, medical
care system like in, in, atleast in Mexico City, and is it
the same all throughout Mexico?
Is there nationalizedhealthcare?
Is it private?
Is it a mixture of public andprivate?
Tell, tell our listeners alittle bit about how healthcare
(14:17):
is delivered in Mexico so we canunderstand the environment
you're working in.
Francisco Gomez Torres (14:23):
Sure.
in Mexico we have, uh, twodifferent ways of doing things.
The, the first one is the, um,the public one, which is divided
mostly into three institutions,which, which are IMS is there,
and, uh, which is, um, health ingeneral.
(14:47):
These three services are thepublic ones.
Yeah.
so we are, um, how do you say,uh.
We do have, uh, um, we're stuckto the, to the money the
government gave us to performsurgeries.
(15:07):
So, for example, to do ananterior approach, you know,
better than me, that maybe wedo, we need special, um,
instrumentation to place this,this, um, uh, how do you say
prosthetics?
So it's kind of hard for the,the government to, to pay No.
(15:32):
And through the public to theprivate one.
Well, we do have the, theinsurances, which do mostly in
the biggest hospitals like this,like hospital Al.
But there is also a way wherepeople can pay on their own
without having, uh, aninsurance.
(15:53):
So.
There are three kinds.
No public, private, or a hybridone.
Yeah.
Joseph M. Schwab (16:01):
Self play.
Self pay are there.
So when we had, um, a RichardField from the UK came and gave
a talk at the Anterior HipFoundation about, uh, anterior
hip replacement in the uk, whichis only about 1% of, uh, of hip
replacements between one and 2%.
(16:21):
Um, Mexico is similar in itspercentage, but he also
described there's the publicsystem, there's the private
system, there's the self pay,and then there's also the public
system that, for lack of abetter term, contracts out
certain types of, uh, cases tothat they are, are not able to
(16:44):
handle within the publichospitals, to private
institutions who will takepublic patients.
Does that also exist in Mexico,or is that aspect not a, is that
not similar?
Francisco Gomez Torres (16:57):
yeah, yeah.
It does exist, but it's not likethe biggest, uh, way of doing
things.
It's mostly because thehospitals are very crowded, so
they choose to deliver the, thiskind of patients to, uh,
specific, um, center.
You know?
But I have only hear of thatmaybe here in Mexico City and
(17:21):
maybe in Monterey andGuadalajara.
So it's not like the most commonthing.
But I think things are going tothat way because the public
service, it's full, it'sovercrowded, uh, awfully.
Yeah, we do have that problemhere.
Yeah.
Joseph M. Schwab (17:38):
Yeah, the o the overcrowding problem.
Um, how much do patients in thepublic system in Mexico, how
much do they have input into howthey want their care to be
delivered?
So could somebody in the publicsystem say, I, I want an
anterior approach, hipreplacement, all as uncommon as
(17:59):
that might be in Mexico?
Could somebody say that andexpect that that's what they
would get?
Francisco Gomez Torres (18:08):
I must say the patient doesn't have,
uh, an option when they arethrough the public service.
It's mostly, uh, the decision ofthe service, maybe the decision
of their surgeons.
Uh, but no, as far as I know,the patient doesn't have their
(18:28):
right to choose, but they cantalk with their doctor, and if
he does now the entire approachmaybe.
It's a possibility.
Like in that hospital, I toldyou before, the doctor that was
doing his own, uh, anteriorapproaches, but he got, I mean
he got, uh, he got punished.
(18:50):
It's crazy.
Joseph M. Schwab (18:51):
Yeah.
Well, and and that leads me tomy next question.
If you could change one thingabout how anterior approach hip
surgery is either perceived orpracticed or it sounds like it's
not taught much in LatinAmerica, in Mexico, um, what
(19:13):
would that be?
What would be the first thingyou would change?
Francisco Gomez Torres (19:17):
Yeah.
Well, I think there is acultural problem because of
doctors that are not willing tochange their approach.
I think that's the biggestthing.
The big names, the names thathave been with us a lot of time,
they are accept or they doesnot, do not want to change this
(19:39):
kind of, uh, technique.
Mostly because, well, they don'twant to lose their.
Power position.
you know, as we saw inNashville, as I have been
watching through the days,during my, uh, surgeries, the
surgeries of my friends or co orcolleagues, and we see this kind
(19:59):
of better results.
I, I don't remember a doctor whotold me in, in Nashville, the
worst, uh, plant is the one thatdoesn't want to see, and that
was Dr.
Mar.
So it's crazy how we are so, soret to say, no, no, keep it
(20:21):
lateral.
Keep it posteriorly because it'sthe bear.
I even had a discussion with afriend of mine, I mean, a friend
of mine told me the posteriorway is the way.
I was saying like, dude, you arelike a shoulder surgeon.
Why are you talking about hipsurgery?
That that's the way it's likediscussing about the football.
(20:43):
You know, football is somethingbig here in Mexico and people
gets, it breaks relationships.
It was the same with this guy.
He was saying, why are, yeah.
Yeah.
Go lambster.
Joseph M. Schwab (20:56):
I, I, I, no, that's okay.
I was gonna say maybe it'll takea famous, uh, footballer from
Mexico to get an anteriorapproach, hip replacement
someday to change the
Francisco Gomez Torres (21:06):
you're talking.
Yeah, yeah, yeah.
I, I do remember having afootball coach.
Um, he was already retired, buthe was a very famous, uh,
football player back in the day.
He have anterior approach andhe's doing great.
He's still playing football.
You know, he, he tells me thatwhen he's playing football
(21:31):
nowadays he plays, but when theother, um, teammate comes to
closer, he just drops the ball.
Joseph M. Schwab (21:38):
yeah.
Francisco Gomez Torres (21:39):
But he's playing football.
It's crazy.
He shoots and he scores from faraway.
He has it still, but, you know,it's crazy.
And people, people doesn't, uh,maybe they don't know that yet.
I think another
Joseph M. Schwab (21:55):
know that.
Yeah.
That he's had a hip replacement.
Yeah.
Francisco Gomez Torres (21:58):
Yeah.
Yeah.
Maybe the thing I will try tochange will be, um, making this
info even more, um, availablefor people that wants to, to get
better results.
Not, I'm not talking aboutpatients because patients do
(22:19):
come and they ask for the AMIapproach, but I mean, through
another colleagues, you know,through doctors, through another
hip surgeons That are stuckbecause they learn that way as
the way I learned back for yearsago when I was doing orthopedic
surgery, but not a following hipreplacement.
Joseph M. Schwab (22:42):
So talk to me a little bit more about the
group of orthopedic leaderswithin, um, the Mexican
community who have, um, maybesome, uh, some oversight over
what They, perceive to bequality and what they perceive
to be the right way to dothings.
(23:03):
Is this a formal structurewithin the Mexican orthopedic
community, or is it, is it a bitmore informal and um, uh, you
know, is this, is this the elderstatesman, so to speak, or
stateswomen of the, of theorthopedic community who are
telling you, quote unquote, theright way to do things?
Francisco Gomez Torres (23:25):
Yeah, well, I think mostly of them.
It's not like a formal, um,group.
It's this.
Bunch of groups that have beenthrough a lot of time.
They, they, for example, they dowork a lot with the insurance,
uh, companies.
They have been there forever andthey keep growing because they
(23:47):
do accept more fellows, more,more, uh, doctors to join their
team as they are the voices thatresonate between us.
Um, they are the ones that haveto change, I guess.
I mean, not very easy for me toraise the voice and to make
(24:10):
people hear me, but little bylittle as what a lady was
telling me yesterday, uh, wehave an, uh, an interview with,
um, a social activist who toldus, don't you ever give up.
Just if you can change a persona day, it's okay.
I think.
(24:30):
We have to keep pushing withthis kind of efforts.
I don't know, uh, Joe, if youwill have the metrics of this
speak layer, but I would like toknow if Latin America is
listening because we did have alot of, uh, talks with our
friends back in Brazil, Chile.
(24:51):
Uh, I don't, I even have adiscussion with, uh, uh,
research team in Egypt, uh, whois committed, was committed to
hear this talk.
I think we have to keep pushingto, to make people's mind
change, especially these ones,these big guys, uh, that have
(25:13):
been there forever and that arenegative about the anterior hip.
But just because they have, theydon't know it.
Maybe they are, they don't wantto change.
I mean, 20 years doing the sameprocedure the very same way.
I do understand that.
Um, they might be in a comfortzone, but for example, Dr.
(25:36):
Sa also talks about, uh, histransition through the, from
posterior to anterior, which issomething crazy for me.
I, I, I, I, it's kind ofremarkable for me because it's,
uh, 180 degrees, uh, change.
It's totally different.
But I can say Dr.
(25:56):
S is having great results, andhe even talks about it in his
book also.
So.
Joseph M. Schwab (26:02):
Yeah.
And, uh, just to, um, just to,uh, address one of your, uh,
comments there.
We've got live about 15 peoplewatching us right now, which is
for a first live podcastepisode.
I'll take it.
And I wanna remind those userson YouTube and on LinkedIn that
in the latter half of thisdiscussion, if you have
(26:23):
questions, uh, for Dr.
Gomez Torres or for myself.
Um, we've got our producer Lila,behind the scenes and she is
feeding us the best comments andquestions, um, that you leave.
So please feel free to be a partof the conversation.
We would love to have you.
I wanted to uh, sort of followup because one of the things
(26:46):
that you seem to have done orseem to have put together in
your quest to bring anteriorapproach to Mexico and to Latin
America is you have really, uh,made a lot of international
connections or madeinternational global outreach
something, um, that somethingthat's part of how you learn,
(27:11):
but also how you connect.
Um, how do you stay engaged withthe orthopedic community
internationally?
How do you cross borders likethat?
Francisco Gomez Torres (27:23):
Well, I, can, I would like to say that
since I was a kid, I was like areally friendly guy.
you know, I, I don't know.
Why is it easy for me to talk topeople and to, you know, I.
To know if we can be friends orno, you know, it's okay if we
don't agree in everything, but Ido like this kind of
(27:46):
communication.
I don't want to be flat with thepeople.
I want to know a little bit ofthem and if they want to know
for me it's okay.
So I think it's my, the way I dofriendships with people that
took me.
I, I took it internationally.
I say, I am making friends allaround Mexico.
Let's try in Switzerland.
Let's see if I can make somefriends there.
(28:09):
I did make some friends and theywere, um, for lucky, lucky me.
They were a officers.
So then I got, uh, engaged withthe AO Foundation, and I do love
that.
I am working nowadays with themalso.
Uh, for example, uh, when I wentto Nashville, I did find this
(28:30):
group of very enthusiast, uh,colleagues, which are the
Berkeley fellows.
I can tell you that everybodyhas a special talent, uh,
especially for example, Dr.
Amed Omar from Egypt.
He, as soon as I got, uh, intouch with them, with him, we,
(28:51):
we had a click and.
I was invited to participate inhis research group, which is,
um, an author of, of More Than50 Research, for example.
No.
And, and he is encouraging,encouraging his students to, to
(29:12):
do a do as he to publish andpublish and publish.
So I can see that that's thetrue benefit of having
friendships that matters.
You know, it's not just beingfriends, it's trying to work,
uh, together.
Um, in, in back in Nashville,for example, I was looking for
(29:36):
maybe any chance to, to get, uh.
Uh, traveling Fellowship info.
That was another thing I waslooking for.
It's not just talking fortalking, it's with a purpose.
No.
To get in touch with people,maybe searching for, um, the
exchange of benefits.
(29:57):
If I can do that, the entire hipfoundation, uh, put some
attention of them in LatinAmerica.
I think that's somethinginvaluable for the whole region.
If some, uh, doctors, someteachers of mine are listening
to, listening to this and theysee that maybe podcasts are
(30:20):
nowadays the way, um, televisionevolved, for example, or, you
know, the broadcasting, um, it'sa new wave, well, a new way of
communication, and I think it's.
The interior approach is thefuture of communicate.
If not, I will then be able totalk to you from Switzerland to
(30:41):
Mexico with in California.
It's crazy, but I do love it.
Uh, that's the way I, I am doingpodcast post podcasting right
now.
Uh, the last year was amazing toget in touch with a lot of
people, uh, friends from NewYork, friends from new uh
(31:02):
Belgium, some doctors from Asia,for example.
I was invited to give a talknext, uh, February on the apo,
the Asia Pacific, uh, orthopedicAssociation.
So maybe I will be there fornext February.
Joseph M. Schwab (31:18):
Mm-hmm.
Francisco Gomez Torres (31:19):
It's, it's the way things are
happening.
I'm not just sitting and with,uh, arms crossed.
I'm looking forward to connectwith people, as you say, but.
That's, that's the way thingsare happening.
I am.
Joseph M. Schwab (31:37):
So you, you clearly have an interest in
technology and you have aninterest in using that
technology to not, not only tolearn, but also to teach and to
engage.
I'm curious about your use oftechnology in the operating room
and let's, I just wanna startwith a basic question about your
your setup.
(31:58):
Um, do you have a technologyenabled or setup?
Is it pretty basic?
Is it more advanced?
Can you walk me through whatfeatures kind of matter most to
you in, in terms of your orsetup?
Francisco Gomez Torres (32:14):
Yeah.
Well first of all, I would liketo say that, uh, I did learn to
perform hip and knee surgeriesin the traditional way to begin
with, you know, at the veryfirst I wasn't able to, uh,
manage their robotic arm.
But nowadays we can do, we dohave access through this kind of
(32:38):
technology, especially in theprivate sector about the public
sector is a little bit hardbecause of the economics.
But now that we do have thiskind of, um, liberty to, of
freedom to choose.
Well, we do perform with arobotic surgery in a site.
(32:59):
Uh, we do have a, a tech guy,uh, who is taking care of it.
Um, when we are performing some,um, surgeries, we do have this
kind of, um, how do you say,like the, like the belly system,
you know, to, to match the prethe prayer and the postop, even
(33:22):
with a pre, uh, trans, um, uh,visualization of if we are okay.
Uh, so I can say it's not likethe most equipped, um, um, or,
but it's not also like the mostbasic one.
I think we do the, the fourselves.
(33:44):
Uh, I think there are doctorswho are more, um, in a need of
having everything, uh, but.
I, I'm kinda, I don't want toget so, so used to this kind of
technology that then I don't, I,I kind of forget how to make
(34:06):
them traditionally because,well, another thing I would like
to say is that apart from MexicoCity, I do perform surgeries
across the country.
So I try to go, I don't know,maybe California, sometimes
mores, maybe South Mexico.
We do try to help in differentways, uh, to the people.
(34:29):
Sometimes I do work, I performsurgeries with another, uh,
surgeons who asked for my help.
Were, were, um, kind of a, um, aMexican, um, how do you say?
We try to communicate to makethings possible, but that's
Joseph M. Schwab (34:48):
Sure
Francisco Gomez Torres (34:49):
the way I don't have a robot
Joseph M. Schwab (34:51):
within the, okay.
Interesting.
Francisco Gomez Torres (34:54):
I do collaborate a lot.
Joseph M. Schwab (34:56):
do, do you, um, find difference in access
to, to implants, differentquality of implants depending on
the place that you're operatingat, whether it's public or
private, or do you pretty muchhave the same type of implants
available wherever you are?
Francisco Gomez (35:15):
Unfortunately, I, I don't know if that's
unfortunate, but no, I do havelike a, a whole options of, um,
implants.
Uh, I do, I would like to saythat I do have my favorites.
You know, I do perform mostlywith three kind of uh, implants
(35:35):
But you know, if I am back inMexico State and they got these,
these prosthetics because of thebudget, let's make it, you know,
uh, so I think.
That we do have to be also very,um, versatile with these kind of
(35:56):
mires.
If you get used to a singlething, um, it can be, you can
get into a trouble later.
Um, and maybe it's the time forme, maybe later, um, when, when
I, uh, you know, um, basetotally my, my practice into a
(36:17):
single uh, thing, then I willstart doing with only one
implant, one kind of implant.
But nowadays I'm trying fromeverything.
Joseph M. Schwab (36:29):
We, we have a question from one of our users
on LinkedIn, um, about,specifically about implants, but
about custom 3D titaniumimplants.
Wanting to know if you have any,um, experience with those
implants, and if so, if you'veencountered any challenges with
them.
Francisco Gomez Torres (36:49):
Well, we do have a friend of us who is
mostly into this.
Um, with this technology, thething that we have found is that
after you have the cuts withhave to be really specific
through a TC for a C forexample.
Um, even when you perform.
(37:11):
Very good.
The surgery, um, you can'texpect, you can expect
everything because as it is aper a treat, d personalized, uh,
a personalized, uh, system, youdepend a lot in the activities
this person is doing.
We don't have the record of howthis implant is going to work
(37:33):
because it might be, it's sopersonalized that you can't have
like rep reproducibility, um,of, of, um, how you say, um,
cases before.
No.
So every case is different.
We even have one day this, thisperson that, uh, the implant
(37:55):
just came off from the, from IACbone and we have to, to reenter
and to, to fix it with morematerial, but you know.
That was an experience we don'twant to have again.
And we have had more, um, alittle bit more of experience
(38:19):
with the trabecular implantsthat, um, you know, these,
these, um, I, I did forgot the,the name, but we do have more,
more practice with monds, withalmonds.
It's mostly more than 3Dprinted.
Besides that it's expensive aswell.
(38:41):
The 3D printing thing.
Yeah, I.
Joseph M. Schwab (38:44):
Um, we do have one, uh, user who commented on
LinkedIn.
Um, and I'll, I'll just read thecomment that I have here.
It says, I believe that thereality of the Mexican
healthcare system is so similarto the rest of Latin America.
And so different from theAmerican healthcare system where
decisions often depend not onwhat the patient wants or what
(39:06):
the surgeon prefers, but on whatis available at the time of
surgery in each case.
Is that your experience?
Francisco Gomez Torres (39:15):
Well, I have to say Joe, that I have
heard that a lot of times.
What about you?
Do you find it like, uh,something crazy because yeah,
it's a reality in the publicservice here in Mexico.
Yeah.
but I don't know.
I don't know that maybe inColombia is very different.
Columbia is kind of more privatething.
Joseph M. Schwab (39:38):
Um, my, so my only experience operating in
Latin America was in Nicaragua,um, where we had an opportunity
to go, um, as an educational,um, exchange when we were
residents and what I recall fromthe.
Uh, cases that.
(39:58):
we did in in Nicaragua, at leastat the place where we did them,
um, the patients had to buy theimplants out of, out, basically
out of pocket.
And so it was, you put inwhatever they could afford, um,
and if they couldn't afford, youtook whatever you had that was,
you know, on the shelf if therewas something available or that
(40:20):
could be donated by a company.
Um, but it was a, anexceptionally different
situation than what I'veexperienced in the US healthcare
system and certainly differentthan in the, in the Swiss
healthcare system.
But it also sounds like it,that's a bit different.
Yeah, a bit different than whatyou experience in Mexico City.
Francisco Gomez Torres (40:39):
Yes, yes.
I can say that.
Well, here as, as the p as thepopulation is growing, um, like
never before.
The, the, the population isstill growing as fast as 30
years ago, maybe a little bitmore.
Um, the, the institutions, Theyget, uh, stuck into trouble.
(41:03):
We even had, uh, like 15 yearsago, the, how do you say, the
pensions, the jubilations.
Joseph M. Schwab (41:09):
Yeah,
Francisco Gomez Torres (41:11):
They were, took off the, of the
federal budget because itwasn't, um, possible affordable
for the government to keep thosepayments.
So nowadays, uh, we don't havejubilations anymore.
It's something crazy.
You will have to work until you,you, you are incapable of.
(41:33):
But it's mostly because we don'thave the budget already.
So imagine if that's the way,uh, things are happening.
You can expect anything from apublic service, uh, to give you
on, on a prosthetics.
Yeah,
Joseph M. Schwab (41:49):
We have some great.
questions coming in.
I wanna read this one fromAncon,
Francisco Gomez Torres (41:53):
that's great.
Joseph M. Schwab (41:54):
orthopedic surgeon.
Um, what common mistakes do yousee surgeons make early on in
their anterior journey, and howcan they avoid them?
What have you seen?
Francisco Gomez Torres (42:06):
Well, I would like to tell you, uh, uh,
even I do feel like I am an, uh,I am a young surgeon on this.
I'm not the most experimented,uh, but I am on my cure already.
I think one of the biggestmistakes was not, Um, not, not
(42:28):
to locate the right, um,intermuscular, um, segment.
You know, sometimes I was alittle bit anteriorly, a little
bit more, or in the, in thelater cases I was creating a
little bit posterior.
So nowadays I do have like thiskind of metric, uh, not only
(42:51):
with hands, but also with thefeeling.
Joseph M. Schwab (42:54):
Mm-hmm.
Francisco Gomez Torres (42:55):
And I do, um, now I, I can initiate my
approach just right in the way,in the place I wanted to.
To make a little flip of thefascia.
That's the way to be.
I don't know you if you have anytrouble, um, because I think the
approach is the 60% of thesurgery, you know, the implants,
(43:21):
you know, when they are welllocated, uh, to exposure, expose
the femoral is another thing Iwould like to discuss.
But, uh, I think mostly it's theapproach.
You have to be real secure inthe approach and then the
surgery will just flow as youwant it to.
Joseph M. Schwab (43:38):
The, I would say the biggest mistake that I
see early learners, um, make inanterior approach is, um, some
of them, some of them don'tunderstand how many people have
come before them and have madethe exact same mistakes they've
made.
And they feel like with, assuccessful as anterior approach
(43:59):
is that if they talk aboutanything they're having trouble
with or that they're, uh, youknow, a mistake that they've
made or a difficulty thatthey've encountered, that they
would somehow be looked down onwhen, what I have found, at
least with the anterior hipfoundation.
Is a community of people whohave made every single mistake
that you can make with ananterior approach and would love
(44:22):
to talk to anybody who isstruggling, um, so that they can
help them through it.
Um, and it, it's the, the ideathat you need to hide things
that, um, are difficult for you,um, until you just get enough
cases under your belt and theyget better.
Um, there are people who, whoare out there who can help you.
And, um, you're an example ofhow you do this.
(44:45):
You reach out and you, you youknow, You cross boundaries, you
cross borders, you cross, uh,uh, cultures and, um, you try
and find answers to the problemsthat you're encountering and the
questions that You have.
Um, another question came in.
What specifically, specificallydo you think needs to happen for
(45:07):
anterior approach hips to becomemore common and even widespread
across all of Mexico?
Francisco Gomez Torres (45:17):
What will be?
Hmm.
I do think that, you know, anactualization in education, it's
a must because if you, if you,you enter a fellow, okay.
You enter into a hipreconstructive fellow, okay?
But the teachers are doinglateral approach.
(45:39):
And then the fellow ask, can wedo maybe one anteriorly?
But your, the practitionerdoesn't, doesn't even know it.
Or maybe they have here onlybad, um, bad, uh, reviews about
the anterior approach, and theyare not trying to excel this
(46:01):
myth.
No, I hear that.
It was like a crazy approach.
Oh, no, it's not, it's not anybetter than the lateral or the
posterior, just because theyheard from somebody that heard.
So I think that's the most, themo the very most important, um,
issue is to make anactualization or, or to improve,
(46:26):
um, to make it put it on thetable as an option.
Joseph M. Schwab (46:31):
The education, specifically the education.
So how, how it does, and I'mgonna ask a little more detail
about this, because one, I
Francisco Gomez Torres (46:41):
What?
One thing.
One thing?
Yeah.
Yeah.
I got you.
I got you.
Just to add a little bit, maybefor example, I am, I am,
unfortunately, I don't havelike, uh, a program to teach now
or maybe the friends of mind whoare working as freelancers or
(47:02):
their own bosses.
We don't have, like thisprogram, a specific program of,
of fellows, but we have, wewe're avid to learn the entire
week.
Well, I think this has to beinto a program.
There are no programs where theentire approach is teach.
(47:24):
I think that's the.
Most important thing, the, the,the time one teacher starts
performing Ontario, people willgo there and try to learn, you
know, as I did in Nashville, asI, as we are all doing.
Joseph M. Schwab (47:42):
And I remember early on, so nowadays in, in the
US and certainly both in the USand in Europe, it's quite common
for any of the fellowships that,you go to to learn hip surgery,
you're gonna learn anteriorapproach.
That's very common at, at many,many fellowships.
But when I was learning, therewere not as many fellowships
(48:04):
that were offering that as aregular opportunity.
And the education was mostlycoming from partnership with
industry.
Is that something that you cando in Mexico before the, the,
the, teachers, so to speak?
Um, take it on as can industrybe a help in that?
Francisco Gomez Torres (48:23):
Of course, I think that, uh, every
time I do approach with a, witha rep, uh, and they just start
talking me about, uh, their newhip system, it's okay, hey, oh,
it's really great.
This, it has, uh, trabecularmetal, it hydroxy appetite, it
(48:44):
has, uh, beamin, um, uh, how yousay Polyol?
And I say, is it possible tomake it anteriorly or do you
have any special instruments tomake it a pro, um, anteriorly?
And they say no, or they sayyes.
You know?
So I think that's.
(49:05):
The way I, I think the reps canget into this to making, um,
the, the tools perfect for theirimplants or, or to make them
unter.
I do now have, for example, Iwas talking with, uh, nowadays
with a, a new rep I haven't herebefore, and they are bringing a
(49:26):
Korean, Korean, I think it is,uh, hip prosthetics, uh, that
has its own instrumental to dowith anteriorly.
It's the first one I haven't, Ihave here, uh, hurt that is not
American, for example.
So, or, or, or like the bad, Idunno if we are, are able to
(49:48):
talk, uh, about
Joseph M. Schwab (49:50):
Hip Foundation, we are, we are free
to use, uh, product names and infact, we encourage it.
Francisco Gomez Torres (49:58):
great.
That's great because
Joseph M. Schwab (49:59):
is, how's anyone gonna know what you're
using?
If you say, ah, I use this, andthen they find something that
looks like that.
But maybe, I mean, use the name,it makes sense.
Francisco Gomez Torres (50:09):
Yeah.
Yeah.
For example, I, yeah,
Joseph M. Schwab (50:12):
you, I was gonna say, you're c we know, we
received a comment, uh, as youwere speaking from, uh, David
Ktu Morales, who says, um,exactly the point that you were
making.
We need more surgeons performingthis approach so that the
implant companies startrequesting the necessary
implants and tools, even if theyrequested them today, the
(50:33):
Mexican FDA, which he says KofaPRIs, if that's, if I'm
pronouncing that correctly,takes between three to five
years to approve them.
So, just to give an example,trabecular metal only became
available in Mexico about fiveor six years ago.
So if we want to have.
For instance, the Actis stem,uh, collared implants, it'll
(50:55):
likely take another three tofive years before they arrive.
So that sounds like exactly thepoint you were making.
There needs to be this, um,relationship with industry to
get the technology in And theimplants in to facilitate the
approach.
So, so working with industryseems to make a ton of sense.
Francisco Gomez Torres (51:15):
Yeah, I do remember, I do remember we
had a talk, uh, a couple ofweeks, uh, before, on a
Saturday,
Joseph M. Schwab (51:24):
Mm-hmm.
Francisco Gomez Torres (51:24):
a Sunday.
I was, I was talking to youthat, uh, a Johnson and Johnson,
uh, rep came to me to say, Hey,you have a great time at, at,
uh, Palm Beach.
Right?
Uh, we met you there.
Yeah.
And he was talking, we weretalking about the, the, I invite
him to the, to the office and heshowed me the implants he have
(51:47):
and stuff.
And as I was talking with him,because.
I attend to a palm beach in aneo course where we had some
kind of tech, you know, somekind of hip replacements, some
kind of knee replacements, whichwere very similar but different
(52:08):
to the ones we used inNashville, for example, in
Nashville with, we use the Sise.
He was asking me is the numberone and or number two, and then
we research.
But for example, and I, I, Iasked him, why don't we have
Sise in Mexico?
And he says, he said like, Ooh,doctor First and Mexico, you
(52:32):
should, you should seek forChile or Brazil, where the FDA
from those countries is not asbureaucratic as the Mexican one
is.
So he.
If, if that was his firstcomment is because it's a very,
uh, hard thing to make tointroduce these implants into a
(52:55):
country.
So he said you are like 10 yearsbehind.
Chile might be five, Brazil maybe three, and then it's Mexico.
Uh, you know, so, so you shouldstart looking what's happening
in Colomb or Chile to see what'scoming to Mexico.
It's like really?
Do they have king size therenow?
So king size is coming maybe in20, I don't know, but
Joseph M. Schwab (53:18):
it's, yeah.
Francisco Gomez Torres (53:18):
like some kind of
Joseph M. Schwab (53:20):
It's kinda like you have a little bit of
time machine you get to see intothe future a little bit.
It's just, uh, it'sunfortunately the present for
others.
But, um, and so I know I, I do,uh, we've been, um, talking for,
uh, for almost 50 minutes now,which is great, and I, I, but I
want to see, I know you hadmentioned you had some questions
for me and so I wanted to berespectful of your time and I'm
(53:43):
happy to answer any questionsthat you might have.
Francisco Gomez Torres (53:47):
Thanks a lot Joe.
I mean, I don't want to toextend this that much, but I
would really like to ask you asa leader you are because, well,
people that follows the HFalready know that you are.
Now you are the ex-president of,of past president from the a HF,
(54:09):
but I would like to know how wasyour, um, how would you say,
mandate, what did you, how didyou feel with your mandate for
an institution?
Well, uh, uh, foundation thatit's, um, kind of junk as we
might say, without with these,um, eight years nowadays is
(54:31):
having the EHF and if you havesome, uh, issues through it, or
how was it possible that you,you got to be a president?
Joseph M. Schwab (54:43):
Yeah.
Um, well, so you know, thequestion about the mandate and,
and the, the organization itselfand its youth, youth and
inexperience in an organizationcomes with some benefits and
some drawbacks.
And the benefits are, are great.
You don't know what you don'tknow.
(55:03):
And so you oftentimes take onthings that, um, uh, maybe
somebody who's a little moreexperienced or a little wiser
would say, I wouldn't do that.
But you do it and it ends up,uh, you know, sometimes being a,
a big success.
Um, we have always focused, um,our main thrust, uh, for the A
HF has always been the annual,uh, meeting, um, which every
(55:28):
year continues to, to grow andgrow in popularity, in size, in,
um, offerings.
And that's, you know, my mandatefor this year was to continue
that trajectory.
Um, and the one thing I'll saythat all of us in the
leadership, uh, team of the AHF, and we have so many
(55:51):
fantastic people, um, you know,helping us.
Uh, and I mean, I can, I, I canembarrass them all by name, but
they know who they are, um, whodo amazing things to put that,
that meeting on.
Um, but you know, the goal ofcontinuing that meeting, growing
(56:11):
it, um, and trying something alittle bit new or a little bit
different every year, um, thisis the first, I would say within
the last two years is the firsttime that the entire leadership.
Team has felt like, um, whetherwe do anything or not, the a HF
will continue.
(56:32):
Like it's, it has, it's not amature organization, but it's
gotten to the point of maturitywhere it's a, it's a train
that's moving along the trackand it would take some effort to
stop it at this point.
So we, we all feel verycomfortable with where we're
moving.
As an organization, um, I amexceptionally proud of the fact
(56:52):
that we get to hand over thereins to Dr.
Charles Lowry, who is my vicepresident.
Um, he's an incredibly skilled,uh, gifted surgeon.
He's an incredible person.
He's an incredible visionary.
Um, and I, I couldn't think of abetter person to hand the
organization off to.
And it, it's, it next year isonly gonna get better.
(57:14):
And I don't know how, and Idon't know why, and I don't
know, I don't know when, butit's going, it's gonna just keep
getting better and better.
So it's, it's been a, it's beenone of my professional
highlights, um, of my career isto, to be honored to, to work
with the people at the AnteriorHip Foundation.
Francisco Gomez Torres (57:34):
That's so great to, to hear the, the ne
The next question will be, uh,what did you see for the future
of the A HF?
Where is it pointing?
Because we did have, uh, likethis European meeting last
month, so I would like to know,how do you say, do you, would
(57:54):
you see the a HF maybe in thenext five years or any point you
would like to, you know, figure
Joseph M. Schwab (58:03):
Well, the, the good news about being the, the
immediate past president is Iget to say all sorts of wild and
crazy things that we could do inthe next five years.
And I have to, I get to rely ona whole other group of people to
make it happen.
But, um, you know,
Francisco Gomez Torres (58:18):
not pressure, but
Joseph M. Schwab (58:19):
there's no pressure.
I, I mean, we, we have a, wehave a vision to, to, um.
You know, kind of take a pagefrom you and expand, uh, our
outlook internationally.
Um, and whether that's throughdirect collaborations or support
of other organizations or, um,whether it's through, you know,
(58:41):
directly creating organizationsin different regional areas.
Um, we haven't quite figuredthat out yet.
But, you know, there were anumber of us from the leadership
team at the A HF who were at theEuropean anterior hip meeting,
um, and participated as thefaculty.
It was, um, a great experiencetalking with the European
(59:01):
surgeons.
It was a great, um, it felt verymuch like the same sort of, um,
collegial family environmentthat we, uh, put on for the A
HF.
Um, I know there's interest indoing this in, in Latin America,
in South America, there's beentremendous interest from the
ocean region and Australia andNew Zealand.
(59:23):
Um, and, you know,
Francisco Gomez Torres (59:25):
The Australians are, for example, a
big, big, uh, team, right?
Uh, the entire, uh, approach ishappening a lot in Australia, as
I can see.
Joseph M. Schwab (59:35):
they're almost 40% anterior approach.
Yeah.
Um, and you know what, I knowI'm answering questions, but I
just got one that came in onLinkedIn that I, I'm curious to
hear your thoughts on.
Do you have experience, I'mdoing anterior approach through
a bikini incision, and, uh,that's question, that's the
first part of the question.
And the second part is, can yougive from your perspective, um,
(01:00:00):
uh, an outlook on computerassisted or computer navigated a
hip replacement surgery inMexico and Latin America?
So bikini incision and computerassisted computer navigated
Francisco Gomez Torres (01:00:15):
Well, I can tell you, that about talking
about the, the bikini incision.
I even had got a, a earlierdiscussion through LinkedIn with
you where we were discussingshould it be, you know, like
horizontal, uh, vertical, uh,you know, angulated with a, a
Glip.
(01:00:35):
So as you, I would like to, topick this, uh, quest.
These, um, words you told methat is not what the incision is
creating is that you have tounderstand that there has been
plenty of patients, a lot,millions, if not, that are
(01:00:58):
having better results in anykind of incision is not the
incision for start.
Now if you are asking about, um,the issues one or the, or the
other, have, we can say thatthe, the vertical incision, it,
uh, break more longer handslines.
(01:01:20):
So there might, there you canexpect a little bit more of, uh,
healing tissue issues, but doingit, uh, through a bikini
incision, it might be, you know,you might attend to that
question, but, um, the bikiniincision is not, uh, extent of
(01:01:42):
having, uh, cutaneous problemsalso, you know, but it might be
a little bit more aestheticbecause you are close to the, to
the, the part where the skin,uh, faults.
But I mean, it's not the mostimportant, uh, part of the
surgery and.
(01:02:03):
To, to, to close that question,I would like to say that you
have to be comfortable with the,the work you are having.
You have to, to think in what'shappening inside or even deeper.
And the bikinis just, well, thesignature, you know, that you
will keep performing bare day byday.
Joseph M. Schwab (01:02:24):
You, you have to know what you're doing under
the skin and to make the, thequality of the incision be the
deciding factor about
Francisco Gomez Torres (01:02:33):
yeah,
Joseph M. Schwab (01:02:34):
or not.
yeah.
I agree.
Uh, and how about computernavigation?
Francisco Gomez Torres (01:02:38):
Yeah.
Well, I do, I, I, I haven't beenable to, to perform a robotic
assisted surgery with a directanterior approach, but I do have
some colleagues that are doingit right now with the Macco
system.
I can't even tell you that.
Uh, a month ago, the, first RosaHip, uh, surgery was performed
(01:03:00):
at the very next door of asurgery I was having.
So, and it was another colleagueof mine who I do anterior
approaches with him sometimes,but, um, I, I do know the
patient is going excellentthrough with that system and
with that direct anteriorapproach, it is possible about
(01:03:22):
doing, um, uh, navigation.
Surgeries.
I haven't done it, done them.
I think, um, I don't know.
Well, my generation is notlooking forward a lot into
navigating, but we do are, weare having the whole attention
(01:03:44):
to the robotics, um, issue.
Maybe I even have well in, inbetween my eyes.
The case of Dr.
Za and the team in use, he is,uh, developing to, instead of
having like this whole roboticarm, you just have your machine
(01:04:05):
gun in the hands and perform thesurgery.
Joseph M. Schwab (01:04:09):
Do.
Uh, I'm curious, do you thinkit's more likely that an implant
company or that a, a companylike a Johnson and Johnson or
Zimmer Biomet, um, would be morelikely to bring down a robot to
Mexico than they would a new setof implants?
Um, it it just because of thesize, uh, and impact that, that
(01:04:30):
might have.
Because I, I'm curious to hearthat you have Rosa, but you
don't have concise, and you justgot trabecular metal five years
ago.
You know, that's, that'sinteresting.
Right?
Francisco Gomez Torres (01:04:41):
Yeah, that's the way the cocky crumble
is as somebo, somebody said.
But, uh, I think, I think, uh, Iwould like to take your words
again, doctor, because I, as Itold you before, you are like a
mentor in a center certain,certain remote way.
I think the most important thingmust be to have a centered
(01:05:05):
approach, uh, uh, centeredpatient approach.
It's not about the tech.
It's not about the market.
It's not about the new robot,the new hip, the, the new
implant.
It's if the patient is havingbetter results, we should do it.
If it's just because there is anew robot on the market.
(01:05:28):
That's not the objective or, orthe reason why the robots should
come here or the new set ofimplants.
If we have the evidence that isworking.
Okay.
There is a, there is a reasonto, but if you're having the
robot and your results are beingjust even uglier than the
(01:05:51):
traditional approach, well maybeit's not what you have to be
looking for.
Right?
So,
Joseph M. Schwab (01:05:58):
Interesting.
Well,
Francisco Gomez Torres (01:06:00):
yeah.
Joseph M. Schwab (01:06:01):
Dr.
Gomez Torres, I wanna thank youfor, for really actually being
kind of our test subject righton doing, uh, a live a HF
podcast and engaging, uh, with alive audience.
We've had, uh, you know, apretty steadily, about 15 to 20
people watching us.
We've had, I think, someexcellent comments and
(01:06:24):
questions, uh, from our users.
And, um, I, I just want toencourage you, everything you've
been doing to engage with theinternational orthopedic
community, uh, I want to sayyou're an inspiration to, to
other surgeons, and I wouldencourage you to keep doing what
you're doing keep fighting thegood fight.
Francisco Gomez Torres (01:06:45):
Thanks a lot Joe.
It's such an honor to be part ofyour guests.
Guests.
Now, I can't say, um, that maybehaving a podcast and do these
international, uh, meetings, um,you know, to get some friends
and stuff will take me to thisplace now, now.
(01:07:06):
I wouldn't imagine that.
So I'm really, um, thankful withyou, with, uh, Lila, with all
the whole a HF for the OracleFellowship, everything, because
these things happened.
Just because you are not seatedwaiting for the date to pass,
you have to keep pushingforward.
(01:07:27):
So I do, um, would like to sayonce, once again, thank you for
hearing and thank you for havinga feedback, a feedback for me
and well, Latin America.
I hope they, they hear yourwords.
Joseph M. Schwab (01:07:41):
I, I, I hope they hear your words, and I'm
gonna take a moment to bringLila on.
Um, just to thank her for, uh,doing this in the background.
Lila, thank you for, uh, for,uh, being on the, the podcast.
Oh.
Have you muted yourself?
Uh, excellent.
Um,
Lilah Menashe (01:08:02):
Can you hear now?
Joseph M. Schwab (01:08:03):
now we can hear
Lilah Menashe (01:08:04):
Oh yeah.
Hi.
It was such a pleasure workingtogether and, you know, looking
for different topics to discusstoday.
Uh, you were very committed, Dr.
Gomez Torres, so I reallyappreciate it.
So, for all our listeners, ittook a little bit of work and
effort from all us to put ittogether.
So I, I just hope you enjoyedit.
Joseph M. Schwab (01:08:25):
and we
Francisco Gomez Torres (01:08:26):
Even, the earthquake,
Joseph M. Schwab (01:08:27):
to do it again.
Yeah.
Even through an earthquake.
Oh my gosh.
I hope everybody's okay.
All right.
Thank
Francisco Gomez Torres (01:08:35):
was the announcement that the HIV was
happening right now.
Joseph M. Schwab (01:08:39):
That's created the earthquake.
Well, thank you Dr.
Gomez Torres.
Thank you, Lila.
Um, I'm gonna, yeah, we'll dothis here.
And, um, I just want to saythank you, all of you, uh, for
joining us for this live episodeof the A HF podcast.
And if you can please take amoment to like and subscribe.
(01:09:03):
You'd be helping us find morepeople just like you to share
this type of content with.
And if you have any ideas for afuture episode or topics you
wanna see us discuss from anyportion of the world, drop it in
the comments below.
You can find our normal episodesof the a HF podcast on Apple
(01:09:23):
Podcasts, Spotify, or in any ofyour favorite podcast apps, as
well as in video form on YouTubeslash at anterior hip
foundation.
All one word.
New episodes of the A HF Podcastcome out on most Fridays.
I'm your host, Joe Schwab,asking you to help keep the hips
(01:09:45):
in Latin America and whereveryou are happy and healthy.
I.
Hello and welcome again to the A HF
Podcast Live.
Today on the Anterior HipFoundation podcast, we're gonna
be joined by Francisco GomezTorres, an orthopedic surgeon
and innovator, and a passionatevoice for Latin American
orthopedics.
And interestingly enough, therewas an earthquake today, not too
(00:47):
long ago in Mexico, and thatcaused a little bit of our delay
to the broadcast.
So we're happy to know that, uh,Dr.
Gomez Torres is safe.
That he's gonna be joining ushere momentarily.
Dr.
Torres from founding Osteo FITTin Mexico City to shaping the
next generation throughmentorship and global
(01:08):
collaboration, he's redefiningwhat it means to lead with both
skill and heart.
Whether in the or behind apodcast, Mike or climbing a
mountain, he's on a mission torestore movement, inspire
others, and elevate equity insurgery worldwide.
(01:29):
Dr.
Torres, welcome.
I hope you're okay.
Is everything okay in Mexicowhere you're at?
Francisco Gomez Torres (01:37):
Hello.
Yo, it is really nice to hearfrom you I'm so sorry to be this
late, but guess what?
Welcome to Mexico City.
There was just, an earthquakeand the whole hospital was um,
downstairs.
We are up here right now.
It's so good to, uh, greet you,again.
Thank you, again for invitation.
(01:59):
How are you?
Joseph M. Schwab (01:59):
I, I'm, well, I'm just happy to hear that you,
are safe and, and well, and, uh,hopefully your, your patients
and your staff and, and yourfamily are safe as well.
So, thank you for joining me
Francisco Gomez Torres (02:12):
I, thanks to you Joe.
I would like to start just, um,telling you, do you, don't you
miss these kind of experiencesback in Switzerland?
Joseph M. Schwab (02:28):
It's been a while since we felt an
earthquake here.
Yeah, no.
Um, but I really wanna
Francisco Gomez Torres (02:35):
you, you are missing it.
Joseph M. Schwab (02:36):
yeah, yeah.
I'm sure.
I, I'm really interested inhearing, we had a chance to talk
briefly at the a HF meeting inNashville in June.
And, um, but I'm interested foryou to, to, kind of tell me
about and share with ouraudience a little bit about what
inspired you, um, to pursueorthopedics and specifically how
(02:58):
did you end up, uh, gettinginvolved in hip surgery and in
anterior hip surgery?
We, we learned it's quiteuncommon in Mexico.
Francisco Gomez Torres (03:09):
Yeah.
Yeah, you're totally right.
Well, I would like to start, um,telling you that since I was a
kid, well, I was really exposedto medicine because both of my
parents are doctors.
So my, my mother is a familydoctor and my father was a
surgeon.
Uh, since there, I do rememberto be the whole time with them,
(03:32):
I was raised with another twobrothers who are not at all
doctors.
They see blood and they getdizzy.
So I was the one, they were justsmuggles.
So after, after I, uh, wasexposed to this, I kind of like
(03:52):
it.
Um, I studied medicine back inMexico State.
I even, um, got, um, this, I waslike the president of my, um,
class.
So I, I was always.
Pursuing, um, this kind ofliving.
Um, and from there, when I wason the, on my internship, I had
(04:18):
the chance to have theserotations, uh, through general
surgery, orthopedics, internalmedicine, pediatrics and stuff.
And I saw that orthopedics waslike the most, um, how you say
it decisive.
You, you, you perform, somebodygot broken, you perform a
(04:40):
surgery and it's healed a monthlater, which is something like,
for example, internal medicinedoesn't have to, you know, you
know how to treat, uh, diabetic.
Maybe you can control theirissues, but it'll take years.
Well, I mean, it's not even, uh,there's not even a treatment
(05:03):
right now.
No, maybe soon.
But that, that was the way Ichoose orthopedics.
And then I got a doctor who, ona vacation, he told me, you
should come to me, uh, to the,to the surgery room.
We can see if you like it.
(05:23):
And damn, I saw, uh, uh, hipsurgery that day.
I say, yes, this is the thing.
So I studied for my, um,specialty exam.
I was the number 16th of thewhole country.
So I
Joseph M. Schwab (05:42):
Oh wow.
Francisco Gomez Torres (05:42):
the chance to choose.
And after that, well, the restis history.
I studied in a, in, um, ims,which is like the biggest public
service in Mexico.
I'm from there.
After COVID, I started, um, tocreate these kind of congresses
for, uh, students and to joinsome leading voices about
(06:07):
orthopedics.
And a doctor, Dr.
Victoria Manuel, I was one of myguests.
He was delighted because of theeffort, and I think that's, that
was the way he invite me to joinhis team as a fellow surgeon at
(06:28):
the national, uh, rehabilitationInstitute here in Mexico, where
I learned hip and kneereconstruction surgery with him.
He's like a mentor to me, and I,I do appreciate the way he
taught, uh, teach taught us, uh,on that time.
(06:48):
But, um, as.
Here is where the story starts.
Uh, uh, some, some months ago Iwas reading, um, this, this book
Dr.
Ma signed for us at Nashville,and I saw that he, yeah, yeah, I
(07:08):
saw, I saw he have a mentor ofhim, of his, who was performing
surgeries, uh, in a posteriorway or maybe a lateral approach.
And when he decided that thiswasn't the most natural way, uh,
it was because he have thechance to hear fromelles, you
(07:31):
know,
Joseph M. Schwab (07:31):
Mm-hmm.
Francisco Gomez Torres (07:32):
he, he.
Writes on his book that thefirst time he saw him, it was
because Dr.
Letell was doing, uh, a tabularfracture through a anterior
approach.
But then he decided to join himin Paris, where Dr.
Letell was performing, um,anterior approaches to, for hip
(07:55):
prosthetics, and that he evenhad, uh, a table for it.
So it was like for me, maybe 30years later, but it's the, the
same history here in Mexico.
I don't know if it's a culturalmatter, but the anterior
(08:15):
approach is, might be, it mightbe not the most, um, acceptable,
um, approach for the leadingsurgeons today.
I
Joseph M. Schwab (08:29):
In Mexico specifically.
yeah, And we'll get into alittle bit about, uh, I'm gonna
wanna learn a little bit aboutwhy you think that is and how
you think that might change, butwe'll get to that.
Francisco Gomez Torres (08:41):
Sure, sure.
I, I'm your guest today, so I'mso happy to answer your
questions as well.
I do have some questions for you
Joseph M. Schwab (08:51):
Yeah, of course.
Francisco Gomez Torres (08:52):
I, I can, I can see you as, as a
mentor also.
I, I think I do have a lot of,um, to learn from you and the
whole a HF uh, uh, crew.
Joseph M. Schwab (09:07):
Yeah.
Well, I think the a HF itself isa community of learning, so we
all learn from each other andthere's, there's a lot that we
can learn by having these sortsof conversations, both locally,
nationally, and, andinternationally.
Yeah.
Francisco Gomez Torres (09:22):
Yeah.
For, for example, I would liketo know if the anterior approach
was all, uh, the beginning foryou or if you have to.
Make this switch betweenapproaches when you first
started.
Joseph M. Schwab (09:37):
Well, most of my, uh, residency training was
in posterior approach and directlateral approach.
And, um, I first saw anteriorapproach at a course when I was,
uh, later in my residency years.
And I thought it was veryinteresting.
I got to meet Dr.
Matta, he taught the course.
And, um, uh, when I came backinto practice after doing my
(10:02):
fellowship in Switzerland, whereI saw some anterior approach
towards the end, um, I decidedthat I wanted to start my
practice doing all anteriorapproach.
So when I began my practice, Ijust started doing anterior
approach right away from the getgo.
So my training was, uh, a littlehaphazard.
(10:23):
It's different than it was, thanit is nowadays, uh, for sure.
Um, but uh, but we, we made itthere.
So that's, that's how I ended upwith anterior approach.
But that leads me to a question.
Was there, you talked about howyou, uh, kind of found a mentor
in, in hip and kneereconstruction surgery.
was, there A particular case orpatient or conversation that you
(10:49):
had during that training thatmade you feel, this is exactly
where I'm supposed to be, thisis what I'm supposed to be
doing, and that confirmed thedecision you had made?
Francisco Gomez Torres (11:00):
For sure.
I must say that, for example, inthis, in this practice I had as
a fellow surgeon, it's always inthe very same.
Now you, you can't change theapproach because you want to,
you have to follow strict rulesbecause this is the school we
teach in, in this institute.
(11:23):
Or for example, as I told youbefore, I was, um.
A couple of months ago, I wastrying to, uh, I was working in
a, in IMS where they do havetheir own school.
They do, uh, hips laterally,mainly, mainly, and I heard from
(11:45):
this colleague, a doctor whohave learned the interior way,
um, in the us He was performinghis cases, uh, under the water,
as we say here, because hewasn't allowed to, well, this
doctor even got punished.
He, they took his consultationand he was changed, uh, to
(12:09):
another service.
So I think this, uh, the, theway I have been in touch with
the anterior approach is mostlywith colleagues of mine, friends
who, which I do perform hipsurgeries, but in.
Our own.
We have our own patients, ourprivate, private patients, and
(12:33):
we gather, you know, we gather adoctor from Central Mexico City,
a doctor for, from Bolivia, whonow works here in Mex, Mexico
City.
And I myself, and we do performthe entire hip surgery in on, on
in our own way.
You know, as the way we learned.
One of my friends learned at theHip Institute with Dr.
(12:56):
Uh Dom, for example, and thisother friend of mine learned in
Magdalena De La Salinas, whichis a hospital here in Mexico
City, and I did my own thinglearning through them.
And through you, for example,and you know, like this, like
drop water drops.
(13:18):
I have been learning on my own,as you said before, I'm kind of
an entrepreneur, but I'm lookingfor my practice everywhere.
I even went to Switzerland, uh,at Pass Basil where I had the
chance to perform with Dr.
Carl Stoffel, which I do, Iadmire a lot.
(13:38):
He taught me some tips.
I went to the AO courses, uh, attables at Luer.
So it's all kind of a mix.
You have to look for your ownway and more than look for it.
Create it in some, some way.
Yeah.
Joseph M. Schwab (13:56):
It.
Give me a little bit of an ideaof what the, what's the, medical
care system like in, in, atleast in Mexico City, and is it
the same all throughout Mexico?
Is there nationalizedhealthcare?
Is it private?
Is it a mixture of public andprivate?
Tell, tell our listeners alittle bit about how healthcare
(14:17):
is delivered in Mexico so we canunderstand the environment
you're working in.
Francisco Gomez Torres (14:23):
Sure.
in Mexico we have, uh, twodifferent ways of doing things.
The, the first one is the, um,the public one, which is divided
mostly into three institutions,which, which are IMS is there,
and, uh, which is, um, health ingeneral.
(14:47):
These three services are thepublic ones.
Yeah.
so we are, um, how do you say,uh.
We do have, uh, um, we're stuckto the, to the money the
government gave us to performsurgeries.
(15:07):
So, for example, to do ananterior approach, you know,
better than me, that maybe wedo, we need special, um,
instrumentation to place this,this, um, uh, how do you say
prosthetics?
So it's kind of hard for the,the government to, to pay No.
(15:32):
And through the public to theprivate one.
Well, we do have the, theinsurances, which do mostly in
the biggest hospitals like this,like hospital Al.
But there is also a way wherepeople can pay on their own
without having, uh, aninsurance.
(15:53):
So.
There are three kinds.
No public, private, or a hybridone.
Yeah.
Joseph M. Schwab (16:01):
Self play.
Self pay are there.
So when we had, um, a RichardField from the UK came and gave
a talk at the Anterior HipFoundation about, uh, anterior
hip replacement in the uk, whichis only about 1% of, uh, of hip
replacements between one and 2%.
(16:21):
Um, Mexico is similar in itspercentage, but he also
described there's the publicsystem, there's the private
system, there's the self pay,and then there's also the public
system that, for lack of abetter term, contracts out
certain types of, uh, cases tothat they are, are not able to
(16:44):
handle within the publichospitals, to private
institutions who will takepublic patients.
Does that also exist in Mexico,or is that aspect not a, is that
not similar?
Francisco Gomez Torres (16:57):
yeah, yeah.
It does exist, but it's not likethe biggest, uh, way of doing
things.
It's mostly because thehospitals are very crowded, so
they choose to deliver the, thiskind of patients to, uh,
specific, um, center.
You know?
But I have only hear of thatmaybe here in Mexico City and
(17:21):
maybe in Monterey andGuadalajara.
So it's not like the most commonthing.
But I think things are going tothat way because the public
service, it's full, it'sovercrowded, uh, awfully.
Yeah, we do have that problemhere.
Yeah.
Joseph M. Schwab (17:38):
Yeah, the o the overcrowding problem.
Um, how much do patients in thepublic system in Mexico, how
much do they have input into howthey want their care to be
delivered?
So could somebody in the publicsystem say, I, I want an
anterior approach, hipreplacement, all as uncommon as
(17:59):
that might be in Mexico?
Could somebody say that andexpect that that's what they
would get?
Francisco Gomez Torres (18:08):
I must say the patient doesn't have,
uh, an option when they arethrough the public service.
It's mostly, uh, the decision ofthe service, maybe the decision
of their surgeons.
Uh, but no, as far as I know,the patient doesn't have their
(18:28):
right to choose, but they cantalk with their doctor, and if
he does now the entire approachmaybe.
It's a possibility.
Like in that hospital, I toldyou before, the doctor that was
doing his own, uh, anteriorapproaches, but he got, I mean
he got, uh, he got punished.
(18:50):
It's crazy.
Joseph M. Schwab (18:51):
Yeah.
Well, and and that leads me tomy next question.
If you could change one thingabout how anterior approach hip
surgery is either perceived orpracticed or it sounds like it's
not taught much in LatinAmerica, in Mexico, um, what
(19:13):
would that be?
What would be the first thingyou would change?
Francisco Gomez Torres (19:17):
Yeah.
Well, I think there is acultural problem because of
doctors that are not willing tochange their approach.
I think that's the biggestthing.
The big names, the names thathave been with us a lot of time,
they are accept or they doesnot, do not want to change this
(19:39):
kind of, uh, technique.
Mostly because, well, they don'twant to lose their.
Power position.
you know, as we saw inNashville, as I have been
watching through the days,during my, uh, surgeries, the
surgeries of my friends or co orcolleagues, and we see this kind
(19:59):
of better results.
I, I don't remember a doctor whotold me in, in Nashville, the
worst, uh, plant is the one thatdoesn't want to see, and that
was Dr.
Mar.
So it's crazy how we are so, soret to say, no, no, keep it
(20:21):
lateral.
Keep it posteriorly because it'sthe bear.
I even had a discussion with afriend of mine, I mean, a friend
of mine told me the posteriorway is the way.
I was saying like, dude, you arelike a shoulder surgeon.
Why are you talking about hipsurgery?
That that's the way it's likediscussing about the football.
(20:43):
You know, football is somethingbig here in Mexico and people
gets, it breaks relationships.
It was the same with this guy.
He was saying, why are, yeah.
Yeah.
Go lambster.
Joseph M. Schwab (20:56):
I, I, I, no, that's okay.
I was gonna say maybe it'll takea famous, uh, footballer from
Mexico to get an anteriorapproach, hip replacement
someday to change the
Francisco Gomez Torres (21:06):
you're talking.
Yeah, yeah, yeah.
I, I do remember having afootball coach.
Um, he was already retired, buthe was a very famous, uh,
football player back in the day.
He have anterior approach andhe's doing great.
He's still playing football.
You know, he, he tells me thatwhen he's playing football
(21:31):
nowadays he plays, but when theother, um, teammate comes to
closer, he just drops the ball.
Joseph M. Schwab (21:38):
yeah.
Francisco Gomez Torres (21:39):
But he's playing football.
It's crazy.
He shoots and he scores from faraway.
He has it still, but, you know,it's crazy.
And people, people doesn't, uh,maybe they don't know that yet.
I think another
Joseph M. Schwab (21:55):
know that.
Yeah.
That he's had a hip replacement.
Yeah.
Francisco Gomez Torres (21:58):
Yeah.
Yeah.
Maybe the thing I will try tochange will be, um, making this
info even more, um, availablefor people that wants to, to get
better results.
Not, I'm not talking aboutpatients because patients do
(22:19):
come and they ask for the AMIapproach, but I mean, through
another colleagues, you know,through doctors, through another
hip surgeons That are stuckbecause they learn that way as
the way I learned back for yearsago when I was doing orthopedic
surgery, but not a following hipreplacement.
Joseph M. Schwab (22:42):
So talk to me a little bit more about the
group of orthopedic leaderswithin, um, the Mexican
community who have, um, maybesome, uh, some oversight over
what They, perceive to bequality and what they perceive
to be the right way to dothings.
(23:03):
Is this a formal structurewithin the Mexican orthopedic
community, or is it, is it a bitmore informal and um, uh, you
know, is this, is this the elderstatesman, so to speak, or
stateswomen of the, of theorthopedic community who are
telling you, quote unquote, theright way to do things?
Francisco Gomez Torres (23:25):
Yeah, well, I think mostly of them.
It's not like a formal, um,group.
It's this.
Bunch of groups that have beenthrough a lot of time.
They, they, for example, they dowork a lot with the insurance,
uh, companies.
They have been there forever andthey keep growing because they
(23:47):
do accept more fellows, more,more, uh, doctors to join their
team as they are the voices thatresonate between us.
Um, they are the ones that haveto change, I guess.
I mean, not very easy for me toraise the voice and to make
(24:10):
people hear me, but little bylittle as what a lady was
telling me yesterday, uh, wehave an, uh, an interview with,
um, a social activist who toldus, don't you ever give up.
Just if you can change a persona day, it's okay.
I think.
(24:30):
We have to keep pushing withthis kind of efforts.
I don't know, uh, Joe, if youwill have the metrics of this
speak layer, but I would like toknow if Latin America is
listening because we did have alot of, uh, talks with our
friends back in Brazil, Chile.
(24:51):
Uh, I don't, I even have adiscussion with, uh, uh,
research team in Egypt, uh, whois committed, was committed to
hear this talk.
I think we have to keep pushingto, to make people's mind
change, especially these ones,these big guys, uh, that have
(25:13):
been there forever and that arenegative about the anterior hip.
But just because they have, theydon't know it.
Maybe they are, they don't wantto change.
I mean, 20 years doing the sameprocedure the very same way.
I do understand that.
Um, they might be in a comfortzone, but for example, Dr.
(25:36):
Sa also talks about, uh, histransition through the, from
posterior to anterior, which issomething crazy for me.
I, I, I, I, it's kind ofremarkable for me because it's,
uh, 180 degrees, uh, change.
It's totally different.
But I can say Dr.
(25:56):
S is having great results, andhe even talks about it in his
book also.
So.
Joseph M. Schwab (26:02):
Yeah.
And, uh, just to, um, just to,uh, address one of your, uh,
comments there.
We've got live about 15 peoplewatching us right now, which is
for a first live podcastepisode.
I'll take it.
And I wanna remind those userson YouTube and on LinkedIn that
in the latter half of thisdiscussion, if you have
(26:23):
questions, uh, for Dr.
Gomez Torres or for myself.
Um, we've got our producer Lila,behind the scenes and she is
feeding us the best comments andquestions, um, that you leave.
So please feel free to be a partof the conversation.
We would love to have you.
I wanted to uh, sort of followup because one of the things
(26:46):
that you seem to have done orseem to have put together in
your quest to bring anteriorapproach to Mexico and to Latin
America is you have really, uh,made a lot of international
connections or madeinternational global outreach
something, um, that somethingthat's part of how you learn,
(27:11):
but also how you connect.
Um, how do you stay engaged withthe orthopedic community
internationally?
How do you cross borders likethat?
Francisco Gomez Torres (27:23):
Well, I, can, I would like to say that
since I was a kid, I was like areally friendly guy.
you know, I, I don't know.
Why is it easy for me to talk topeople and to, you know, I.
To know if we can be friends orno, you know, it's okay if we
don't agree in everything, but Ido like this kind of
(27:46):
communication.
I don't want to be flat with thepeople.
I want to know a little bit ofthem and if they want to know
for me it's okay.
So I think it's my, the way I dofriendships with people that
took me.
I, I took it internationally.
I say, I am making friends allaround Mexico.
Let's try in Switzerland.
Let's see if I can make somefriends there.
(28:09):
I did make some friends and theywere, um, for lucky, lucky me.
They were a officers.
So then I got, uh, engaged withthe AO Foundation, and I do love
that.
I am working nowadays with themalso.
Uh, for example, uh, when I wentto Nashville, I did find this
(28:30):
group of very enthusiast, uh,colleagues, which are the
Berkeley fellows.
I can tell you that everybodyhas a special talent, uh,
especially for example, Dr.
Amed Omar from Egypt.
He, as soon as I got, uh, intouch with them, with him, we,
(28:51):
we had a click and.
I was invited to participate inhis research group, which is,
um, an author of, of More Than50 Research, for example.
No.
And, and he is encouraging,encouraging his students to, to
(29:12):
do a do as he to publish andpublish and publish.
So I can see that that's thetrue benefit of having
friendships that matters.
You know, it's not just beingfriends, it's trying to work,
uh, together.
Um, in, in back in Nashville,for example, I was looking for
(29:36):
maybe any chance to, to get, uh.
Uh, traveling Fellowship info.
That was another thing I waslooking for.
It's not just talking fortalking, it's with a purpose.
No.
To get in touch with people,maybe searching for, um, the
exchange of benefits.
(29:57):
If I can do that, the entire hipfoundation, uh, put some
attention of them in LatinAmerica.
I think that's somethinginvaluable for the whole region.
If some, uh, doctors, someteachers of mine are listening
to, listening to this and theysee that maybe podcasts are
(30:20):
nowadays the way, um, televisionevolved, for example, or, you
know, the broadcasting, um, it'sa new wave, well, a new way of
communication, and I think it's.
The interior approach is thefuture of communicate.
If not, I will then be able totalk to you from Switzerland to
(30:41):
Mexico with in California.
It's crazy, but I do love it.
Uh, that's the way I, I am doingpodcast post podcasting right
now.
Uh, the last year was amazing toget in touch with a lot of
people, uh, friends from NewYork, friends from new uh
(31:02):
Belgium, some doctors from Asia,for example.
I was invited to give a talknext, uh, February on the apo,
the Asia Pacific, uh, orthopedicAssociation.
So maybe I will be there fornext February.
Joseph M. Schwab (31:18):
Mm-hmm.
Francisco Gomez Torres (31:19):
It's, it's the way things are
happening.
I'm not just sitting and with,uh, arms crossed.
I'm looking forward to connectwith people, as you say, but.
That's, that's the way thingsare happening.
I am.
Joseph M. Schwab (31:37):
So you, you clearly have an interest in
technology and you have aninterest in using that
technology to not, not only tolearn, but also to teach and to
engage.
I'm curious about your use oftechnology in the operating room
and let's, I just wanna startwith a basic question about your
your setup.
(31:58):
Um, do you have a technologyenabled or setup?
Is it pretty basic?
Is it more advanced?
Can you walk me through whatfeatures kind of matter most to
you in, in terms of your orsetup?
Francisco Gomez Torres (32:14):
Yeah.
Well first of all, I would liketo say that, uh, I did learn to
perform hip and knee surgeriesin the traditional way to begin
with, you know, at the veryfirst I wasn't able to, uh,
manage their robotic arm.
But nowadays we can do, we dohave access through this kind of
(32:38):
technology, especially in theprivate sector about the public
sector is a little bit hardbecause of the economics.
But now that we do have thiskind of, um, liberty to, of
freedom to choose.
Well, we do perform with arobotic surgery in a site.
(32:59):
Uh, we do have a, a tech guy,uh, who is taking care of it.
Um, when we are performing some,um, surgeries, we do have this
kind of, um, how do you say,like the, like the belly system,
you know, to, to match the prethe prayer and the postop, even
(33:22):
with a pre, uh, trans, um, uh,visualization of if we are okay.
Uh, so I can say it's not likethe most equipped, um, um, or,
but it's not also like the mostbasic one.
I think we do the, the fourselves.
(33:44):
Uh, I think there are doctorswho are more, um, in a need of
having everything, uh, but.
I, I'm kinda, I don't want toget so, so used to this kind of
technology that then I don't, I,I kind of forget how to make
(34:06):
them traditionally because,well, another thing I would like
to say is that apart from MexicoCity, I do perform surgeries
across the country.
So I try to go, I don't know,maybe California, sometimes
mores, maybe South Mexico.
We do try to help in differentways, uh, to the people.
(34:29):
Sometimes I do work, I performsurgeries with another, uh,
surgeons who asked for my help.
Were, were, um, kind of a, um, aMexican, um, how do you say?
We try to communicate to makethings possible, but that's
Joseph M. Schwab (34:48):
Sure
Francisco Gomez Torres (34:49):
the way I don't have a robot
Joseph M. Schwab (34:51):
within the, okay.
Interesting.
Francisco Gomez Torres (34:54):
I do collaborate a lot.
Joseph M. Schwab (34:56):
do, do you, um, find difference in access
to, to implants, differentquality of implants depending on
the place that you're operatingat, whether it's public or
private, or do you pretty muchhave the same type of implants
available wherever you are?
Francisco Gomez (35:15):
Unfortunately, I, I don't know if that's
unfortunate, but no, I do havelike a, a whole options of, um,
implants.
Uh, I do, I would like to saythat I do have my favorites.
You know, I do perform mostlywith three kind of uh, implants
(35:35):
But you know, if I am back inMexico State and they got these,
these prosthetics because of thebudget, let's make it, you know,
uh, so I think.
That we do have to be also very,um, versatile with these kind of
(35:56):
mires.
If you get used to a singlething, um, it can be, you can
get into a trouble later.
Um, and maybe it's the time forme, maybe later, um, when, when
I, uh, you know, um, basetotally my, my practice into a
(36:17):
single uh, thing, then I willstart doing with only one
implant, one kind of implant.
But nowadays I'm trying fromeverything.
Joseph M. Schwab (36:29):
We, we have a question from one of our users
on LinkedIn, um, about,specifically about implants, but
about custom 3D titaniumimplants.
Wanting to know if you have any,um, experience with those
implants, and if so, if you'veencountered any challenges with
them.
Francisco Gomez Torres (36:49):
Well, we do have a friend of us who is
mostly into this.
Um, with this technology, thething that we have found is that
after you have the cuts withhave to be really specific
through a TC for a C forexample.
Um, even when you perform.
(37:11):
Very good.
The surgery, um, you can'texpect, you can expect
everything because as it is aper a treat, d personalized, uh,
a personalized, uh, system, youdepend a lot in the activities
this person is doing.
We don't have the record of howthis implant is going to work
(37:33):
because it might be, it's sopersonalized that you can't have
like rep reproducibility, um,of, of, um, how you say, um,
cases before.
No.
So every case is different.
We even have one day this, thisperson that, uh, the implant
(37:55):
just came off from the, from IACbone and we have to, to reenter
and to, to fix it with morematerial, but you know.
That was an experience we don'twant to have again.
And we have had more, um, alittle bit more of experience
(38:19):
with the trabecular implantsthat, um, you know, these,
these, um, I, I did forgot the,the name, but we do have more,
more practice with monds, withalmonds.
It's mostly more than 3Dprinted.
Besides that it's expensive aswell.
(38:41):
The 3D printing thing.
Yeah, I.
Joseph M. Schwab (38:44):
Um, we do have one, uh, user who commented on
LinkedIn.
Um, and I'll, I'll just read thecomment that I have here.
It says, I believe that thereality of the Mexican
healthcare system is so similarto the rest of Latin America.
And so different from theAmerican healthcare system where
decisions often depend not onwhat the patient wants or what
(39:06):
the surgeon prefers, but on whatis available at the time of
surgery in each case.
Is that your experience?
Francisco Gomez Torres (39:15):
Well, I have to say Joe, that I have
heard that a lot of times.
What about you?
Do you find it like, uh,something crazy because yeah,
it's a reality in the publicservice here in Mexico.
Yeah.
but I don't know.
I don't know that maybe inColombia is very different.
Columbia is kind of more privatething.
Joseph M. Schwab (39:38):
Um, my, so my only experience operating in
Latin America was in Nicaragua,um, where we had an opportunity
to go, um, as an educational,um, exchange when we were
residents and what I recall fromthe.
Uh, cases that.
(39:58):
we did in in Nicaragua, at leastat the place where we did them,
um, the patients had to buy theimplants out of, out, basically
out of pocket.
And so it was, you put inwhatever they could afford, um,
and if they couldn't afford, youtook whatever you had that was,
you know, on the shelf if therewas something available or that
(40:20):
could be donated by a company.
Um, but it was a, anexceptionally different
situation than what I'veexperienced in the US healthcare
system and certainly differentthan in the, in the Swiss
healthcare system.
But it also sounds like it,that's a bit different.
Yeah, a bit different than whatyou experience in Mexico City.
Francisco Gomez Torres (40:39):
Yes, yes.
I can say that.
Well, here as, as the p as thepopulation is growing, um, like
never before.
The, the, the population isstill growing as fast as 30
years ago, maybe a little bitmore.
Um, the, the institutions, Theyget, uh, stuck into trouble.
(41:03):
We even had, uh, like 15 yearsago, the, how do you say, the
pensions, the jubilations.
Joseph M. Schwab (41:09):
Yeah,
Francisco Gomez Torres (41:11):
They were, took off the, of the
federal budget because itwasn't, um, possible affordable
for the government to keep thosepayments.
So nowadays, uh, we don't havejubilations anymore.
It's something crazy.
You will have to work until you,you, you are incapable of.
(41:33):
But it's mostly because we don'thave the budget already.
So imagine if that's the way,uh, things are happening.
You can expect anything from apublic service, uh, to give you
on, on a prosthetics.
Yeah,
Joseph M. Schwab (41:49):
We have some great.
questions coming in.
I wanna read this one fromAncon,
Francisco Gomez Torres (41:53):
that's great.
Joseph M. Schwab (41:54):
orthopedic surgeon.
Um, what common mistakes do yousee surgeons make early on in
their anterior journey, and howcan they avoid them?
What have you seen?
Francisco Gomez Torres (42:06):
Well, I would like to tell you, uh, uh,
even I do feel like I am an, uh,I am a young surgeon on this.
I'm not the most experimented,uh, but I am on my cure already.
I think one of the biggestmistakes was not, Um, not, not
(42:28):
to locate the right, um,intermuscular, um, segment.
You know, sometimes I was alittle bit anteriorly, a little
bit more, or in the, in thelater cases I was creating a
little bit posterior.
So nowadays I do have like thiskind of metric, uh, not only
(42:51):
with hands, but also with thefeeling.
Joseph M. Schwab (42:54):
Mm-hmm.
Francisco Gomez Torres (42:55):
And I do, um, now I, I can initiate my
approach just right in the way,in the place I wanted to.
To make a little flip of thefascia.
That's the way to be.
I don't know you if you have anytrouble, um, because I think the
approach is the 60% of thesurgery, you know, the implants,
(43:21):
you know, when they are welllocated, uh, to exposure, expose
the femoral is another thing Iwould like to discuss.
But, uh, I think mostly it's theapproach.
You have to be real secure inthe approach and then the
surgery will just flow as youwant it to.
Joseph M. Schwab (43:38):
The, I would say the biggest mistake that I
see early learners, um, make inanterior approach is, um, some
of them, some of them don'tunderstand how many people have
come before them and have madethe exact same mistakes they've
made.
And they feel like with, assuccessful as anterior approach
(43:59):
is that if they talk aboutanything they're having trouble
with or that they're, uh, youknow, a mistake that they've
made or a difficulty thatthey've encountered, that they
would somehow be looked down onwhen, what I have found, at
least with the anterior hipfoundation.
Is a community of people whohave made every single mistake
that you can make with ananterior approach and would love
(44:22):
to talk to anybody who isstruggling, um, so that they can
help them through it.
Um, and it, it's the, the ideathat you need to hide things
that, um, are difficult for you,um, until you just get enough
cases under your belt and theyget better.
Um, there are people who, whoare out there who can help you.
And, um, you're an example ofhow you do this.
(44:45):
You reach out and you, you youknow, You cross boundaries, you
cross borders, you cross, uh,uh, cultures and, um, you try
and find answers to the problemsthat you're encountering and the
questions that You have.
Um, another question came in.
What specifically, specificallydo you think needs to happen for
(45:07):
anterior approach hips to becomemore common and even widespread
across all of Mexico?
Francisco Gomez Torres (45:17):
What will be?
Hmm.
I do think that, you know, anactualization in education, it's
a must because if you, if you,you enter a fellow, okay.
You enter into a hipreconstructive fellow, okay?
But the teachers are doinglateral approach.
(45:39):
And then the fellow ask, can wedo maybe one anteriorly?
But your, the practitionerdoesn't, doesn't even know it.
Or maybe they have here onlybad, um, bad, uh, reviews about
the anterior approach, and theyare not trying to excel this
(46:01):
myth.
No, I hear that.
It was like a crazy approach.
Oh, no, it's not, it's not anybetter than the lateral or the
posterior, just because theyheard from somebody that heard.
So I think that's the most, themo the very most important, um,
issue is to make anactualization or, or to improve,
(46:26):
um, to make it put it on thetable as an option.
Joseph M. Schwab (46:31):
The education, specifically the education.
So how, how it does, and I'mgonna ask a little more detail
about this, because one, I
Francisco Gomez Torres (46:41):
What?
One thing.
One thing?
Yeah.
Yeah.
I got you.
I got you.
Just to add a little bit, maybefor example, I am, I am,
unfortunately, I don't havelike, uh, a program to teach now
or maybe the friends of mind whoare working as freelancers or
(47:02):
their own bosses.
We don't have, like thisprogram, a specific program of,
of fellows, but we have, wewe're avid to learn the entire
week.
Well, I think this has to beinto a program.
There are no programs where theentire approach is teach.
(47:24):
I think that's the.
Most important thing, the, the,the time one teacher starts
performing Ontario, people willgo there and try to learn, you
know, as I did in Nashville, asI, as we are all doing.
Joseph M. Schwab (47:42):
And I remember early on, so nowadays in, in the
US and certainly both in the USand in Europe, it's quite common
for any of the fellowships that,you go to to learn hip surgery,
you're gonna learn anteriorapproach.
That's very common at, at many,many fellowships.
But when I was learning, therewere not as many fellowships
(48:04):
that were offering that as aregular opportunity.
And the education was mostlycoming from partnership with
industry.
Is that something that you cando in Mexico before the, the,
the, teachers, so to speak?
Um, take it on as can industrybe a help in that?
Francisco Gomez Torres (48:23):
Of course, I think that, uh, every
time I do approach with a, witha rep, uh, and they just start
talking me about, uh, their newhip system, it's okay, hey, oh,
it's really great.
This, it has, uh, trabecularmetal, it hydroxy appetite, it
(48:44):
has, uh, beamin, um, uh, how yousay Polyol?
And I say, is it possible tomake it anteriorly or do you
have any special instruments tomake it a pro, um, anteriorly?
And they say no, or they sayyes.
You know?
So I think that's.
(49:05):
The way I, I think the reps canget into this to making, um,
the, the tools perfect for theirimplants or, or to make them
unter.
I do now have, for example, Iwas talking with, uh, nowadays
with a, a new rep I haven't herebefore, and they are bringing a
(49:26):
Korean, Korean, I think it is,uh, hip prosthetics, uh, that
has its own instrumental to dowith anteriorly.
It's the first one I haven't, Ihave here, uh, hurt that is not
American, for example.
So, or, or, or like the bad, Idunno if we are, are able to
(49:48):
talk, uh, about
Joseph M. Schwab (49:50):
Hip Foundation, we are, we are free
to use, uh, product names and infact, we encourage it.
Francisco Gomez Torres (49:58):
great.
That's great because
Joseph M. Schwab (49:59):
is, how's anyone gonna know what you're
using?
If you say, ah, I use this, andthen they find something that
looks like that.
But maybe, I mean, use the name,it makes sense.
Francisco Gomez Torres (50:09):
Yeah.
Yeah.
For example, I, yeah,
Joseph M. Schwab (50:12):
you, I was gonna say, you're c we know, we
received a comment, uh, as youwere speaking from, uh, David
Ktu Morales, who says, um,exactly the point that you were
making.
We need more surgeons performingthis approach so that the
implant companies startrequesting the necessary
implants and tools, even if theyrequested them today, the
(50:33):
Mexican FDA, which he says KofaPRIs, if that's, if I'm
pronouncing that correctly,takes between three to five
years to approve them.
So, just to give an example,trabecular metal only became
available in Mexico about fiveor six years ago.
So if we want to have.
For instance, the Actis stem,uh, collared implants, it'll
(50:55):
likely take another three tofive years before they arrive.
So that sounds like exactly thepoint you were making.
There needs to be this, um,relationship with industry to
get the technology in And theimplants in to facilitate the
approach.
So, so working with industryseems to make a ton of sense.
Francisco Gomez Torres (51:15):
Yeah, I do remember, I do remember we
had a talk, uh, a couple ofweeks, uh, before, on a
Saturday,
Joseph M. Schwab (51:24):
Mm-hmm.
Francisco Gomez Torres (51:24):
a Sunday.
I was, I was talking to youthat, uh, a Johnson and Johnson,
uh, rep came to me to say, Hey,you have a great time at, at,
uh, Palm Beach.
Right?
Uh, we met you there.
Yeah.
And he was talking, we weretalking about the, the, I invite
him to the, to the office and heshowed me the implants he have
(51:47):
and stuff.
And as I was talking with him,because.
I attend to a palm beach in aneo course where we had some
kind of tech, you know, somekind of hip replacements, some
kind of knee replacements, whichwere very similar but different
(52:08):
to the ones we used inNashville, for example, in
Nashville with, we use the Sise.
He was asking me is the numberone and or number two, and then
we research.
But for example, and I, I, Iasked him, why don't we have
Sise in Mexico?
And he says, he said like, Ooh,doctor First and Mexico, you
(52:32):
should, you should seek forChile or Brazil, where the FDA
from those countries is not asbureaucratic as the Mexican one
is.
So he.
If, if that was his firstcomment is because it's a very,
uh, hard thing to make tointroduce these implants into a
(52:55):
country.
So he said you are like 10 yearsbehind.
Chile might be five, Brazil maybe three, and then it's Mexico.
Uh, you know, so, so you shouldstart looking what's happening
in Colomb or Chile to see what'scoming to Mexico.
It's like really?
Do they have king size therenow?
So king size is coming maybe in20, I don't know, but
Joseph M. Schwab (53:18):
it's, yeah.
Francisco Gomez Torres (53:18):
like some kind of
Joseph M. Schwab (53:20):
It's kinda like you have a little bit of
time machine you get to see intothe future a little bit.
It's just, uh, it'sunfortunately the present for
others.
But, um, and so I know I, I do,uh, we've been, um, talking for,
uh, for almost 50 minutes now,which is great, and I, I, but I
want to see, I know you hadmentioned you had some questions
for me and so I wanted to berespectful of your time and I'm
(53:43):
happy to answer any questionsthat you might have.
Francisco Gomez Torres (53:47):
Thanks a lot Joe.
I mean, I don't want to toextend this that much, but I
would really like to ask you asa leader you are because, well,
people that follows the HFalready know that you are.
Now you are the ex-president of,of past president from the a HF,
(54:09):
but I would like to know how wasyour, um, how would you say,
mandate, what did you, how didyou feel with your mandate for
an institution?
Well, uh, uh, foundation thatit's, um, kind of junk as we
might say, without with these,um, eight years nowadays is
(54:31):
having the EHF and if you havesome, uh, issues through it, or
how was it possible that you,you got to be a president?
Joseph M. Schwab (54:43):
Yeah.
Um, well, so you know, thequestion about the mandate and,
and the, the organization itselfand its youth, youth and
inexperience in an organizationcomes with some benefits and
some drawbacks.
And the benefits are, are great.
You don't know what you don'tknow.
(55:03):
And so you oftentimes take onthings that, um, uh, maybe
somebody who's a little moreexperienced or a little wiser
would say, I wouldn't do that.
But you do it and it ends up,uh, you know, sometimes being a,
a big success.
Um, we have always focused, um,our main thrust, uh, for the A
HF has always been the annual,uh, meeting, um, which every
(55:28):
year continues to, to grow andgrow in popularity, in size, in,
um, offerings.
And that's, you know, my mandatefor this year was to continue
that trajectory.
Um, and the one thing I'll saythat all of us in the
leadership, uh, team of the AHF, and we have so many
(55:51):
fantastic people, um, you know,helping us.
Uh, and I mean, I can, I, I canembarrass them all by name, but
they know who they are, um, whodo amazing things to put that,
that meeting on.
Um, but you know, the goal ofcontinuing that meeting, growing
(56:11):
it, um, and trying something alittle bit new or a little bit
different every year, um, thisis the first, I would say within
the last two years is the firsttime that the entire leadership.
Team has felt like, um, whetherwe do anything or not, the a HF
will continue.
(56:32):
Like it's, it has, it's not amature organization, but it's
gotten to the point of maturitywhere it's a, it's a train
that's moving along the trackand it would take some effort to
stop it at this point.
So we, we all feel verycomfortable with where we're
moving.
As an organization, um, I amexceptionally proud of the fact
(56:52):
that we get to hand over thereins to Dr.
Charles Lowry, who is my vicepresident.
Um, he's an incredibly skilled,uh, gifted surgeon.
He's an incredible person.
He's an incredible visionary.
Um, and I, I couldn't think of abetter person to hand the
organization off to.
And it, it's, it next year isonly gonna get better.
(57:14):
And I don't know how, and Idon't know why, and I don't
know, I don't know when, butit's going, it's gonna just keep
getting better and better.
So it's, it's been a, it's beenone of my professional
highlights, um, of my career isto, to be honored to, to work
with the people at the AnteriorHip Foundation.
Francisco Gomez Torres (57:34):
That's so great to, to hear the, the ne
The next question will be, uh,what did you see for the future
of the A HF?
Where is it pointing?
Because we did have, uh, likethis European meeting last
month, so I would like to know,how do you say, do you, would
(57:54):
you see the a HF maybe in thenext five years or any point you
would like to, you know, figure
Joseph M. Schwab (58:03):
Well, the, the good news about being the, the
immediate past president is Iget to say all sorts of wild and
crazy things that we could do inthe next five years.
And I have to, I get to rely ona whole other group of people to
make it happen.
But, um, you know,
Francisco Gomez Torres (58:18):
not pressure, but
Joseph M. Schwab (58:19):
there's no pressure.
I, I mean, we, we have a, wehave a vision to, to, um.
You know, kind of take a pagefrom you and expand, uh, our
outlook internationally.
Um, and whether that's throughdirect collaborations or support
of other organizations or, um,whether it's through, you know,
(58:41):
directly creating organizationsin different regional areas.
Um, we haven't quite figuredthat out yet.
But, you know, there were anumber of us from the leadership
team at the A HF who were at theEuropean anterior hip meeting,
um, and participated as thefaculty.
It was, um, a great experiencetalking with the European
(59:01):
surgeons.
It was a great, um, it felt verymuch like the same sort of, um,
collegial family environmentthat we, uh, put on for the A
HF.
Um, I know there's interest indoing this in, in Latin America,
in South America, there's beentremendous interest from the
ocean region and Australia andNew Zealand.
(59:23):
Um, and, you know,
Francisco Gomez Torres (59:25):
The Australians are, for example, a
big, big, uh, team, right?
Uh, the entire, uh, approach ishappening a lot in Australia, as
I can see.
Joseph M. Schwab (59:35):
they're almost 40% anterior approach.
Yeah.
Um, and you know what, I knowI'm answering questions, but I
just got one that came in onLinkedIn that I, I'm curious to
hear your thoughts on.
Do you have experience, I'mdoing anterior approach through
a bikini incision, and, uh,that's question, that's the
first part of the question.
And the second part is, can yougive from your perspective, um,
(01:00:00):
uh, an outlook on computerassisted or computer navigated a
hip replacement surgery inMexico and Latin America?
So bikini incision and computerassisted computer navigated
Francisco Gomez Torres (01:00:15):
Well, I can tell you, that about talking
about the, the bikini incision.
I even had got a, a earlierdiscussion through LinkedIn with
you where we were discussingshould it be, you know, like
horizontal, uh, vertical, uh,you know, angulated with a, a
Glip.
(01:00:35):
So as you, I would like to, topick this, uh, quest.
These, um, words you told methat is not what the incision is
creating is that you have tounderstand that there has been
plenty of patients, a lot,millions, if not, that are
(01:00:58):
having better results in anykind of incision is not the
incision for start.
Now if you are asking about, um,the issues one or the, or the
other, have, we can say thatthe, the vertical incision, it,
uh, break more longer handslines.
(01:01:20):
So there might, there you canexpect a little bit more of, uh,
healing tissue issues, but doingit, uh, through a bikini
incision, it might be, you know,you might attend to that
question, but, um, the bikiniincision is not, uh, extent of
(01:01:42):
having, uh, cutaneous problemsalso, you know, but it might be
a little bit more aestheticbecause you are close to the, to
the, the part where the skin,uh, faults.
But I mean, it's not the mostimportant, uh, part of the
surgery and.
(01:02:03):
To, to, to close that question,I would like to say that you
have to be comfortable with the,the work you are having.
You have to, to think in what'shappening inside or even deeper.
And the bikinis just, well, thesignature, you know, that you
will keep performing bare day byday.
Joseph M. Schwab (01:02:24):
You, you have to know what you're doing under
the skin and to make the, thequality of the incision be the
deciding factor about
Francisco Gomez Torres (01:02:33):
yeah,
Joseph M. Schwab (01:02:34):
or not.
yeah.
I agree.
Uh, and how about computernavigation?
Francisco Gomez Torres (01:02:38):
Yeah.
Well, I do, I, I, I haven't beenable to, to perform a robotic
assisted surgery with a directanterior approach, but I do have
some colleagues that are doingit right now with the Macco
system.
I can't even tell you that.
Uh, a month ago, the, first RosaHip, uh, surgery was performed
(01:03:00):
at the very next door of asurgery I was having.
So, and it was another colleagueof mine who I do anterior
approaches with him sometimes,but, um, I, I do know the
patient is going excellentthrough with that system and
with that direct anteriorapproach, it is possible about
(01:03:22):
doing, um, uh, navigation.
Surgeries.
I haven't done it, done them.
I think, um, I don't know.
Well, my generation is notlooking forward a lot into
navigating, but we do are, weare having the whole attention
(01:03:44):
to the robotics, um, issue.
Maybe I even have well in, inbetween my eyes.
The case of Dr.
Za and the team in use, he is,uh, developing to, instead of
having like this whole roboticarm, you just have your machine
(01:04:05):
gun in the hands and perform thesurgery.
Joseph M. Schwab (01:04:09):
Do.
Uh, I'm curious, do you thinkit's more likely that an implant
company or that a, a companylike a Johnson and Johnson or
Zimmer Biomet, um, would be morelikely to bring down a robot to
Mexico than they would a new setof implants?
Um, it it just because of thesize, uh, and impact that, that
(01:04:30):
might have.
Because I, I'm curious to hearthat you have Rosa, but you
don't have concise, and you justgot trabecular metal five years
ago.
You know, that's, that'sinteresting.
Right?
Francisco Gomez Torres (01:04:41):
Yeah, that's the way the cocky crumble
is as somebo, somebody said.
But, uh, I think, I think, uh, Iwould like to take your words
again, doctor, because I, as Itold you before, you are like a
mentor in a center certain,certain remote way.
I think the most important thingmust be to have a centered
(01:05:05):
approach, uh, uh, centeredpatient approach.
It's not about the tech.
It's not about the market.
It's not about the new robot,the new hip, the, the new
implant.
It's if the patient is havingbetter results, we should do it.
If it's just because there is anew robot on the market.
(01:05:28):
That's not the objective or, orthe reason why the robots should
come here or the new set ofimplants.
If we have the evidence that isworking.
Okay.
There is a, there is a reasonto, but if you're having the
robot and your results are beingjust even uglier than the
(01:05:51):
traditional approach, well maybeit's not what you have to be
looking for.
Right?
So,
Joseph M. Schwab (01:05:58):
Interesting.
Well,
Francisco Gomez Torres (01:06:00):
yeah.
Joseph M. Schwab (01:06:01):
Dr.
Gomez Torres, I wanna thank youfor, for really actually being
kind of our test subject righton doing, uh, a live a HF
podcast and engaging, uh, with alive audience.
We've had, uh, you know, apretty steadily, about 15 to 20
people watching us.
We've had, I think, someexcellent comments and
(01:06:24):
questions, uh, from our users.
And, um, I, I just want toencourage you, everything you've
been doing to engage with theinternational orthopedic
community, uh, I want to sayyou're an inspiration to, to
other surgeons, and I wouldencourage you to keep doing what
you're doing keep fighting thegood fight.
Francisco Gomez Torres (01:06:45):
Thanks a lot Joe.
It's such an honor to be part ofyour guests.
Guests.
Now, I can't say, um, that maybehaving a podcast and do these
international, uh, meetings, um,you know, to get some friends
and stuff will take me to thisplace now, now.
(01:07:06):
I wouldn't imagine that.
So I'm really, um, thankful withyou, with, uh, Lila, with all
the whole a HF for the OracleFellowship, everything, because
these things happened.
Just because you are not seatedwaiting for the date to pass,
you have to keep pushingforward.
(01:07:27):
So I do, um, would like to sayonce, once again, thank you for
hearing and thank you for havinga feedback, a feedback for me
and well, Latin America.
I hope they, they hear yourwords.
Joseph M. Schwab (01:07:41):
I, I, I hope they hear your words, and I'm
gonna take a moment to bringLila on.
Um, just to thank her for, uh,doing this in the background.
Lila, thank you for, uh, for,uh, being on the, the podcast.
Oh.
Have you muted yourself?
Uh, excellent.
Um,
Lilah Menashe (01:08:02):
Can you hear now?
Joseph M. Schwab (01:08:03):
now we can hear
Lilah Menashe (01:08:04):
Oh yeah.
Hi.
It was such a pleasure workingtogether and, you know, looking
for different topics to discusstoday.
Uh, you were very committed, Dr.
Gomez Torres, so I reallyappreciate it.
So, for all our listeners, ittook a little bit of work and
effort from all us to put ittogether.
So I, I just hope you enjoyedit.
Joseph M. Schwab (01:08:25):
and we
Francisco Gomez Torres (01:08:26):
Even, the earthquake,
Joseph M. Schwab (01:08:27):
to do it again.
Yeah.
Even through an earthquake.
Oh my gosh.
I hope everybody's okay.
All right.
Thank
Francisco Gomez Torres (01:08:35):
was the announcement that the HIV was
happening right now.
Joseph M. Schwab (01:08:39):
That's created the earthquake.
Well, thank you Dr.
Gomez Torres.
Thank you, Lila.
Um, I'm gonna, yeah, we'll dothis here.
And, um, I just want to saythank you, all of you, uh, for
joining us for this live episodeof the A HF podcast.
And if you can please take amoment to like and subscribe.
(01:09:03):
You'd be helping us find morepeople just like you to share
this type of content with.
And if you have any ideas for afuture episode or topics you
wanna see us discuss from anyportion of the world, drop it in
the comments below.
You can find our normal episodesof the a HF podcast on Apple
(01:09:23):
Podcasts, Spotify, or in any ofyour favorite podcast apps, as
well as in video form on YouTubeslash at anterior hip
foundation.
All one word.
New episodes of the A HF Podcastcome out on most Fridays.
I'm your host, Joe Schwab,asking you to help keep the hips
(01:09:45):
in Latin America and whereveryou are happy and healthy.
I.
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