The Art of Total Hip Arthroplasty
Total hip arthroplasty ( THA ) has certainly been acclaimed by most to represent the greatest addition in orthopedic treatment of patients . Through many years , surgeons and orthopedic companies have reached the addition of artificial knees , shoulders , ankles and other small joints . Engineers have been of utmost importance with these endeavors . It behooves one to understand the history before detailing the advancement .
Sir John Charnley is the “ father of THA .” He served in WWII and afterward progressed in his education with degrees in anatomy and physiology . At age 25 , he was the youngest to receive admission to the Royal College of Surgeons in the UK – I think of this as akin to winning the Nobel Prize in Britain .
During the ‘ 50s , he worked with engineers to develop a hip replacement with stem and ball of stainless steel . This proved to present many failures due to wear of the socket and pain . He worked
12 LOUISVILLE MEDICINE by ERNEST EGGERS , MD
then on a socket of plastic , similar to Lucite , and the wear properties were a disaster . After a few years the joints were revised .
By 1964 , he ’ d brought the Charnley hip of steel stem and head with an improved polyethylene socket to market with the goal of easing the friction in the joint . The joint was fixed with a cement or “ grout .” Charnley continued to improve his plastic “ friction / wear and tear ” properties on the socket side . Even before the 60s , Maurice Mueller from Berne , Switzerland , accompanied him in research . Charnley was , however , a surgeon and engineer in his work , but both developed a THA of their own . The Thackray company constructed the implants then , but it was later bought by DePuy , an American orthopedic industry .
In the late ‘ 60s , DePuy and Zimmer were producing total hips , but mainly in New York , Boston , Cleveland , Chicago and UCLA . There were two methods of approach : Charnley cut the trochanter and later fixed it back with wire post implantation , whereas Mueller used a smaller posterior incision and did not remove the trochanter .
In 1971 , two years after serving in the Navy during Vietnam , I spent a month with Charnley in Wrightington , England , and