The surgical technique hip ' inside out ' reduces complications, time and costs

How did you decide to dedicate yourself to hip arthroscopy?

I was always fascinated by arthroscopy: diagnose pathologies through the visualization of a joint with a small lens connected to your camera and repair the lesions without the need for an open exposure. I knew it would be the surgery of the future and I learned from my teachers this amazing art. I became a convinced arthroscopist. That's how I got into the fascinating world of the hip. It was the year 2002 and in Spain there were very few surgeons who performed this type of intervention. Being one of the pioneers at the national level and starting in one of the most complex and important joints of the human body was a professional challenge. It was hard and complicated. The technique used was very demanding, reserved for expert surgeons, with a long and expensive learning curve.

How did you become one of the leading innovators in arthroscopic surgery worldwide?

The research spirit is innate. It's a skill that takes you by the hand towards innovation. I had learned this complex arthroscopic technique and had spent years of work but I had the impression that it could improve what we were doing, that the technical limitations that were an exclusive technique for a few could be reproducible, that the complications that our patients presented after 4 or 5 hours of operating room could be eliminated. Failures can be successful.

From failure to success?

I was a leading surgeon of national opinion in this technique and part of my activity was the training of surgeons from all over the country and put it into operation in different hospitals in Spain. I often thought that my teaching work was sterile, given the complexity and difficulty of the process. The economic issue was also a burden, since the infrastructure needed to perform this technique was expensive, in very specific material and instruments.. So those years of teaching went by until, in a national congress held in Vitoria, I was invited to perform a live hip arthroscopy and, before a hundred attending surgeons,. Despite trying, we could not access the hip. It was when I posed before the room: "can we leave and think that it has been impossible or try to do something different?". For the first time, I performed an alternative technique to address that joint and solve the injuries that the patient had. Here the Out Inside technique was born.

How do you get to be known worldwide for your technique inside Margalet?

That day, on the plane back to Barcelona, ​​my mind kept spinning, thinking about the opportunity that had been put before us, a new path of arthroscopic approach. From that first moment, many hours of work begin: cadaverous dissection, development of the technique examining each step. I wanted to be sure that our new technique was better than the existing one. We had achieved a simple access, with basic instrumentation, which reduced the surgery time to 1 hour, and with fewer complications and lower economic cost. Those were months of hard work, writing and publishing works, presenting it in different national congresses. But after those first months of innovation in the world of arthroscopy, critics came for envy and commercial interests and individuals. My method was questioned, so simple and accessible, so different and innovative, it could not be that a Spanish surgeon developed a new technique, faster, cheaper, simpler and with fewer postsurgical complications. The companies that had invested millions of euros in developing a specific instrument in the classical technique saw their development and monopoly threatened. The criticism of some colleagues, ignorance or because they saw in my technique direct competition and not their benefit, made those early years, a tough stage in my career.

How do you fight against adversity?

When something is difficult, you have to put double effort and double passion. I believed in my technique. I embarked in different international meetings showing my technique outside my country, trying to make real the saying that nobody is a prophet in their land. Rome, Paris, Portugal, USA.. I felt very small, but I defended with passion and courage every step of my technique, to consolidate what we represent today: to be the center of international reference in hip arthroscopy, forming surgeons from around the world and dedicating part of my activity to disseminate it in different international hospitals.

It is one of the most important centers in Europe.

Our goal is to offer our patient the best. The impossible does not exist, we must fight to achieve it and only in this way is it possible. Our center has the best technology for the study, diagnosis and treatment of the pathologies of the hip. We are one of the international reference centers dedicated to joint reconstruction and regeneration.