Winter 2001 Newsletter

Sitting on the terrace of my room at the Istanbul Hilton in the Beyoglu district of the city, where the pace of life never slackens day or night, I can watch the ferries carrying people across the Bosphorus between Asia and Europe. Two elegant bridges from east to west link the continents high above the giant cargo vessels plying north to south between the Black Sea and the Mediterranean. Istanbul is truly the crossroads of the world.

I am here to take part in the 5th Congress of the Turkish Sports Traumatology, Arthroscopy and Knee Surgery Association. The Turkish Association continues to grow, and this year it has attracted more than 700 colleagues from the Middle East, North Africa and Eastern Europe who share our interest in their Sports Traumatology, Arthroscopy and Knee Surgery Congress.

Turkey is home to 65 million people, stretching 2,000 kilometers from east to west and 1,500 kilometers from north to south. There is a single association for sports traumatology, arthroscopy and knee surgery that is all the stronger because there are no separate societies for arthroscopy, knee surgery and/or sports trauma. Instead, the Turkish society has six regional branches sharing the common goals of improved patient care and teaching. The arrangements are similar in Greece.

This reminds me of the time when the European Society (ESSKA) was founded to bring together European surgeons with the same interests, and how two great international societies, the International Society of the Knee (ISK) and the International Arthroscopy Association (IAA), were united as ISAKOS only five years ago. David Dandy of the IAA and Kenneth DeHaven of the ISK had the vision to realize that their two organizations had a common interest with sports trauma and should work together, forgetting their past. It took more than a decade of careful planning and cooperation for them to achieve this goal. They deserve our gratitude.

Each country has its own political and clinical needs, and it would be wrong for ISAKOS to suggest how any nation should conduct itself. The role of ISAKOS is to improve the exchange of ideas and knowledge between nations, not to interfere with national or local politics. Arthroscopy, knee surgery and sports traumatology are separate specialties, and at first sight they are a disparate group. Total knee replacement has little in common with arthroscopy of the shoulder or plantar fasciitis, but some surgeons who replace the knee also reconstruct the anterior cruciate ligament (ACL), and some who replace the ACL treat athletes with foot disorders. There are genuine areas of shared interest: a cooperative grouping of all three specialties works well in Turkey, Greece and Europe, and internationally as ISAKOS.

An alternative is for the three specialties to form separate associations, but this can lead to problems of scale with small associations competing for funding, speakers, professional cooperation with industry and, most importantly, the available time of busy surgeons. If your country has separate associations with each arranging its own small meetings, and you do not have the time to attend as many as you wish, the ESSKA/ ISAKOS model may be worth considering.

Small associations have their own traditions, internal politics can be intense, and sudden amalgamation may be impossible. Yet it is not necessary to amalgamate associations to enjoy the advantages of scale, and politics need not be an obstacle to cooperation. Joint meetings held simultaneously, consecutively or with an overlap bring the same benefits without threatening any group. History has shown that while diversity is interesting, unity is strength.

The aim of ISAKOS is to encourage cooperation and the exchange of ideas at every level. Without communication, the individual member of a society may be lost. The focus of a society needs to lie in and within its members. For this to happen, communication and unification are of paramount importance. Please, I welcome you to write to me with your views and express your opinion, regardless of whether it presents an opposing opinion. This newsletter is your forum!

I find myself and others with a similar cooperative philosophy in attendance this year at the Turkish Congress. The Turkish Association, which is based on a unified model, is becoming stronger and stronger. At first glance there is disparity ­ revision total knee replacement, shoulder arthroscopy and the treatment of plantar fasciitis. Yet when cooperatively grouped together, there is truly shared interest and association. This cooperative model is one that works well.

In Istanbul, I find myself at the crossroads of the world. I continue to gaze at the ferries and cargo vessels of the powerful Bosphorus. By bridge, boat or even tunnel, there is constant flow of traffic between Asia and Europe. Here at the Turkish Congress, there is a cooperative flow of information between diverse topics among people with a shared interest. The Turkish society is strong, for they have unified arthroscopy, knee surgery and sports traumatology into one cooperative model, similar to the philosophy of ISAKOS. Unity is strength. My stay here in Turkey has further reconfirmed my belief that the cooperative model is a strong one and should be considered by all.