美国纽约特种外科医院膝关节和髋关节大师Ranawat教授

发表者：王先泉人已读

美国纽约特种外科医院（HSS，Hospital for Special Surgery）是许多大师级（Master Surgon）人物的摇篮。当然，最著名的大师是“现代人工膝关节之父”John N. Insall，但不幸的是，Insall教授已经于2000年12月30日逝世，但是他设计的一系列人工膝关节假体（Zimmer）至今依然被全世界的关节外科医生应用，为几百万膝关节关节炎的患者解除了疼痛。我们无法去参观Insall教授的手术，但他的同事以及徒弟依然活跃在手术台上，这些教授都有自己不同的思路和手术技巧，如果你有幸去该院参观学习，一定不要放过跟随这些国际著名大师级的教授刷手上台参加手术的机会，得到他们的言传身教，博众家之所长，一定会极大的提高你的手术技术。除去Insall教授外，关节置换外科领域另外一位国际最著名的大师是Chitranjan S. Ranawat教授。

Chitranjan S. 美国纽约特种外科医院（图1）是HSS的主诊医生（Attending Orthopedic Surgeon），康奈尔大学医学院（Weill Cornell Medical College）的骨科教授，是现代膝关节置换技术的主要创立者之一，是美国Total Condylar Knee膝关节系统、DePuy PFC Sigma、 Attune系统、Ranawat-Burstein 全髋关节系统和史塞克（Stryker）Accolade全髋关节系统的主要设计者，为此，美国强生公司和史塞克公司分别在该款假体在植入第100万个患者体内是颁发了荣誉证书，为纪念他在对人类做的贡献。

他于1983年参与创立美国膝关节学会（The Knee Society），并担任1983年和1984年的主席；于1992-1993年担任美国髋和膝关节外科学会（AAHKS，American Association of Hip and Knee Surgeons）的主席。他还在AAOS, AOA, EOS, SICOT, RASS, International Hip Society, Royal College of Physicians and Surgeons of Canada等美国和国际骨科学会中担任重要职务。他还发表了超过200篇的骨科文章，在人工膝关节和髋关节置换领域也发明了很多技术并发表文章在全球推广，例如，膝关节置换使胫骨脱位的Ranawat-Insall技术，膝外翻畸形松解膝关节外侧结构的“Pie-Crust”技术，使用Coplanar试验判断髋关节假体位置的联合前倾角技术等。

他获得的奖项（Awards）包括：Padma Bushan Award, 2001；Lifetime Achievement Award, American College of Rheumatology, 2002；America's Health Network Mercury Award, 1998；Distinguished Alumnus Award, Hospital for Special Surgery, 2007；"Best Doctors in New York," New York magazine, 2009, 2010。

他也是一个慈善家，设计假体使他从公司里获得了大量专利费，富裕以后他抽出一部分资金成立了Ranawat Orthopaedic Research Foundation，用于资助优秀的青年骨科医生进修、学习。最近该基金会为印度普纳（Pune，印度西部城市）的一家医院提供资助。

Chitranjan S. Ranawat是印度人，在印度读的医学院，1958-59年、1959-63年分别在印度Indore M.Y.Hospital做实习和住院医师；然后在他28岁时来到美国，当时他没有任何朋友、家庭成员，资金也非常有限，他于1963-64年和1964-65年分别在纽约州的奥尔巴尼市（Albany）的St. Peters Hospital 和Albany Medical Center做住院医师；1966-67年在HSS手外科做fellow，1967-68年在HSS的风湿-骨科重建外科（Rheumatology-Orthopaedic Reconstructive Surgery）做fellow。1969年他在HSS担任主诊医师，直到1994年他去了Lenox Hill Hospital做骨科主任并成立ROC（Ranawat Orthopaedic Center），后来他又回到了HSS。印度前总理阿塔尔•比哈里•瓦杰帕伊（Atal Bihari Vajpayee）的膝关节置换手术就是他做的。

在2009年他在2009的American Academy of Orthopedic Surgeons Class上做了一个演讲，非常的感人，题目是：Giving back to your country, the people, and your family。全文如下：

It is with a great personal sense of pride and fulfillment that I welcome the graduating class of 2009. Today, my special thanks to the leadership of the Academy, especially Dr. Tony Rankin, for the honor and privilege of being here with you today.

Forty-five (45) years ago, who would have thought that I would have the privilege to stand on this podium, to address you all. Certainly not me or my parents. I came to this country fromIndia, alone, at the age of 28, without any friends or family, and with limited financial resources.

TheUnited States of Americais the only country I know of where first- and second-generation immigrants can rise to their full potential. Just think how fortunate we all are to practice medicine in this country. I urge the members of the AAOS to remain together to preserve and grow our specialty, take it to a higher level, and play a major role in Washington. You, the graduating class, are the future of Orthopaedics and you all should participate with heart and soul.

By choosing our 44th President, Barack Obama, the son of an African immigrant, this country and its people have provided further evidence how greatAmericais. The greatness of this country lies in providing safety to people, legacy of freedom—of speech, of the press, of life, liberty, and the pursuit of happiness, as envisioned two centuries ago by the founding fathers to create this democracy, guaranteed by the Constitution and protected by our brave men and women in uniform (military and police).

Now I come to my main theme, giving back in life and profession is important and needs to be emphasized. What you have acquired in your life, you should share with those who are not that privileged or possess less. I am going to touch on three aspects of giving back. The first relates to financial success and philanthropy. Many of us have or will achieve financial success through the profession or otherwise. If this be the case, I say it is time to share it with those who have less or need more. Philanthropy in general, in American society, is an important aspect of the lives of people who have succeeded.

The second aspect of giving back relates to our professional obligation for sharing knowledge and time and giving the best care to your patients. Giving back in our profession is to give back one’s precious time and knowledge to help in education, research, art, and science of surgery. We as physicians have the moral obligation to treat patients with compassion, honesty, dignity, and respect. Needless to say, it should be based on evidence and to satisfy a patient’s need.

The third kind of giving relates to assuming roles of distinguished leadership. Such distinguished leadership which occurs very infrequently is when people such as Mahatma Gandhi, Martin Luther King, Dalai Lama, Sister Theresa, and others give back all what they possess in their life to achieve peace, equality, and justice. Allow me to talk about the three principles I have lived with.

The following life-affirming principles have imparted meaning in my own life: Nothing endures but change (Heraclitus 480 BC).

Change is very powerful; it for sure sets the tone to be different. The way I understand it is that it could be either better or worse, but it would not be the same. From time to time, I have taken a position to make changes and on several occasions I was all alone. My advice is to be bold, stand firm, and believe in yourself. I have believed that everything in practice and life can be improved with maximum effort and, therefore, I have come up with a line: Everything in life can be improved (CSR).

Albert Einstein claimed that the only rational way to educate is by example. Teaching, education, and research have always been important to me. I am going to present a practical example of what I have done. As you know, I came fromIndia. I have given my time and financial resources, since the late 1980s, to teach Indian orthopedic surgeons through a Fellowship Program and Continuing Education courses. My team and I are proud to say that we have trained 45 orthopedic surgeons through the Ranawat Orthopaedic Research Foundation Fellowship Program (RORF); 90% of them have returned toIndiato practice orthopedic surgery. I have carried out nine (9) Continuing Education courses to date. The next one is in Chennai,India, during the month of June with around 400 orthopedic surgeons attending.

My family and I are committed to philanthropy. The Ranawat Family Trust has decided to support various educational missions. Our family trust continues to donate to the Orthopaedic Research and Education Foundation, The Hospital For Special Surgery, and the Ranawat Orthopaedic Research Foundation. A substantial amount is being donated to Duke University and the Eastern Orthopaedic Educational Foundation and a few loyal employees. So what I want from you all is to think to give back to the country and profession. I hope that many of you will become important and successful physicians and surgeons, and when that happens you will want to give back your personal time, money, intellect to your country, profession, the special people in your life and your family.

I have analyzed how success comes in life. A successful life embodies many qualities, but the important ones are self-discipline, self-reliance, and self-motivation. Back in 1958, after my graduation, I made the commitment to rise at 5:30 AM, go to work, and work for at least 10 to 12 hours, a schedule I follow to this day. To succeed in life you must establish your goals, develop a passion and plan of action for achieving them. Allocate the necessary resources and always periodically reassess your goals and your progress towards achieving them.

And so, graduates of 2009, I leave with you three important thoughts for success and being a good person:

1. To succeed in life one needs good health, peace within yourself, wisdom to make the right decisions, sense of fairness and honesty, and above all, the desire to do better every day.

2. It takes days, months and even years to build a relationship; however, it takes only 30 seconds to destroy it by uttering insulting or inappropriate remarks.

3. Professional success is important; however, in real life one’s family is what really matters. Do not ignore this aspect of your life.

Finally, some of you will become leaders in the near future. Let me give you my thoughts on the qualities of a leader: A leader has the ability to identify, differentiate, and define a complex problem in a manner that everyone can understand; he surrounds himself with loyal, smart and knowledgeable people.

I conclude by wishing all of you the best our profession has to offer, happiness in your personal life, become a leader, succeed, and make the difference. God bless you all and God BlessAmerica.

Please rise and give a big round of applause to the graduating Class of 2009.

Chitranjan Ranawat, M.D.

American Academy of Orthopedic Surgeons

Annual Meeting 2009

Chitranjan S. Ranawat教授已近80岁高龄，2013年做过心脏搭桥手术，因受身体健康状况限制，他现在每周只做一台手术。我有幸跟随Ranawat教授上台参加了几台全髋关节和全膝关节置换手术（图2），见识了他在文章中描述的Ranawat-Insall技术、Pie-Crust技术、Coplanartest、dial等手术技术和技巧。每周一、周二晚上6点到7点，Ranawat教授都会给HSS的住院医生和fellow讲课，我只要有空就去听Ranawat教授的课。

他不追求手术速度，手术非常精细，一丝不苟，不会仅凭临床经验省略一些必要的步骤，没有费动作，绝不返工，保证了优秀的手术效果和关节假体的最长使用寿命。由于手术认真仔细，加上年事已高导致的动作略微迟缓，所以他的手术时间比HSS其他教授的要长。他在行全膝关节置换术时利用低压麻醉，让麻醉师将患者的血压控制在90/60以下，手术时出血很少，由于没有止血带造成的股四头肌损伤，所以患者康复非常的快。

子承父业，Chitranjan S. Ranawat教授的两个儿子也在HSS工作，大儿子Amar S. Ranawat的专业是关节置换，小儿子Anil S. Ranawat的专业是运动医学。Amar S. Ranawat是他父亲的Fellow，虽然没有他父亲的名气大，但他继承了他父亲严谨、仔细、不追求手术速度、追求手术质量的手术风格，与他父亲的手术理念、技术和方法一脉相承、基本上相同。他的手术日是周二和周三，手术房间也恒定，在17号和18号房间。我也跟随Amar S. Ranawat教授上台参加了多台人工全髋和全膝关节置换手术（图3），间接的学习了Chitranjan S. Ranawat教授的关于人工关节置换理论和手术技术的精髓。