"Only A Beautiful Operation Will Give A Good Result"

Expert Profile

Andrey Vadimovich Korolev is co-founder, chief physician, and medical director of MARS Clinic (Moscow), trauma surgeon-orthopedist, Doctor of Medical Sciences, and professor. A leading Russian specialist in sports traumatology and arthroscopic joint surgery, he is one of the pioneers in the development of arthroscopic methods in Russia. President of the Association of Sports Traumatologists, Arthroscopic and Orthopedic Surgeons, and Rehabilitation Specialists (ASTAOR).

Overall work experience: 36 years.

Education and Qualifications:

1985 – Higher medical education in "General Medicine," First Moscow Medical Institute named after I.M. Sechenov.

1987 – Residency in "Surgery," Moscow Medical Academy named after I.M. Sechenov.

1990 – Postgraduate studies in "Surgery," Moscow Medical Academy named after I.M. Sechenov. Scientific supervisor: Academician M.I. Perelman.

1990 – Awarded the academic degree "Candidate of Medical Sciences." Dissertation: "Tracheal Allotransplantation: Clinical and Experimental Study."

2004 – Awarded the academic degree "Doctor of Medical Sciences." Dissertation: "Comprehensive Restorative Treatment of Patients with Knee Joint Injuries and Diseases."

2005 – Professor, Department of Traumatology and Orthopedics, RUDN University.

2006 – Awarded the academic title "Professor."

International Training and Internships:

1992–1994 – Internship in surgery and traumatology-orthopedics at the Innenstadt Clinic of Ludwig Maximilian University (Munich, Germany) under Professor Leonard Schweiberer, during the active period of arthroscopic joint surgery development in Europe.

Work Experience:

1990–1992 – Surgeon, senior researcher in the academic research group under Academician M.I. Perelman, Russian Scientific Center of Surgery.

1994–2001 – Trauma surgeon-orthopedist, associate professor, Department of Traumatology and Orthopedics, Russian Medical Academy of Postgraduate Education.

2001–present – Trauma surgeon-orthopedist, professor, Department of Traumatology and Orthopedics, RUDN University.

2002–2024 – Chief trauma surgeon-orthopedist, "European Medical Center" Group of Companies.

2009–July 2024 – Co-founder, chief physician, and medical director, European Clinic of Sports Traumatology and Orthopedics (ECSTO), "European Medical Center" Group of Companies.

July 2024–present – Chief physician and medical director, "Olymp Clinic MARS."

Public and Scientific Activities:

• President of the Association of Sports Traumatologists, Arthroscopic and Orthopedic Surgeons, and Rehabilitation Specialists (ASTAOR)
• Member of the American Academy of Orthopaedic Surgeons (AAOS)
• Member of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA), member of the Sports Medicine Committee
• Member of the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS), member of the Arthroscopy and Shoulder Surgery Committee
• Member of the Russian Arthroscopic Society (RAS)
• Member of the editorial boards of "Bulletin of Traumatology and Orthopedics of Russia" and KSSTA Journal

Author of several monographs, chapters in monographs (including international ones), and more than 200 scientific works. Scientific supervisor of 2 doctoral and 12 candidate dissertations.

Regularly speaks as a lecturer, moderator, and organizer at international and Russian congresses, symposia, and conferences on traumatology, orthopedics, and sports medicine.

"I HAD COMPLETE FREEDOM"

– What was your path into traumatology and sports medicine?

– I was a student of Academician Mikhail Izrailevich Perelman and was fascinated by thoracic surgery. My first dissertation was on tracheal transplantation. It was very interesting work because the trachea is 70% cartilage, and cartilage became my lifelong passion. I performed hundreds of experimental operations on animals, from rats to dogs, and worked with microsurgical techniques. Imagine: the diameter of a rat's trachea is only 1.5–2 mm; to suture it, you need 8-9 zero threads that are almost invisible to the naked eye.

But in the 1990s, thoracic surgery in Moscow began to decline for economic reasons. Patients from the former Soviet Union stopped coming, and there was no funding. It was then that I was invited to give lectures in Europe, and later Professor Leonard Schweiberer from Munich (who headed the Department of Surgical Clinic and Polyclinic at the Innenstadt Clinic at LMU in Munich) suggested I study there. He found a scholarship and accommodation for me. I went with the idea of continuing work in vascular surgery.

But when I arrived, the professor advised me to choose traumatology. He said: "In thoracic surgery we won't teach you anything; your teacher Professor Perelman is a brilliant surgeon, you've already seen the top level. But in traumatology in Russia and in Europe, it's simply night and day." It really was. What was even more important, I found myself in the clinic at the exact moment when arthroscopic surgery was beginning to develop intensively throughout Germany. Our clinic was one of the key centers for the development of sports traumatology in the country. I essentially got in at the very beginning of this field in Europe. The guys I worked with then became professors and heads of major clinics. And some, to my surprise, have already retired.

– You returned to Moscow in the mid-90s. That's a difficult time, especially for developing a new field. 

– I had the opportunity to be at the very beginning of the development of arthroscopic surgery and sports traumatology in Russia, right here in Moscow. I came here young and already a fairly experienced specialist, and literally found myself in the middle of a vast field that needed to be cultivated. My brother and I bought an arthroscopic unit in Germany with our own money, by the way, it cost as much as a good car. And it paid off. For several years I was at the Department of Traumatology and Orthopedics at RMAPO, then moved to the department at the Russian University of Peoples' Friendship.

I had complete freedom. Very few clinics in Moscow were doing arthroscopic surgery, and I held consultations according to the German principle: once a week, on Wednesdays, from 1 PM until the last patient. When consultations reached 9 hours a day at 20 minutes per patient, I began taking students and organizing the process. From the first day, I hired a secretary. Because in Germany I saw that having a secretary increases a doctor's efficiency exponentially.

– How has the level of Russian traumatology, particularly arthroscopy, changed over these years?

– Speaking of progress, initially at our courses and conferences, basic things were popular: how to perform arthroscopy, how to position the patient, what instruments to use. And if you look at today's conferences, the level of presentations doesn't differ from leading European and world conferences.

From the perspective of healthcare accessibility on a national scale, the situation has improved significantly—the government participates in treating complex pathology, there are quotas for high-tech medical care—joint replacement and arthroscopic operations. Things are especially good in Moscow and large cities; in smaller ones it's more difficult, but it's still possible. We have access to proper implants, technologies, and surgical methods. The level has increased exponentially over 30 years.

Remember in "The Little Prince": if you want to stand still, you must run fast. If you want to move forward, you must run even faster. Medicine works exactly the same way. You must keep up with news, congresses, publications, new surgical techniques, Russian and international conferences. And you must definitely speak yourself to share knowledge with the audience.

– What currently excites you in terms of technology development?

– We try to implement everything modern that appears on the market. Among the most realistic things, we're waiting for technologies that will help improve local cartilage healing and restoration. Now we use, for example, platelet-rich plasma: we take the patient's own blood, extract its most active part, and inject it where the tear occurred. This stimulates healing.

What can be considered revolutionary appeared quite recently: at one university they identified a gene responsible for aging of the entire organism. If this gene is slowed down, the whole organism begins to age more slowly, including cartilage. Of course, I'd like to have something in my arsenal that would change the DNA of the process and stop it. Not just suppress symptoms with pills, but affect the process itself. That would be a breakthrough.

"I DREAMED OF BUILDING A MULTIFUNCTIONAL CLINIC"

– "Olymp Clinic MARS" is not your first project. What were you able to implement in this center that's fundamentally new and especially important compared to previous clinics?

– Yes, there was another project before—the European Clinic of Sports Traumatology and Orthopedics. This clinic was completely conceived by me; I sought opportunities to implement it with a ready project, and I managed to do so with investors from the European Medical Center. We worked for many years and achieved certain success and reputation. Over time, interaction with investors began to change, which prompted me toward a new project.

Organizationally, I build the work based on extensive experience from European and American clinics. All my life I've loved and still love looking at other clinics: how, where, what is arranged. You can always see something useful. For example, once in the USA I met a famous professor. It was his last year before retirement. I knew about him and really wanted to see how he worked, consulted, and operated. And I brought back several consultation tricks that I hadn't suspected before. They weren't widespread in Europe.

One such trick is about the speed of consultation flow, both from the perspective of patient communication and technical organization of the appointment. Before the consultation, assistants open the images, you quickly review them, then come to the patient already prepared. The computer is placed at standing height so you don't waste time on "sitting down and standing up." And so on. As a result, you can see exponentially more patients in one hour. 

I dreamed of building a multifunctional clinic with many specialists. One doctor cannot know everything. I wanted to be able to quickly assemble a consultation, rather than calling someone from another clinic, but to solve it here and now. We had such a situation today: we needed to quickly gather cardiologists, internists, anesthesiologists, surgeons to understand whether we could operate or not. In 15 minutes we made a balanced decision: it turned out we could.

– How is the multifunctionality principle reflected in the clinic's infrastructure?

– In one building there is an emergency department with a large examination hall, a separate entrance, and an emergency operating room. We designed the radiology department ourselves, literally down to the millimeter. There are changing rooms for patients before the procedure, where they can change into MRI-safe clothing and leave metal items. Then the study is conducted, and the patient exits through a pass-through door. This didn't exist before, and I wanted to ensure comfort for patients and staff in everything.

We have a robust 24-hour reception, a café, several floors of outpatient clinic, as well as operating rooms and inpatient units. We managed to create all the possibilities for surgeons to work. After all, patients are different, especially if it's an elderly person with multiple medical conditions, then during surgery we need to know precisely that all organs and systems are functioning adequately. For this we have hospitalists who examine, determine the possibility of surgery, and fully prepare the patient for it.

The operating block itself is very comfortable. We drew each room ourselves and constructed everything as we considered correct, down to the wall color. After all, the only place where a surgeon mentally rests is the operating room.

And most importantly—rehabilitation. This is a fantastic advantage because I can trust rehabilitation specialists who clearly know my principles. An inexperienced or overly ambitious physical therapist can tear apart and ruin everything you've sewn for the patient. Our rehabilitation department is headed by Dr. Denis Ilchenko—one of the leading Russian rehabilitation specialists who started his career as a trauma surgeon-orthopedist. He understands the line when conservative treatment is needed versus when surgery is needed, and what rehabilitation should follow.

– So from a conceptual perspective, this is a multidisciplinary clinic with a center of excellence in traumatology, sports medicine, and rehabilitation?

– Yes, that's exactly the concept. You can't create a clinic that's "everything for everyone."  There are such examples in Moscow; these clinics don't take off. They treat everything, but at the same time nothing. High staff turnover, and if you go there, they'll take some tests, listen, palpate. But this project won't become leading, won't be talked about. For a clinic to occupy leading positions and for excellent specialists in all areas to want to work there (and to be able to invite any specialist for treatment), its portfolio must have several leading areas. In our case, it's traumatology, orthopedics, and rehabilitation.

– How is the clinic's capacity, considering the project is brand new?

– Over a full year of operation, we've already performed more than 1,500 operations of various types, but of course traumatology and orthopedics are the flagship direction; quite a large flow of patients comes precisely because they know me. At the start, this helps a lot. We're developing medical tourism; previously there were more foreign patients in my practice, of course, but with the resumption of direct flights between countries, this flow will be restored.

"FITNESS FIVE TIMES A WEEK, HALF MARATHON TWICE A WEEK"

– When people say "sports medicine," there's a feeling that it's only about athletes. The focus shifts a bit. Who are your main patients?

– We have several key patient groups. The first is young athletes. There are sports practiced from childhood: figure skating, rhythmic gymnastics, ballet. The Russian school is the strongest; these are great workers and hard workers. Parental ambitions certainly matter, but the child's own interest remains decisive: if they really like this sport, they can withstand tremendous loads.  Sometimes the body can't withstand them, and we come to help.

The second group: professional athletes who earn their living from their sport.

The third large group includes people who play sports for themselves. This can be recreational, once or twice a week. But there are men around 40 years old who've built their business, have free time, and do fitness five times a week, run a half marathon twice a week, a marathon every two weeks, or even Iron Man in Hawaii at temperatures around 120 degrees Fahrenheit with 100% humidity. Such people also come to us.

And the fourth, so to speak, age group, when joints wear out over time from heavy use and overload. There are incredibly many of these patients, and they are underdiagnosed. They live and suffer until the last moment. Some come for diagnosis and treatment earlier to understand what preventive measures are needed. And some endure until the very end.

– Now many clinics are engaged in outpatient treatment, joint injections, and often this is essentially the only method in their toolkit. Perhaps this is why some patients take so long to get to surgery.

– If you only do conservative treatment, sooner or later you become an "injection" doctor. This doesn't mean injections shouldn't be used; we also use them a lot. But there must be a line, and it's only possible to determine it by having extensive experience and the opportunity to work in a multidisciplinary team.

– Tell us how a patient's journey goes, especially if they're from another region or country?

– Many patients first contact us for a remote consultation. We communicate by phone or video, the patient sees the clinic, talks with the doctor, receives a written report, and decides whether to come to us for surgery. I speak English, German, and French. We have a special hospital department that speaks several languages—Polish, Croatian, Bulgarian, Czech, Arabic. If our own knowledge isn't enough, there's always Google Translate, which can translate audio.

The algorithm is as follows. Surgery day is day zero. Five days before surgery, the person gets all tests done. Three days before—meets with the anesthesiologist and internist. If something needs to be completed, we finish it in a day or two. On the morning of surgery day we admit and operate. Two to three nights after surgery the patient is with us, then a couple of days at home. About a week later, rehabilitation begins with our team.

– Who is your target audience in terms of price segment?

– Our clientele is upper middle class, their children and parents. I've always been against clinics for the super-rich. In Moscow there was an attempt to create such a project about ten years ago—the concept was ultra-elite rooms and doctors who would be brought in for crazy money. But I'm convinced that an extra 100 euros won't make a doctor with a huge patient flow rush somewhere. In general, that clinic didn't even open.

– Nevertheless, from a design perspective, the clinic can be classified as a premium segment.

– There's a wonderful principle in architecture: utility, strength, beauty. This should underlie both a clinic and any building. My grandfather, Sergei Pavlovich Korolev, always paid great attention to the aesthetics of spacecraft. He said that only a beautiful product would work adequately in space. I'll continue this thought: only a beautifully performed operation will give a good, adequate result. If you haphazardly sew something together, there will be no result.

And only when a patient is in beautiful surroundings, in a beautiful interior, helped by courteous reception staff, finds themselves in a beautiful inpatient unit, in a beautiful operating suite, and exercises with experienced rehabilitation specialists in a beautiful facility—will their result be better. We elevate the patient to a high level. They see that they are treated with respect, that the clinic has built beautiful facilities for them. This is the basic principle of any international hospital.