Nicola Maffulli, the world’s most cited orthopaedic surgeon, is a former wrestling champion

The Stanford University ranking has listed him as the world’s most cited researcher in scientific publications on orthopaedics and sports medicine (his name appears over 5,200 times). This is not the only distinctive feature of Professor Nicola Maffulli, full professor of orthopaedics and traumatology at Sapienza University and head of the orthopaedic and traumatology clinic at Sant’Andrea Hospital, a native of Naples but who has spent more years abroad than in Italy. Maffulli was also a competitive wrestler, judoka and sambo (the Soviet combat sport) athlete, having finished fourth at the European Championships: his sporting career earned him medals but also two hip replacements, allowing him to experience, both as an athlete and as a patient, the specialism for which he is renowned as a doctor.

As a boy, he won a bronze medal at the Italian championships in freestyle wrestling. When he moved to Great Britain, he discovered sambo and won the open championships in ’87 and ’89; he then earned a black belt in judo and a silver medal at the South East England championships. He ended his career with a fourth-place finish at the European Sambo Championships. He competed in the under-57-kilo category, then in the under-62-kilo category. At the time, he was already a teacher and found himself competing against professional athletes, but after retiring from competitive sport, he continued to tread the ‘tatami’ until he was 42, then stopped due to a lack of time, not a lack of desire, despite his hip replacements. His involvement continued as a doctor at the 2012 London Olympics, when he coordinated the medical team for judo and freestyle wrestling.

Many people enjoy playing padel or five-a-side football, but it is essential to be physically fit in order to play while minimising the risk of injury. Cycling and jogging are far less likely to cause injury. When it comes to competitive sport, the situation is quite different: a footballer who plays 70 matches a season must accept the possibility of injuries and physical wear and tear.

In 2013, following Law 238 on the ‘brain gain’ initiative, I initially taught at the University of Salerno, but I have continued – and continue to do so – to maintain academic links in the UK, where many of my former students now hold senior academic posts. It is a country where the medical profession has changed profoundly and is now comparable to that of a healthcare manager – but without the guarantee of a permanent contract, which only senior consultants have – and with earnings no higher than those of their Italian colleagues. It is discouraging for those who do not regard medicine first and foremost as a vocation.

Perhaps influenced by my father, I had already decided as a child that I would become a doctor, although I was also passionate about the humanities. A background in the humanities is useful: the other day I quoted Thomas Mann’s "The Magic Mountain" to my postgraduate students to explain how a long stay in hospital – something some patients hope for – isn’t actually all that good for them. But nobody had read the book. One student even asked me who the author was.

Essays on pandemics and mythology, but I’m also re-reading Salgari because it takes me back to my younger days. I’ve just finished one of his lesser-known novels: "I naufragatori dell’Oregon".

It is an interest that began when I was a boy: whilst I was a middle-distance runner, I often suffered from Achilles tendinopathy and realised how little scientific attention was being paid to it. Bone always heals, cartilage never does; tendons make all the difference. I began to specialise in this field and, whilst in England, treated several footballers, such as Leeds United midfielder David Batty; I later served as a consultant for Fiorentina and earned that nickname.

It is the result of collaboration between teams from the various countries where I have taught. The main aim is to share our study materials for the benefit of the next generation of academics. I am also convinced that a researcher should not confine themselves to their subspecialism, and this applies not only to sports orthopaedics but also to surgeons, who cannot ignore all the steps that preceded their operation. I am continuing my research with the support of the Vice-Chancellor of Sapienza University and the Director-General of Sant’Andrea Hospital, yet I still go into the operating theatre every day.

Based on the findings, particularly in the United States, there has been a shift in recent years towards a re-evaluation of the generalist. The belief in hyper-specialisation is not substantiated by science, nor has it been by health economics: those who know one thing very well tend to do only that, whilst a professional must have a holistic view; otherwise, they are no different from a washing machine repairman. An orthopaedic surgeon cannot, for example, specialise in the hand whilst ignoring the rest.

Also explore its history and developments, as well as the concepts of pharmacopoeia and rehabilitation practised over time and across different medical traditions.