Francisco A. S. Cafalli, Dr. Cafalli, or simply Cafalli, as he liked to be called by his friends, was born in São Paulo, the son of Italians, and always stood out because of his unparalleled politeness, tenacity and intelligence.
He completed his middle and high school education with honorable mentions at the Dante Alighieri Italian-Brazilian Secondary Education Institute, which was later renamed the Dante Alighieri College. He was admitted to the Medical School of the University of São Paulo (USP) through the university entrance examination in 1948, and passed in third place. There, during the medical course, he spent time with illustrious professors of the medical school and he began his scientific career with awards and published papers.
He graduated in medicine in December 1953 and chose orthopedics as his specialty, attracted by the prominence of the recently inaugurated building of the Institute of Orthopedics and Traumatology, then known as the Orthopedics and Traumatology Clinic, which comprised a structure of ten floors and an annex of three floors, with floor area of around 20,000 m2. He completed his internship and medical residency in orthopedic and traumatological clinical medicine (29th professorship) at the teaching hospital of the USP Medical School between 1954 and 1956, under the direction of Professor F. E. Godoy Moreira. He was admitted as an auxiliary teacher and physician.
In 1959, he obtained study bursaries funded by the French Ministry of Foreign Affairs and by the Brazilian Coordination Office for Improvement of Higher-Education Personnel (CAPES) for a training program in the clinics of the Professors R. Judet, Paris, France; M. D'Aubigné, Paris, France; M. Guilleminet, Lyon, Françe; J.J. Herbet, Aix-les-Bains, Françe; R. Zanoli, Bologna, Italy; O. Scaglietti, Florence, Italy; R.G. Pulve- nartaft, Derby, England; and W. Sommerville, Oxford, England. Upon returning to Brazil, in 1963, he began his activities at the Orthopedics and Traumatology Clinic of the "Francisco Morato de Oliveira" State Public Servants' Hospital, by invitation from Dr. Plínio Cândido de Souza Diasto de Oliveira. This hospital had recently been inaugurated and had resources that were extremely advanced for the era, such as "surgical arc" radioscopy apparatus. There, also in 1963, he participated in creating the hospital's medical residency program, which was one of the first to be accredited by the Brazilian Society of Orthopedics and Traumatology (SBOT).
In November 1970, he was fascinated by the visit by Professor G.K. McKee F.R.C.S to the Public Servants' Hospital, where, together, they performed metal-to-metal cemented total arthroplasty procedures with unprecedented transmission by television to the audience of the Ninth Orthopedics and Traumatology Study Day.
Through his scientific restlessness and in search of advances within the specialty, he traveled abroad again in 1971, on a training program with the Professors G.K. McKee F.R.C.S, in Norwich, England; Sir J. Charley F.R.C.S, in Wigan, England; R.S. Garden F.R.C.S, in Preston, England; and R. Meary and M. Postel, in Paris, France. For further refinement, he participated actively in surgery with the Professors H. Sed- don F.R.C.S, in London, England; M. Freeman F.R.C.S, also in London; H. Frost, in Detroit, United States; and R.B. Salter, in Toronto, in Canada.
His great interest at that time centered on minimally invasive procedures and, in conjunction with Dr. Milton Iacovone, a colleague from his medical school year group and during medical residency, he received the Godoy Moreira award for 1972, for the study "Percutaneous intramedullary fixation of fractures of the distal extremity of the radius". He applied the percutaneous tenotomy techniques that he had learned with Professor H. Frost and he insisted that his residents should obsessively observe the first principle of medical treatment: primum non nocere (first, do no harm).
With this focus, after reading the article "The role of arthroscopy in the management of disorders of the knee", published by R.W. Jackson and Isao Abe in JBJS54 (1972) 310–322, he decided to visit Professor Jackson in Toronto. After intensive correspondence and with the acquisition of a Watanabe 21 arthroscope for the Orthopedics and Traumatology Clinic of the Public Servants' Hospital, he was able to bring Dr. Robert W. Jackson to visit the hospital in 1973, for the first theoretical-practical course on arthroscopy in Brazil. This procedure became important after this course and culminated with a visit to Brazil by Professor Watanabe in 1975 and visits abroad by several orthopedists.
At Dr. Cafalli's invitation, several internationally renowned professors, such as Eduardo A. Salvati, John Insall, Robert Salter, H. Frost and D. Evans, gave courses and talks and participated in surgery at the Public Servants' Hospital, always improving and innovating the orthopedics practiced there.
In 1981, when Brazilian orthopedics had the honor to host the 15 th SICOT Triennial World Congress, under the chairmanship of the late Professor Dagmar Chaves, the Fourth Congress of the International Arthroscopy Association also took place at the Hotel Intercontinental in Rio de Janeiro. On August 28 of that year, at a meeting with several prominent colleagues within Brazilian orthopedics and with Dr. Robert W. Jackson and Dr. Masaki Watanabe, Dr. Cafalli founded the Brazilian Society of Arthroscopy and took on the presidency of the first administration.
He was also active in the scientific program of the 15th SICOT Triennial World Congress. He took part in round-table discussions in the main auditorium with distinguished figures within the worldwide orthopedic community such as Dr. W. Harris, of Harvard University, on the topic of the importance of preventing deep vein thrombosis during the postoperative period after orthopedic surgery, through using heparin, which at that time was little used.
In 1982, he took leave from the Public Servants' Hospital to take on the role of Orthopedics Coordinator, as chief surgeon, at the "Sarah Kubitschek" Hospital for Diseases of the Locomotor System. This hospital was recently inaugurated but lacked technical and scientific foundations in orthopedics.
After planting seeds there, he returned to São Paulo to take on the position of Director of the Orthopedics Clinic of the Public Servants' Hospital, after the retirement of Dr. Plínio Cândido de Souza Dias.
In 1985, he created the Orthopedics Study Center of the Public Servants' Hospital, which focuses on continuing medical education for residents and attending physicians at the clinic.
In 1989, he took on the presidency of the Department of Orthopedics of the São Paulo Medical Association/São Paulo Regional Association of SBOT. He organized the first study days at Campos do Jordão, which originated the present-day Orthopedics and Traumatology Congress of the State of São Paulo (COTESP).
He continued as Director of the Orthopedics and Traumatology Clinic of the State Public Servants' Hospital until 1998. He was an active member of several international societies, such as the British Orthopedic Association (Overseas Fellow), American Academy of Orthopedic Surgeons (Reciprocal Member) and International Arthroscopy Association (Director at Large). He participated in several government committees, published many scientific articles and book chapters and received awards and homage over the entire course of his career.
Dr. Cafalli made many technical and scientific contributions to Brazilian and international orthopedics, but what always marked the profile of this irreplaceable physician was his character: simple but noble, polite and attentive toward his colleagues and patients, but absolutely intransigent toward substandard work.
He held firm to strong principles of honesty, humanism and sensitivity, and always focused on his mission to minimize human suffering, while calling himself "apolitical".
He brought up his two children with great attention and care, transmitting unmatchable values to them, and also had the opportunity to enjoy the loving company of his grandchildren.
He shared his deserved years of love and joy with his dearly loved wife Nancy L. Cafalli, who remained beside him until his last moments.
Dr. Cafalli, this great man who is so much missed, was buried in Salvador, on May 7, draped in the banner of Palmeiras Football Club, his favorite team.
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Please cite this article as: Ramalho Júnior A. Francisco A. S. Cafalli (1929-2014). Rev Bras Ortop. 2014;49(5):550–1.
Publication Dates
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Publication in this collection
Sep-Oct 2014
