I was privileged to be awarded the 2021 ISAKOS Global Travelling Fellowship. This came on my second attempt and found me just one year below the age limit of 45 years. When the 2021 Congress was cancelled due to the Covid-19 pandemic, it looked like all was lost. However, we received an email reassuring us that it would happen in 2023 despite the age limit and this cleared the air for me.
Preparations for travel went well with the only hitch being a delay in getting a visa for Canada due to a long waiting list (average 589 days for Kenyans) and I finally got it on the last working day before date of travel.
I left Kenya on Friday, June 2, 2023 and met one of the other fellows, Dr. Saroj Rai, on transit in Germany. We arrived in London, Ontario on the third of June, welcomed by Drs. Alan Getgood, Richard Litchfield and the Fowler Kennedy team, despite a few travel hitches. I was able to complete a 46th birthday run on our first full day in London. This was followed by a rope course, ziplining and dinner hosted by Dr. Getgood.
The second day began with presentations, and I was privileged to do a presentation on complications of ACL surgery. The subsequent discussion was very informative for me. This was followed by operating room visits where we observed hip arthroscopy with resection of cam lesion, tibial tubercle osteotomies, MPFL reconstruction, trochleoplasty, distal femoral osteotomy and reconstruction of multiligament injured knee. We paid a visit to the research lab where we apprised on the ongoing Stability II study. I am eagerly waiting for the results of the study as I know it will have significant impact on my practice. That afternoon, we visited cadaver labs to further observe and practice surgery. On the last day, we had an early visit to the breathtaking Niagara Falls and Wayne Gretzky winery before leaving for Calgary.
At Canmore in Calgary, Dr. Laurie Hiemstra and her team received us. We visited the OR in Banff on the second day. Surgeries observed included tibial tubercle osteotomies, MPFL reconstruction and trochleoplasty. We also had insightful discussions on measurements used in assessing patellofemoral alignment including TT TG and TT PCL. We took a tour of Banff in the afternoon. On the second day, we visited the Banff Sports Medicine Clinic and were able to observe the approach to sports injury prevention and the rehabilitation processes. We were also briefed on the ongoing research and were given a presentation on patellofemoral disorders and current research. We toured Lakes Moraine, Louise and Minnawanke and took a drive to see some wildlife. We were then hosted for dinner by the Banff team. On the last day, we were able to join some staff at Banff for an "easy" run that turned out to be some taxing hill work before leaving for Stanford. During the run, we had a bird’s eye view of Canmore and were able to appreciate the beauty of the landscape.
At Stanford University, we were welcomed by Dr. Seth Sherman and started off with a tour of the University grounds. Later, we attended a live, San Jose Earthquake match at PayPal Park. This was the first social event before a trip to Monterey and Pebble Beach alongside the Monterey Aquarium and Cannery Row. We later visited the San Francisco suspension bridge and attended an Oakland Athletics baseball game at the Oakland Coliseum.
The operating room experience was quite educational as we observed hip arthroscopy with chondroplasty and capsular closure. We were also able to observe a revision of Roux Goldthwait procedure with TTO, MACI and MPFL reconstruction. There was also Dr. Safran’s grand round where our Godfather, Prof. Ponky Firer, presented the ‘big five” in relation to the stages of professional development and elaborating on the pearls and pitfalls. We had another paper review session where I was able to analyze a paper comparing clinical and MRI findings to arthroscopy findings in knee pathology.
Our last observation Centre was in Taos, New Mexico. We were warmly welcomed by Dr. Dan Guttman and his team. Surgical procedures observed included shoulder arthroscopy with subscapularis repair, sub pectoral biceps tenodesis and lower trapezius transfer. Other procedures included first stage revision ACL reconstruction using bone dowels and rotator cuff repair using a novel technique by Dr. Sean Marvil. We also had a cadaver lab session where I was able to practice arthroscopy procedures for shoulder instability. This was followed by a discussion session reviewing scientific papers on lateral extraarticular tenodesis and use of quadriceps autograph for ACL reconstruction. In addition to this, we experienced interesting sightseeing tours—starting with a visit to Taos pueblo where we learnt about the Tiwa people and were able to appreciate their history, culture and architecture. This was followed by a visit to the Rio Grande Canyon and the Earthship Community. We were then later treated to dinner by Dr. Guttman. On the morning of departure, I was able to do some high altitude running with a maximum elevation of 2173 meters above sea level before heading to Santa Fe for the flight to Boston.
We arrived at Logan Airport in Boston on June 17, ready for the Biennial ISAKOS Congress. Early next morning, there were instructional course lectures and registration. This was followed by the Presidential Speech and Presidential guest lecture by Dr. Paula Pareto. The speech by Dr. Pareto, an Olympic judo gold medalist and Orthopaedic surgeon was “How the ‘impossible’ becomes possible”—which was quite inspiring. She discussed her struggles including injuries and her path to winning an Olympic gold medal. She also emphasized the need for teamwork. The phrase I took home from her speech was that “failure is worse than not trying.”
The next day was equally busy starting with instructional course lectures. I attended the one on the approach to musculotendinous injuries in high performance athletes. This was followed by the Freddie Fu Lifetime Achievement Award given to Dr. John Bartlett from Australia. Dr. Bartlett subsequently gave the Freddie Fu Honor Lecture, "Honour the Work" and risk of popliteal artery injury in ACL deficient knees.
The third day also started with instructional course lectures followed by the introduction of international presidents, recognition of outgoing and incoming JISAKOS Editors in Chief, ISAKOS awards ceremony and introduction of the 2025 Congress. We were also honored to appear at the podium as the 2021 Travelling Fellowship winners. I must admit the experience for me was surreal. Though quite excited, I was humbled and thankful for the privilege.
During the conference, I was able to learn a lot by attending instructional course lectures, paper presentations, lunch time sessions and even the virtual reality challenge. I also met world leaders in orthopaedics and colleagues from Africa and the rest of the world. We were also introduced to the Magellan Society that incorporates former travelling fellowship winners.
Some of the valuable lessons I picked from the travelling fellowship were:
- Improve skills to improve training, a better surgeon makes a better trainer.
- The importance of work life balance—even during the most demanding or challenging tasks.
- Building networks/teams and the power of teamwork in accomplishing tasks.
- The satisfaction and fulfillment of giving back to society.
- The importance of "Standing on the shoulders giants"
At the end of it all, I felt a renewed drive to improve myself and my service to patients. I also realized that I still have so much to learn and see. There is also a need to share my experiences with the rest of the world through publishing. I met many amazing people. Though the encounters were brief, I hope it was the beginning of lifelong connections.
I will remain forever grateful to ISAKOS, our Godfather, Prof. Ponky Firer, and our hosts who went out of their way to ensure the fellowship was fruitful. I believe it is now my turn to give back to society.