Hip and knee surgery



  • Doctor of Medecine, PhD
  • Orthopedic Surgeon
  • Master of Orthopedic and Traumatologic Surgery
  • Master of Science in Micro-Surgery
  • Master of Science in Biomechanics Orthopedic


  • Arthrosis expertise
  • Knee and Hip Prosthesis surgery expertise
  • One day surgery expertise
  • Enhanced Recovery After Surgery


  • Private Hospital Clairval in Marseille (since 1992)
  • Monticelli Vélodrome Ambulatory Surgery Center in Marseille (since 2017)
  • Private Hospital Residence du Parc in Marseille (since 2007)
  • Clinique de l'Etang de l'Olivier in Istres (since 2009)


Dr Didier PROST had his accreditation renewed on September 20, 2018 by the High Authority of Health (HAS) for a period of 4 years.

Accreditation certification : here.

Docteur Prost


  • Member of the French Society of Orthopedic and Traumatologic Surgery
  • Member of the Society of Hip and Knee Surgery
  • Président of the non-profit organization
    of research on infection
    in orthopedic surgeries
  • Member of the French group of ERAS
    (Enhance Recovery After Surgery)
  • Member of the French Society of Ambulatory Surgery (SFCA)
  • Member of the French and the European Society of Surgical Oncology
  • Member of the French Society for Computer Assisted Surgery
  • Member of the International Society for Computer Assisted Orthopaedic Surgery



Historically the goal of surgeons was to cure their patient, nonetheless the patient had to deal with some downside aspect of their case such as : large scars, suffering time, sickness, bad mood, inferiority complex...

At that time, one said : You are going to undergo your surgery. The physician healed an organ not a patient. Medicine was focused on surgical techniques.

Moreover, before the nineties, when they operated, surgeons had to clearly see the injured organ in order to cure it. A well-known slogan was: “A large scar means a brilliant surgeon”.

In 1993, I performed a study on prosthesis scars : their average lenght was 10 inches !


Computer-assisted surgery had made strong technical advances by the end of the nineties. In 1999, I had the opportunity to be part of team of 6 French surgeons to be trained and certified in this technique. Hence, between November 1999 and April 2001, I performed over 50 hip prosthesis utilizing this innovative technique, so-called CASPAR (Computer Assisted Surgical Planning And Robotics).

Unfortunately, this technology has not been rolled out in the French healthcare system since it has not been approved for reimbursement for budget reasons. However, the CASPAR technique has been broadly deployed in Germany and in the USA.

The initial CASPAR technique consisted of using a robot to drill the femur bone according to the patient accurate scanner measurements. The obvious upside was the unparalleled 3D millimeter accuracy, that no human being was able to match. But the downside was the complexity of the process consisting of a 2 step-approach. A first operation had to place metal marks within the patient's bones to get an accurate mapping through the scanner image. The second operation was to place the prosthesis with a larger scar.


From my early twenties, I did annual trips to USA for advanced surgery training and international workshops. I had the opportunity to meet Thomas Sculco, a well-recognized expert in orthopedic surgery. This surgeon set up a new surgery technique that was innovative not only on the technical side, but also on the philosophic side. Actually, this surgeon was convinced of the patient engagement factor in the success of a surgery.
Thomas Sculco trained me to place hip prosthesis with small incisions – 8 to 10 cm vs 20 -23 cm. I then followed up this advanced technique within the Chicago university and back in France, I trained French surgeons to use this technique.
“Minimal invasive surgery” was born.

This innovation has been a major forward step that has changed my surgery vision for ever. In fact, if the surgery goal is still to place a prosthesis, carefully preserving the soft tissues makes the operation philosophy much different : less bleeding and less pain make the recovery much faster.
From time to time, this mini-invasive technique has been enhanced reducing the bleeding and the surgery time, and above all the infection risks : the shorter the surgery is, the lesser the infection risks are.
But to use this technique, surgeons must have appropriate training with regular practice since it requires more dexterity due to smaller incisions. Today, this surgery time is less than one hour. In 2012, I decided to exclusively use this minimal invasive technique for hip and knee prosthesis.


Some times after, surgery navigation technique was developped which brought significant help to surgeons.
This technique is 5 times less pcostly than the CASPAR technique. Thanks to my CASPAR experience, I sm able to quickly and seamlessly use surgery navigation systems.

But it turns out that these systems help young surgeons more than experienced ones: they are add extra steps within the surgery process that lengthen the surgery time.

Moreover, these robots dehumanize the surgery process and created an extra mindset barrier between the surgeon and the patient.

Hence, the ROI for the patient is not clear and I decided not to pursue the use of navigation systems. But this innovative technique has been fruitful for my professional experience.


At the same time, the minimal invasive techniques have been developed for knee prosthesis as well.

The philosophy is the same: to preserve the soft tissues of the knee as much as possible. This minimal aggression of soft tissues significantly benefits the patient: less pain, less bleedings, and faster recovery.

My initial training started in the USA and was complemented in Paris in 2004.

This mini invasive surgical technique has been constantly enhanced by surgeons reaching the point where the infection risks are minimal due to a short surgery time.


In 2007, the Danish surgeon Dr Kehlet pushed the envelope. Initially designed for digestive surgery, he adapted the « fast track surgery » or « ERAS » to orthopedic surgery. ERAS is a patient care pathway.

It has been successfully deployed in several countries for years. The ERAS process is very promising and should be extensively used in France since the Ministry of health changed the reimbursement method for arthroplasty of hip and knee.

The ERAS is not a specific surgical technique but a new medical process. This is a new organization within the whole medical team which becomes a patient-centric team. Therefore, the mindset of the patient is moving towards a more engaged mindset, the patient becomes pro-active in their recovery. This engagement clearly reduces the recovery time and increases the patient's quality of life.

Medical studies clearly demonstrate that this ERAS process reduces post-surgical complications knowing that mini invasive techniques are a given to perform the ERAS care pathway.

ERAS has completely changed the way the medical team takes care of the patient's pain. Thanks to this process, this pain factor has been stepped up as a critical factor and has been fixed thanks to a closer collaboration between surgeons and anesthetists. Reducing the pain level is a clear benefit for the patient but also for the healthcare system, costing less through a shorter hospital stay.

This is a major mentality change in France.

The patient is not considered as sick anymore, he has just had a surgical procedure.

To know more, please click here


Now, we are reaching the ultimate goal of the ERAS process.

Since 2016, surgeons are able to do total hip or knee prosthesis (TKA or THA) within less than a day. That means the patient enters the hospital in the morning and is able to get back home the same day, late in the afternoon: with just a few hours in the hospital.

Multiple medical studies have clearly established that this process is not only safe for the patient but also creates significant benefits such as less post-surgery complications compared to traditional process. Ambulatory process is a standard process, and is performed on a daily basis in the USA. It requires a specific organization within the hospital that could be compared to lean management in industry: a thorough analysis of each step of the medical process and organization enables an optimized care pathways, increasing the overall patient satisfaction.

The brand new Monticelli-Velodrome hospital, located in Marseille, which started operation in November 2016, is a center of excellence in the ambulatory process.

Today, two thirds of THA and half of TKA are performed under as a day procedure.

To know more, you can click here