Didier Patte

 

Didier Patte: co-founder of the European Society of Shoulder and Elbow Surgery 1933 - 1989

Written by G. Walch

Didier PATTE was born in 1933. He did his medical School in Paris and was successively resident and Assistant Professor of Orthopaedic Surgery with Professor DEBEYRE in Paris. He should have been Professor too, but Didier got married young, had 4 children to take care of and this was the reason why he choosed the private practice. With some colleagues he acquired in Melun, the large Parisian suburb, la clinique des Fontaines.

Excellent surgeon, hard worker, very active organizer, his practice was general orthopaedically oriented, but gradually he specialized in shoulder surgery with his partner in Melun, Jean Claude SHEFFER, and his successor at the University Hospital Henri Mondor in Creteil, Daniel GOUTALLIER.

In 1963 he defended a thesis about "Surgical treatment in rotator cuff ruptures". At this time there were 2 schools for shoulder surgery in Paris and in France: the one from Gosset, Dautry, Apoil, who defended the debridement of the RCT and the Debeyre's school which recommended the repair of the tears. Influenced by the American way and the famous Neer's acromioplasty, Didier went progressively to think that repair and decompression were both necessary: He described the famous GLA which included acromioplasty and resection of the lateral cm of the clavicle. This approach gave a larger view on the RC and allowed to perform the Supraspinatus slide transposition which he developped with Debeyre. Later on, he developped together with D. Goutallier the combined supra+infraspinatus transposition to cover massive RC defects. Didier was the first to understand the difference between the anterosuperior ruptures and the posterosuperior ones. He was the first to segment the cuff and subclassify the rotator cuff tears and this was published in the CORR with his Canadian friend Hans UHTHOFF. He developped an "algo-functional score" to evaluate pre- and postoperatively the patients with rotator cuff tears. Unfortunately this score was a little bit too complicated and long to fullfil and is not used any more.

For the treatment of anterior instability he popularised in France the Latarjet procedure that he modified and called "the triple blocking procedure". He was the first to recognize that his operation should not be considered as a "block" but rather a dynamic procedure. He typically used to cut the superior two third of the subscapularis and recommended to suture the lateral capsule to the conjoint tendon. His technique is still largely used in France. With GARDES he described the famous EDI (Epaule Douloureuse et Instable) ( painful unstable shoulder) and with Jacques BERNAGEAU he standardized le Profil Glenoidien to analyze the anteroinferior bony Bankart lesions. This incidence, known as “Bernageau View”, is still the best one for many surgeons, as standard imaging studies in anterior instability.


He developped with WEBER, who was a radiologist in his clinic, a classification of the acromio-clavicular instability and reported operative techniques for surgical treatment of both acute and chronic instability.


Regarding shoulder arthroplasty, he used the NEER prosthesis and in 1985 he founded the Duplay Group to put together all the young surgeons who were more and more numerous to visit him in Melun: Daniel MOLÉ, Jean-Claude SCHEFFER, Henri MESTDAGH, Dominique GAZIELLY, Cecile NEROT, LE SAOUT, myself and many others. The objective of the Duplay Group was to design a new prosthesis with the 3M company. Unfortunately this never happened. Like many French surgeons, Didier did not speak English very well and was very frustrated not being able to debate on equal terms with surgeons from European and American countries.

Nevertheless, he attended the 3rd ICSS in Fukuoka in 1986 with Professor TAKAGISHI as chairman. He met Doctor NEER there and was appointed to host and organize the 5th ICSS in Paris in 1992. In FUKUOKA, together with Norbert GSCHWEND, he decided to found a European society to counter balance the American group and to help the organisation of the International Conference in Paris.. Norbert GSCHWEND was very well known in France for his publications on the rheumatoid shoulder. He was fluent in French and English, German, Italian and other languages I forget. Also Norbert had many connections with surgeons all over the world and especially in Europe, like Mario RANDELLI in Italy, Otto SNEPPEN in Denmark, Mickael WATSON in England, Jochen EULERT in Germany. The SECEC was founded in 1987 and the inaugural congress was held in Paris during the French Orthopaedic Society Congress under the patronage of C.S. NEER.
Norbert was the first President, Didier PATTE was General Secretary and there were seven other members who became in turn Presidents of the SECEC: Daniel GOUTALLIER, his good and probably best friend, Mario RANDELLI, Otto SNEPPEN, Jochen EULERT, Mickael WATSON. Didier Patte wanted that the Society should be bilingual to allow the French people to report their works and to debate on equal terms with other surgeons in Europe.


While the SECEC was starting to be successful, a lung cancer stopped his incredible energy in the winter of 1988. He was a hard smoker and liked the "café crème" cigars maybe more than his life. The day before his death, he was still smoking cigars in his bed at the Villejuif Hospital Didier PATTE was extremely kind and a great support for his young colleagues. He was so enthusiastic and charismatic that he gave the desire to many of us to specialize in Shoulder Surgery and to dedicate their career to this specialty. He was the one who actually initiated, together with Michel MANSAT, the subspecialty of shoulder surgery in France and then in Europe: I am sure that he would have been proud to see what the SECEC is now .


He died on February 28, 1989 and we will remember and honor him either as a friend, a mentor, a master, a father or a Godfather. He never let anybody unconcerned or indifferent.
I am happy that the SECEC honors him on occasion of its 20th anniversary.