June 6, 2025 • 19 mins
Revolutionizing Hip Surgery: Anterior Approach with Prof. Frederic Laude - AHF Podcast
Join host Joe Schwab in an in-depth conversation with Professor Frederic Laude, a leading figure in anterior approach hip surgery. In this episode, they discuss the historical roots and key developments of the anterior approach, Laude's innovative educational methodologies, and his growing presence on LinkedIn. They delve into Laude's collaboration with Medacta to build a robust training system for surgeons and his role in organizing the European anterior hip meeting. This episode is a must-watch for anyone interested in the advancements of hip surgery and the importance of comprehensive surgical education.
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Episode Transcript
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Joseph M Schwab (00:25):
Hello, and welcome back to another episode
of the AHF podcast.
I'm your host, Joe Schwab.
There are few surgeons as closeto the epicenter of anterior
approach hip surgery asprofessor Frederic Laude
practicing in Paris, France.
Frederic trained under EmileLetournel, the protege of Robert
(00:47):
Judet.
Together, Judet and Letournelrevolutionized surgery of the
hip and pelvis, transformingacetabular fracture care from
mostly non-surgical treatment toa full blown discipline within
the world of orthopedic surgicaltrauma.
And while Frederic saw many ofthese advances in fracture
(01:07):
surgery firsthand.
He also recognized the benefitof some of Judet and
Letournel's, at the time, lesswell-known developments like
anterior approach, hipreplacement.
I caught up with Frederic arecent weekend morning before he
headed off to ski, and our wideranging conversation bounced
back and forth from how he wasexposed to anterior approach at
(01:31):
first, how he helped develop aneducational system around it,
his newfound interest inLinkedIn and how he's working
with a group of like-mindedsurgeons across Europe to help
foster its growth.
Let's join in on theconversation.
I.
So Professor Frederic Laude,welcome to the AHF Podcast.
Frederic Laude (01:52):
Thank you.
Joseph M Schwab (01:53):
You're located in Paris, France, uh, and, think
a lot of anterior approach hipsurgeons, uh, would agree that
France and Paris specifically,um, is a special place in the
history of the development ofthe anterior approach.
So from your perspective, um,what are some of the key
developments out of Paris thathave helped make the anterior
(02:16):
approach what it is today?
Frederic Laude (02:19):
ThEre is two things that change a little bit,
uh, the, the, the world ofanterior approach.
First, Joel Matta came a longtime ago in Paris and start to
do the anterior approach.
I think I wrote 97 or 96 or 98.
I, I don't know exactly thetime, but he start to do that
because he had seen, uh, Emil todoing this kind of case.
(02:39):
I think also something really pethe entire approach was the fact
that, uh, Zimmer promotes thedual dual incision at the early
2000.
People rediscovered the anteriorapproach and especially when we
tell them that it was possibleto do everything through the
single anterior approach, butpeople start to get interest
again in the anterior approach.
(03:00):
And maybe I would say maybe thelast, I'm not so sure.
I think the fact the Austriansstart also to do anterior
approach without table wasprobably something which was
quite important for the anteriorapproach, but it was without the
table.
So it's another story.
Joseph M Schwab (03:15):
Um, and you, you have worked quite a bit, um,
a as in terms of um, educatingfor anterior approach
specifically with Medacta.
Um, and tell me a little bitabout how you developed an
educational platform with them,uh, regarding anterior approach.
Frederic Laude (03:35):
Okay.
It, it, it's quite funny to seethat in the nineties, the entire
approach it was, had nearlydisappeared.
When I tried to promote thisapproach, it was like, we are
not interested e even especiallyAmerican company at this time,
they start to get.
Interest when Joel start to showthat it was possible in America.
And then I think I start to workwith Medacta 2004.
(03:56):
I had a few surgeons that visitme to, to see how it works
because early 2000, so three,four years before I was working
with Medacta, a few surgeonvisit me, but it was very
unusual.
But, uh, so we start 2004 andyou know, it's quite a different
job to know to do it and toteach it.
So at the beginning we, peoplewere just coming to see me, they
(04:19):
go back home and that was adisaster, uh, because, um, you
cannot, um, understandeverything in one sim single
shot.
Maybe you can see me doing oneor two cases, but that's not
sufficient.
So we decide.
Very fast.
That was not solution.
Solution was to do some cadavercourse, which is still, um, I
(04:40):
think the gold standard todayand also what they call, uh,
mentoring people.
At the beginning I was going tothe surgeon who want to start
and uh, I was helping them.
So how to do, uh, so usually Iwere doing one case, he was
doing two or three other casesand I was just behind them.
So I, it start really inSwitzerland and after all over.
(05:01):
At the beginning I was very busyto travel everywhere, but after
I was able to, to teach some guywho become really good, they
also teach.
So it was, uh, like, um,something very positive because
many surgeon, now, I'm not theonly one to teach, I would say.
Uh, I don't teach anymore.
The basic, uh, if I do somecourse, it's more revision
(05:21):
course or advanced course, theguy.
But it's, I think it was reallya very good and interesting way
to do that.
And I, I think education isreally the basis of our, our
job.
We can put a lot of technologybehind whatever you want, but
education, uh, side by side isthe, the basic for us.
Joseph M Schwab (05:41):
Uh, it's interesting, I, I watched an
online q and a, um, that youwere a part of.
This was maybe about five, sixyears ago.
And this question came up abouthow do you approach, um,
learning curve for surgeons whowanna learn anterior approach?
And you made a reallyinteresting point that seemed to
(06:02):
focus on what I would call, youdidn't use these words exactly,
but.
You, you said, uh, really thefocus should be less on the
learning curve and more on theteaching curve, um, which is how
do you become betterinstructors?
How do you become betterteachers as opposed to, um, you
know, h how many surgeries doesit take for a surgeon to be
proficient at it?
(06:23):
can we to make them bettersurgeons?
Frederic Laude (06:27):
One thing was very important for me and very
efficient.
With Medacta, I was teaching theguy, and the guy start, and
after I, I had the news, I hadthe information.
What was the problem?
The problem was by example, tocut the femoral neck.
Do.
So I, I insist, I try to findthe best, best way to explain
how to cut femoral neck, how toplace the retractors, and each
small step, sometimes it's somevery small step, and if you miss
(06:50):
one of those steps, that's aproblem.
So really by having a feedbackfrom what was the problem the
surgeon encounter.
I was able to change the way Iwas teaching and that was really
interesting for me because Itold you I knew to do it.
But teaching is another storyand just by, because I have the
feedback of all those case, uh,the poly during, I would modify
the way I was teaching and thatwas really important.
Joseph M Schwab (07:13):
how I find this really fascinating, how do you
approach those modifications inyour own way of teaching?
I mean, obviously you, you seethe, the areas that your, your
learners are struggling.
Um, but then what do you do inyour process to make sure that
you can teach it differently,better, more effectively the
next time?
Frederic Laude (07:32):
The, I think when I do my surgery, the id, I
have no parit movement.
I try to do everything step bystep, the more logical and
simple and as simple as aspossible.
And I think this is a very goodway.
I just want to come back tovery, in the nineties I was a
resident with, uh, the anteriorapproach I learned from
(07:53):
Letournel was.
He, he was not teachinganything.
It was show me.
And if you can do it, you can doit that.
But there is another school inParis, which was K Kha, Marcel
Kabul.
They were doing thetranstrochanteric approach and
they were doing exactly likethat step by step.
How to do a transtrochantericapproach.
Charnley style.
And I must say that was superefficient.
(08:13):
So I decide to try to do.
This way of teaching to theanterior approach.
And that was so efficient.
'cause the way Letournel andeverything else teach me was
just, just watch me.
Don't ask any question.
If you can do it, you can do it.
If you don't do it, do somethingelse.
Joseph M Schwab (08:30):
It's a real sink or swim educational
philosophy.
Frederic Laude (08:33):
Yeah.
Joseph M Schwab (08:35):
Um, so that's interesting.
I, I see you're, you'rereasonably active online as
well, making comments on siteslike LinkedIn, on other people's
posts, for example.
Is that something you enjoydoing or is that something you
sort of feel a sense of, ofobligation?
Like is that an extension ofyour teaching or is there
something else?
Frederic Laude (08:56):
No, you know, I'm on LinkedIn for only maybe
two months before I didn't evenknew what it was, but I
honestly, I think it's quitefascinating because.
What I receive, like news fromLinkedIn, it's only on
orthopedics, so I see a lot ofother guy makes great contact.
So, um, and also it's a verygood way to promote simple
things and I will try to placeone small.
(09:19):
Um, video or explanation orteaching every week.
I, I, I don't know how long Ican do that, but I will try
every week to do one stuff likethat.
So I show some critical step ofthe, of the teaching and
everything, but I will try.
It's, it's brand new for me.
No, no, I'm not social guy,social media guy.
Joseph M Schwab (09:37):
Are you enjoying it at least?
Frederic Laude (09:41):
I, yes, I, I was a bit afraid at the beginning,
but I quite enjoy it.
The problem, many guy want tovisit me now, so I, I don't know
how can I can manage that, but Ienjoy to do.
Yeah, yeah, yeah.
It's quite nice.
You, you really just realizedthat I, I all the fascination
about this approach.
So it's, uh, it's interesting.
I have, I don't know, manyfollowers I have in one or two
(10:03):
months.
It's crazy.
Or maybe it's not crazy at all.
It's just regular.
But, uh, my feeling, it's crazy.
Joseph M Schwab (10:08):
it's, uh, not what you expected maybe, huh?
Frederic Laude (10:12):
No, not really.
I was just, uh, I was justcurious at the beginning.
Some guy said, you should go onLinkedIn.
So I went there.
I was, I was positivelysurprised.
Joseph M Schwab (10:20):
Um, well, that's good.
I mean, it's, it's interesting.
Not everybody has a such apositive reaction to, you know,
using social media, but I thinkthat speaks to the community of
surgeons who are interested inthe anterior approach and their
desire for high qualityeducation and high quality
materials.
So, uh.
Frederic Laude (10:39):
I think I, I was especially fascinating by people
from, I will say third countryworld because there is no more
sales world, but from India,Turkey, Egypt, those guys really
want to learn.
That's fascinating.
They just want to improve andlearn and become Chinese.
I have some chi be from China.
They are really?
Yeah.
They, they want to grapple youall.
(11:00):
Oliver, in your nose.
That's interesting.
Joseph M Schwab (11:02):
And, and oftentimes those are folks who
are tackling some of the mostdifficult cases, uh, and we,
know, that I would say in, in,in France, certainly in the US
and Switzerland are, we're muchless likely to see.
Uh, the education of that quiteinteresting, doesn't it?
Frederic Laude (11:21):
yeah.
Absolutely.
Yeah.
They have some crazy cases also.
Joseph M Schwab (11:24):
Um, so apart from your, your activity online,
you're on this organizingcommittee for the European
anterior hip meeting, um, whichtakes place, uh, June 26th and
27th, I London.
Frederic Laude (11:37):
Hmm.
Joseph M Schwab (11:38):
and this is the.
The first meeting of thisorganization, and
Frederic Laude (11:42):
Yeah.
Joseph M Schwab (11:43):
is that this organizing committee is kind of
a powerhouse of Europeananterior approach surgeons,
including you, uh, RichardField, Michael Leunig, Kristoff
Corten in Belgium and JonathanHutt.
Tell me a little bit, how didthis meeting come to be and what
are you trying to accomplishwith it?
Frederic Laude (12:04):
I, I, honestly, honestly, I, I would be totally
unable to organize this kind ofmeeting.
I'm really, uh.
Uh, the worst organizer ofeverything.
If you watch my, my, my, my deskwhere it is, I here, it look
like nearly okay.
But if you go, it's a nightmare.
So Richard Field is not likethat.
Richard Field is a guy who liketo organize everything.
(12:25):
So this is really his idea.
And as you know, we are verygood friend and I really admire
him and he's, I say, whateveryou ask me, I will do it.
So I have no choice.
So, um, and we also try toinvite Christoph Corten.
Michael Leunig, the other guy,will really promote this
approach and are really veryserious guy, very enthusiastic
guy.
So I think it's, uh, he shouldbe a good, and we also want to,
(12:48):
to have something, uh.
Uh, dependent of what's happensin America, where it's very
active and Joel Matta is veryactive, also a very good
organizer.
So we have the, Richard Fielddoes the job very well, so I
want to thank him for, for doingthat.
Joseph M Schwab (13:04):
And what do you think is the opportunity in
Europe, uh, in terms of anteriorapproach?
There's a decent amount ofanterior approach being done.
Of course, it's differentcountry by country, but what's
the, what are the opportunitiesin improving anterior approach
in Europe that you see?
Frederic Laude (13:20):
Yeah.
Uh, there is some country byexample, like Belgium.
Nearly eight 70 to 80% of thecase are done.
anterior approach in France, Iwould say it's around maybe 40,
30 plus approach is still verystrong in France, especially
because of dual mobilityimplant, which is uh, maybe 50%
of the market share.
But by in England.
It's maybe one or two persons.
So in England there is a lot ofprobably the Scandinavian
(13:43):
country also and all thosecountries that really ping like
Poland, uh, or uh,Czechoslovakia.
And it's really, people areinteresting and also, um, um,
Turkey, Egypt, all those countryalso, which is not really
Europe, but very close toEurope.
They really want to learn.
So I think there is a lot ofopportunity.
Joseph M Schwab (14:03):
Um, and do you see this, uh, committee
organizing meetings on an annualbasis, on a regular basis, or is
this kind of a we're gonna seewhat happens?
Frederic Laude (14:14):
That we're gonna see what happens.
Usually it's in June, the lastweek of June.
So England is nice at this time,and especially, uh, field
organize something after, whichwould be very nice.
I love.
So, uh, I maybe we're gonna see,we're gonna see and, uh, if it's
a success or not, um, solu see.
Joseph M Schwab (14:33):
Um, I, I'm interested too, shifting gears
just a little bit, um, inaddition to anterior approach,
um, you're, you're known in thefield of hip preservation, young
adult hip surgery as well.
I.
I, I wanna know how, from yourperspective, how is having an
understanding of young adult hipdisease, how has that shaped
(14:53):
your, uh, the way you approachtotal hip replacement, or the
way you approach patients abouttotal hip replacement or the way
you do anterior approach?
Frederic Laude (15:02):
Yeah, I think it, it goes in the same way.
My idea to have only oneincision from.
Child, child to the end of yourlife.
So by example, when you doA-A-P-A-O, it's nearly an
anterior incision when you dofal, I do femoral sto troian
anterior incision.
And when I do my, my first case,I do troian incision because
this is a, you can go three,four time.
(15:23):
I know that without damaging inthe muscle and the patient do
well.
And also when you see very youngpatient doing preservation
surgery, sometime it doesn'twork so well.
So you have to find a solution.
But those very young patient.
Don't want to be like an oldguy.
They want to do sports, theywant to do skis, they want to do
everything.
So it's really nearly the sameapproach.
You don't, you have an implantof course, but at the end the
(15:47):
philosophy is the same.
You want to give them back theirnormal life, not a life that,
uh, would be a guy who is 75years old who have arthritis at
the end of, uh, his life.
So that is, for me, it's, it's acomplete, uh, continuum and I
like to do that.
I have some patient, I have donesome 25 years ago.
Uh.
Preservation surgery and theycome back to have the total hip
(16:08):
replacement.
It's, it's logical.
I think it, yeah, it works.
Joseph M Schwab (16:12):
And if they come back to you, it means they
must have been satisfied withwhat you did.
Frederic Laude (16:15):
Yeah, yeah, yeah.
Say when do you retire?
I say
Joseph M Schwab (16:18):
I.
Frederic Laude (16:19):
few more years.
Joseph M Schwab (16:21):
Well, so the, the, so this raises a question.
I know there's lots of peoplewho want to come visit you.
Um, you have been verythoughtful about the way you
approach education.
Um, what is, I mean, what's theplan for, in terms of what would
you want your legacy to be?
Um, what would you want to beknown for?
What would you want to beremembered for as you, uh, now
(16:43):
have transitioned to sort of thesenior statesman of, of hip, uh,
surgery?
Frederic Laude (16:50):
I am a little bit afraid that nobody will
remember you in 20 or me in 20years.
So I don't know.
Usually people forget, uh, butmaybe, I don't know.
Uh, to do it in a very nice way.
I.
Uh, and uh, also probably I'm,I'm very proud to do revision
through the approach because if,you know to do it, it's really
(17:11):
fascinating for the patient.
And, uh, what else?
Um, okay, we'll see.
Joseph M Schwab (17:19):
see, um, well, I actually think, Frederic, this
has been just a fantasticconversation.
I, I, your time is precious andI want to make sure that I'm of
it.
But, um, from my perspective,uh, one of the most fascinating.
Uh, perspectives that I've heardon education, and I really
(17:39):
appreciate what you've beendoing, uh, for all the surgeons
around the world.
I know there's many in the USwho have come to visit you, uh,
and bring your level ofenthusiasm for anterior
approach.
Uh, back to the us there's many,uh, where I'm located here in
Switzerland that have also cometo visit you.
So, uh, on behalf of them, uh,you know, thank you for the work
you're doing, educatingeverybody.
Frederic Laude (18:00):
Now it's so you are in Switzerland You know this
guy?
Joseph M Schwab (18:04):
I can't see it.
My screen's a Who, who lookingat?
Frederic Laude (18:08):
Yeah.
It's, uh, this guy really, andGester, he, he, he was from
Basel.
He really helped me to, topromote, because at the
beginning, when you are alone topromote something, it's a little
bit not very efficient.
So this guy really helped me topromote.
He is from Switzerland, Basel.
He died a few years ago.
He was a very nice surgeon andhe really, uh, when you, you
have a few guys that follow youand help you to, that's really
(18:31):
interesting because.
When you're alone, it's not veryefficient.
For a long time, I was alone totry to promote anterior airport
didn't work very well.
Medacta really helped me.
And, uh, this kind of guy reallyalso, uh, helped me.
And so I, I all, I was toscience a Swiss surgeon to, uh,
follow me at the beginning.
Uh, that's interesting.
And after all the world, now wehave to convince the, the
(18:52):
English, English guy becauseit's, that's another story.
Joseph M Schwab (18:57):
Many thanks to Frederic Laude for joining me on
the AHF podcast, and thank youfor listening to this episode.
I hope you enjoyed thisconversation as much as I did.
If you can remember to take amoment to like and subscribe,
you'd be helping us find morepeople just like you.
To share our thoughts with.
You can always drop an idea fora topic or any feedback you like
(19:18):
in the comments below.
You can find the AHF podcast onApple Podcasts, Spotify, or in
any of your favorite podcastapps, as well as in video form
on YouTube slash at anterior hipfoundation, all one word.
New episodes of the AHF podcastcome out on Fridays.
(19:38):
I'm your host, Joe Schwab,asking you to keep those hips
happy and healthy.
Hello, and welcome back to another episode
of the AHF podcast.
I'm your host, Joe Schwab.
There are few surgeons as closeto the epicenter of anterior
approach hip surgery asprofessor Frederic Laude
practicing in Paris, France.
Frederic trained under EmileLetournel, the protege of Robert
(00:47):
Judet.
Together, Judet and Letournelrevolutionized surgery of the
hip and pelvis, transformingacetabular fracture care from
mostly non-surgical treatment toa full blown discipline within
the world of orthopedic surgicaltrauma.
And while Frederic saw many ofthese advances in fracture
(01:07):
surgery firsthand.
He also recognized the benefitof some of Judet and
Letournel's, at the time, lesswell-known developments like
anterior approach, hipreplacement.
I caught up with Frederic arecent weekend morning before he
headed off to ski, and our wideranging conversation bounced
back and forth from how he wasexposed to anterior approach at
(01:31):
first, how he helped develop aneducational system around it,
his newfound interest inLinkedIn and how he's working
with a group of like-mindedsurgeons across Europe to help
foster its growth.
Let's join in on theconversation.
I.
So Professor Frederic Laude,welcome to the AHF Podcast.
Frederic Laude (01:52):
Thank you.
Joseph M Schwab (01:53):
You're located in Paris, France, uh, and, think
a lot of anterior approach hipsurgeons, uh, would agree that
France and Paris specifically,um, is a special place in the
history of the development ofthe anterior approach.
So from your perspective, um,what are some of the key
developments out of Paris thathave helped make the anterior
(02:16):
approach what it is today?
Frederic Laude (02:19):
ThEre is two things that change a little bit,
uh, the, the, the world ofanterior approach.
First, Joel Matta came a longtime ago in Paris and start to
do the anterior approach.
I think I wrote 97 or 96 or 98.
I, I don't know exactly thetime, but he start to do that
because he had seen, uh, Emil todoing this kind of case.
(02:39):
I think also something really pethe entire approach was the fact
that, uh, Zimmer promotes thedual dual incision at the early
2000.
People rediscovered the anteriorapproach and especially when we
tell them that it was possibleto do everything through the
single anterior approach, butpeople start to get interest
again in the anterior approach.
(03:00):
And maybe I would say maybe thelast, I'm not so sure.
I think the fact the Austriansstart also to do anterior
approach without table wasprobably something which was
quite important for the anteriorapproach, but it was without the
table.
So it's another story.
Joseph M Schwab (03:15):
Um, and you, you have worked quite a bit, um,
a as in terms of um, educatingfor anterior approach
specifically with Medacta.
Um, and tell me a little bitabout how you developed an
educational platform with them,uh, regarding anterior approach.
Frederic Laude (03:35):
Okay.
It, it, it's quite funny to seethat in the nineties, the entire
approach it was, had nearlydisappeared.
When I tried to promote thisapproach, it was like, we are
not interested e even especiallyAmerican company at this time,
they start to get.
Interest when Joel start to showthat it was possible in America.
And then I think I start to workwith Medacta 2004.
(03:56):
I had a few surgeons that visitme to, to see how it works
because early 2000, so three,four years before I was working
with Medacta, a few surgeonvisit me, but it was very
unusual.
But, uh, so we start 2004 andyou know, it's quite a different
job to know to do it and toteach it.
So at the beginning we, peoplewere just coming to see me, they
(04:19):
go back home and that was adisaster, uh, because, um, you
cannot, um, understandeverything in one sim single
shot.
Maybe you can see me doing oneor two cases, but that's not
sufficient.
So we decide.
Very fast.
That was not solution.
Solution was to do some cadavercourse, which is still, um, I
(04:40):
think the gold standard todayand also what they call, uh,
mentoring people.
At the beginning I was going tothe surgeon who want to start
and uh, I was helping them.
So how to do, uh, so usually Iwere doing one case, he was
doing two or three other casesand I was just behind them.
So I, it start really inSwitzerland and after all over.
(05:01):
At the beginning I was very busyto travel everywhere, but after
I was able to, to teach some guywho become really good, they
also teach.
So it was, uh, like, um,something very positive because
many surgeon, now, I'm not theonly one to teach, I would say.
Uh, I don't teach anymore.
The basic, uh, if I do somecourse, it's more revision
(05:21):
course or advanced course, theguy.
But it's, I think it was reallya very good and interesting way
to do that.
And I, I think education isreally the basis of our, our
job.
We can put a lot of technologybehind whatever you want, but
education, uh, side by side isthe, the basic for us.
Joseph M Schwab (05:41):
Uh, it's interesting, I, I watched an
online q and a, um, that youwere a part of.
This was maybe about five, sixyears ago.
And this question came up abouthow do you approach, um,
learning curve for surgeons whowanna learn anterior approach?
And you made a reallyinteresting point that seemed to
(06:02):
focus on what I would call, youdidn't use these words exactly,
but.
You, you said, uh, really thefocus should be less on the
learning curve and more on theteaching curve, um, which is how
do you become betterinstructors?
How do you become betterteachers as opposed to, um, you
know, h how many surgeries doesit take for a surgeon to be
proficient at it?
(06:23):
can we to make them bettersurgeons?
Frederic Laude (06:27):
One thing was very important for me and very
efficient.
With Medacta, I was teaching theguy, and the guy start, and
after I, I had the news, I hadthe information.
What was the problem?
The problem was by example, tocut the femoral neck.
Do.
So I, I insist, I try to findthe best, best way to explain
how to cut femoral neck, how toplace the retractors, and each
small step, sometimes it's somevery small step, and if you miss
(06:50):
one of those steps, that's aproblem.
So really by having a feedbackfrom what was the problem the
surgeon encounter.
I was able to change the way Iwas teaching and that was really
interesting for me because Itold you I knew to do it.
But teaching is another storyand just by, because I have the
feedback of all those case, uh,the poly during, I would modify
the way I was teaching and thatwas really important.
Joseph M Schwab (07:13):
how I find this really fascinating, how do you
approach those modifications inyour own way of teaching?
I mean, obviously you, you seethe, the areas that your, your
learners are struggling.
Um, but then what do you do inyour process to make sure that
you can teach it differently,better, more effectively the
next time?
Frederic Laude (07:32):
The, I think when I do my surgery, the id, I
have no parit movement.
I try to do everything step bystep, the more logical and
simple and as simple as aspossible.
And I think this is a very goodway.
I just want to come back tovery, in the nineties I was a
resident with, uh, the anteriorapproach I learned from
(07:53):
Letournel was.
He, he was not teachinganything.
It was show me.
And if you can do it, you can doit that.
But there is another school inParis, which was K Kha, Marcel
Kabul.
They were doing thetranstrochanteric approach and
they were doing exactly likethat step by step.
How to do a transtrochantericapproach.
Charnley style.
And I must say that was superefficient.
(08:13):
So I decide to try to do.
This way of teaching to theanterior approach.
And that was so efficient.
'cause the way Letournel andeverything else teach me was
just, just watch me.
Don't ask any question.
If you can do it, you can do it.
If you don't do it, do somethingelse.
Joseph M Schwab (08:30):
It's a real sink or swim educational
philosophy.
Frederic Laude (08:33):
Yeah.
Joseph M Schwab (08:35):
Um, so that's interesting.
I, I see you're, you'rereasonably active online as
well, making comments on siteslike LinkedIn, on other people's
posts, for example.
Is that something you enjoydoing or is that something you
sort of feel a sense of, ofobligation?
Like is that an extension ofyour teaching or is there
something else?
Frederic Laude (08:56):
No, you know, I'm on LinkedIn for only maybe
two months before I didn't evenknew what it was, but I
honestly, I think it's quitefascinating because.
What I receive, like news fromLinkedIn, it's only on
orthopedics, so I see a lot ofother guy makes great contact.
So, um, and also it's a verygood way to promote simple
things and I will try to placeone small.
(09:19):
Um, video or explanation orteaching every week.
I, I, I don't know how long Ican do that, but I will try
every week to do one stuff likethat.
So I show some critical step ofthe, of the teaching and
everything, but I will try.
It's, it's brand new for me.
No, no, I'm not social guy,social media guy.
Joseph M Schwab (09:37):
Are you enjoying it at least?
Frederic Laude (09:41):
I, yes, I, I was a bit afraid at the beginning,
but I quite enjoy it.
The problem, many guy want tovisit me now, so I, I don't know
how can I can manage that, but Ienjoy to do.
Yeah, yeah, yeah.
It's quite nice.
You, you really just realizedthat I, I all the fascination
about this approach.
So it's, uh, it's interesting.
I have, I don't know, manyfollowers I have in one or two
(10:03):
months.
It's crazy.
Or maybe it's not crazy at all.
It's just regular.
But, uh, my feeling, it's crazy.
Joseph M Schwab (10:08):
it's, uh, not what you expected maybe, huh?
Frederic Laude (10:12):
No, not really.
I was just, uh, I was justcurious at the beginning.
Some guy said, you should go onLinkedIn.
So I went there.
I was, I was positivelysurprised.
Joseph M Schwab (10:20):
Um, well, that's good.
I mean, it's, it's interesting.
Not everybody has a such apositive reaction to, you know,
using social media, but I thinkthat speaks to the community of
surgeons who are interested inthe anterior approach and their
desire for high qualityeducation and high quality
materials.
So, uh.
Frederic Laude (10:39):
I think I, I was especially fascinating by people
from, I will say third countryworld because there is no more
sales world, but from India,Turkey, Egypt, those guys really
want to learn.
That's fascinating.
They just want to improve andlearn and become Chinese.
I have some chi be from China.
They are really?
Yeah.
They, they want to grapple youall.
(11:00):
Oliver, in your nose.
That's interesting.
Joseph M Schwab (11:02):
And, and oftentimes those are folks who
are tackling some of the mostdifficult cases, uh, and we,
know, that I would say in, in,in France, certainly in the US
and Switzerland are, we're muchless likely to see.
Uh, the education of that quiteinteresting, doesn't it?
Frederic Laude (11:21):
yeah.
Absolutely.
Yeah.
They have some crazy cases also.
Joseph M Schwab (11:24):
Um, so apart from your, your activity online,
you're on this organizingcommittee for the European
anterior hip meeting, um, whichtakes place, uh, June 26th and
27th, I London.
Frederic Laude (11:37):
Hmm.
Joseph M Schwab (11:38):
and this is the.
The first meeting of thisorganization, and
Frederic Laude (11:42):
Yeah.
Joseph M Schwab (11:43):
is that this organizing committee is kind of
a powerhouse of Europeananterior approach surgeons,
including you, uh, RichardField, Michael Leunig, Kristoff
Corten in Belgium and JonathanHutt.
Tell me a little bit, how didthis meeting come to be and what
are you trying to accomplishwith it?
Frederic Laude (12:04):
I, I, honestly, honestly, I, I would be totally
unable to organize this kind ofmeeting.
I'm really, uh.
Uh, the worst organizer ofeverything.
If you watch my, my, my, my deskwhere it is, I here, it look
like nearly okay.
But if you go, it's a nightmare.
So Richard Field is not likethat.
Richard Field is a guy who liketo organize everything.
(12:25):
So this is really his idea.
And as you know, we are verygood friend and I really admire
him and he's, I say, whateveryou ask me, I will do it.
So I have no choice.
So, um, and we also try toinvite Christoph Corten.
Michael Leunig, the other guy,will really promote this
approach and are really veryserious guy, very enthusiastic
guy.
So I think it's, uh, he shouldbe a good, and we also want to,
(12:48):
to have something, uh.
Uh, dependent of what's happensin America, where it's very
active and Joel Matta is veryactive, also a very good
organizer.
So we have the, Richard Fielddoes the job very well, so I
want to thank him for, for doingthat.
Joseph M Schwab (13:04):
And what do you think is the opportunity in
Europe, uh, in terms of anteriorapproach?
There's a decent amount ofanterior approach being done.
Of course, it's differentcountry by country, but what's
the, what are the opportunitiesin improving anterior approach
in Europe that you see?
Frederic Laude (13:20):
Yeah.
Uh, there is some country byexample, like Belgium.
Nearly eight 70 to 80% of thecase are done.
anterior approach in France, Iwould say it's around maybe 40,
30 plus approach is still verystrong in France, especially
because of dual mobilityimplant, which is uh, maybe 50%
of the market share.
But by in England.
It's maybe one or two persons.
So in England there is a lot ofprobably the Scandinavian
(13:43):
country also and all thosecountries that really ping like
Poland, uh, or uh,Czechoslovakia.
And it's really, people areinteresting and also, um, um,
Turkey, Egypt, all those countryalso, which is not really
Europe, but very close toEurope.
They really want to learn.
So I think there is a lot ofopportunity.
Joseph M Schwab (14:03):
Um, and do you see this, uh, committee
organizing meetings on an annualbasis, on a regular basis, or is
this kind of a we're gonna seewhat happens?
Frederic Laude (14:14):
That we're gonna see what happens.
Usually it's in June, the lastweek of June.
So England is nice at this time,and especially, uh, field
organize something after, whichwould be very nice.
I love.
So, uh, I maybe we're gonna see,we're gonna see and, uh, if it's
a success or not, um, solu see.
Joseph M Schwab (14:33):
Um, I, I'm interested too, shifting gears
just a little bit, um, inaddition to anterior approach,
um, you're, you're known in thefield of hip preservation, young
adult hip surgery as well.
I.
I, I wanna know how, from yourperspective, how is having an
understanding of young adult hipdisease, how has that shaped
(14:53):
your, uh, the way you approachtotal hip replacement, or the
way you approach patients abouttotal hip replacement or the way
you do anterior approach?
Frederic Laude (15:02):
Yeah, I think it, it goes in the same way.
My idea to have only oneincision from.
Child, child to the end of yourlife.
So by example, when you doA-A-P-A-O, it's nearly an
anterior incision when you dofal, I do femoral sto troian
anterior incision.
And when I do my, my first case,I do troian incision because
this is a, you can go three,four time.
(15:23):
I know that without damaging inthe muscle and the patient do
well.
And also when you see very youngpatient doing preservation
surgery, sometime it doesn'twork so well.
So you have to find a solution.
But those very young patient.
Don't want to be like an oldguy.
They want to do sports, theywant to do skis, they want to do
everything.
So it's really nearly the sameapproach.
You don't, you have an implantof course, but at the end the
(15:47):
philosophy is the same.
You want to give them back theirnormal life, not a life that,
uh, would be a guy who is 75years old who have arthritis at
the end of, uh, his life.
So that is, for me, it's, it's acomplete, uh, continuum and I
like to do that.
I have some patient, I have donesome 25 years ago.
Uh.
Preservation surgery and theycome back to have the total hip
(16:08):
replacement.
It's, it's logical.
I think it, yeah, it works.
Joseph M Schwab (16:12):
And if they come back to you, it means they
must have been satisfied withwhat you did.
Frederic Laude (16:15):
Yeah, yeah, yeah.
Say when do you retire?
I say
Joseph M Schwab (16:18):
I.
Frederic Laude (16:19):
few more years.
Joseph M Schwab (16:21):
Well, so the, the, so this raises a question.
I know there's lots of peoplewho want to come visit you.
Um, you have been verythoughtful about the way you
approach education.
Um, what is, I mean, what's theplan for, in terms of what would
you want your legacy to be?
Um, what would you want to beknown for?
What would you want to beremembered for as you, uh, now
(16:43):
have transitioned to sort of thesenior statesman of, of hip, uh,
surgery?
Frederic Laude (16:50):
I am a little bit afraid that nobody will
remember you in 20 or me in 20years.
So I don't know.
Usually people forget, uh, butmaybe, I don't know.
Uh, to do it in a very nice way.
I.
Uh, and uh, also probably I'm,I'm very proud to do revision
through the approach because if,you know to do it, it's really
(17:11):
fascinating for the patient.
And, uh, what else?
Um, okay, we'll see.
Joseph M Schwab (17:19):
see, um, well, I actually think, Frederic, this
has been just a fantasticconversation.
I, I, your time is precious andI want to make sure that I'm of
it.
But, um, from my perspective,uh, one of the most fascinating.
Uh, perspectives that I've heardon education, and I really
(17:39):
appreciate what you've beendoing, uh, for all the surgeons
around the world.
I know there's many in the USwho have come to visit you, uh,
and bring your level ofenthusiasm for anterior
approach.
Uh, back to the us there's many,uh, where I'm located here in
Switzerland that have also cometo visit you.
So, uh, on behalf of them, uh,you know, thank you for the work
you're doing, educatingeverybody.
Frederic Laude (18:00):
Now it's so you are in Switzerland You know this
guy?
Joseph M Schwab (18:04):
I can't see it.
My screen's a Who, who lookingat?
Frederic Laude (18:08):
Yeah.
It's, uh, this guy really, andGester, he, he, he was from
Basel.
He really helped me to, topromote, because at the
beginning, when you are alone topromote something, it's a little
bit not very efficient.
So this guy really helped me topromote.
He is from Switzerland, Basel.
He died a few years ago.
He was a very nice surgeon andhe really, uh, when you, you
have a few guys that follow youand help you to, that's really
(18:31):
interesting because.
When you're alone, it's not veryefficient.
For a long time, I was alone totry to promote anterior airport
didn't work very well.
Medacta really helped me.
And, uh, this kind of guy reallyalso, uh, helped me.
And so I, I all, I was toscience a Swiss surgeon to, uh,
follow me at the beginning.
Uh, that's interesting.
And after all the world, now wehave to convince the, the
(18:52):
English, English guy becauseit's, that's another story.
Joseph M Schwab (18:57):
Many thanks to Frederic Laude for joining me on
the AHF podcast, and thank youfor listening to this episode.
I hope you enjoyed thisconversation as much as I did.
If you can remember to take amoment to like and subscribe,
you'd be helping us find morepeople just like you.
To share our thoughts with.
You can always drop an idea fora topic or any feedback you like
(19:18):
in the comments below.
You can find the AHF podcast onApple Podcasts, Spotify, or in
any of your favorite podcastapps, as well as in video form
on YouTube slash at anterior hipfoundation, all one word.
New episodes of the AHF podcastcome out on Fridays.
(19:38):
I'm your host, Joe Schwab,asking you to keep those hips
happy and healthy.
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