Early development of total hip replacement : the transcript of a Witness Seminar held by the Wellcome Trust Centre for the History of Medicine at UCL, London, on 14 March 2006

2006·1.2 MB·English

by  Reynolds, L. A

EARLY DEVELOPMENT OF
TOTAL HIP REPLACEMENT
The transcript of a Witness Seminar held by the Wellcome Trust Centre
for the History of Medicine at UCL, London, on 14 March 2006
Edited by L A Reynolds and E M Tansey
Volume 29 2006
©The Trustee of the Wellcome Trust, London, 2007
First published by the Wellcome Trust Centre
for the History of Medicine at UCL, 2007
The Wellcome Trust Centre for the History of Medicine
at UCL is funded by the Wellcome Trust, which is
a registered charity, no. 210183.
ISBN 978 085484 111 0
All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/

Please cite as: Reynolds L A, Tansey E M. (eds) (2007) Early Development of Total Hip Replacement.
Wellcome Witnesses to Twentieth Century Medicine, vol. 29. London: Wellcome Trust Centre
for the History of Medicine at UCL.
CONTENTS
Illustrations and credits v
Abbreviations ix
Witness Seminars: Meetings and publications; Acknowledgements
E M Tansey and L A Reynolds xi
Introduction
Francis Neary and John Pickstone xxv
Transcript
Edited by L A Reynolds and E M Tansey 1
Appendix 1
Notes on materials by Professor Alan Swanson 95
Appendix 2
Surgical implant material standards by Mr Victor Wheble 97
Appendix 3
Selected prosthetic hips 101
References 107
Biographical notes 133
Glossary 147
Index 155

ILLUSTRATIONS AND CREDITS
Figure 1 Site of a total hip transplant. Illustration provided by
Ms Clare Darrah. 4
Figure 2 Mr Philip Wiles FRCS, c. 1950. Illustration provided
by Sir Rodney Sweetnam. 5
Figure 3 X-ray of Wiles’ hip, c. 1950s. Illustration provided by
Sir Rodney Sweetnam. 6
Figure 4 Charnley PTFE double cup implant, c. 1960.
Illustration provided by the John Charnley Trust. 7
Figure 5 The Ring total hip replacement: X-ray of
THR in position, 1970. Illustration provided by
Mr Peter Ring. 8
Figure 6 Ken McKee with his total hip replacement system.
Reproduced by permission of ©Eastern Evening
News. The photograph appeared in a Derek James
column, ‘Honour for most deserving doctor’, 28
November 2003. 9
Figure 7 Post-operative X-ray of the McKee artificial
joint, 1963. Illustration provided by the John
Charnley Trust. 10
Figure 8 Hawley orthopaedic table showing a non-sterile
assistant controlling the leg. Illustration provided by
Mr John Kirkup. 11
Figure 9 Professor Sir John Charnley FRCS FRS. Reproduced
by permission of Lady Charnley. 12
Figure 10 Mr Harry Craven, 1981. Illustration provided by
Mr Harry Craven. 13
Figure 11 Stainless steel Smith-Petersen cup (4.5cm diameter
x 4 cm), c. 1938. Donated by Mr Victor Wheble. 14
v
Figure 12 Charnley’s original greenhouse clean air enclosure,
1960. Illustration provided by the John Charnley
Trust.
15
Figure 13 Filters and masks. From The Times (30 November
1965): 20. Illustration provided and annotated by
Mr John Read. 17
Figure 14 Looking down on to the greenhouse roof showing
three cloth infuser bags inflated with clean air.
Illustration provided by Mr Harry Craven. 18
Figure 15 The Charnley low-friction arthroplasty in use from
November 1962. Illustration provided by the John
Charnley Trust. 18
Figure 16 Mr ‘Ginger’ Wilson, 2000. Illustration provided by
Mr Michael Wilson. 20
Figure 17 Principal stages in the design and development of the
Stanmore prosthesis, 1960–85. Illustration provided
by Mrs Phyllis Hampson. 21
Figure 18 ICLH resurfacing arthroplasty done bilaterally,
c. 1980. Illustration provided by Professor
Michael Freeman. 23
Figure 19 Professor John Scales, designer of the Stanmore
hip, c. 1985. Reproduced by permission of Mrs
Phyllis Hampson. 31
Figure 20 The Exeter stem, c. 1969. Reproduced by permission
of Professor Robin Ling. 32
Figure 21 Still’s disease – juvenile chronic arthritis. Reproduced
by permission of the Wellcome Photo Library. 34
Figure 22 A Charnley acetabular reamer. Illustration provided
by the John Charnley Trust. 39
vi
Figure 23 Surgical approaches used in total hip replacement.
Anterolateral incision; direct lateral incision; lateral
incision and the modern minimally invasive incision.
Drawn by Mr Kevin Hardinge.
46
Figure 24 Howorth publicity literature, c. 1976. Illustration
provided by the John Charnley Trust. 75
Figure 25 Casella slit sampler AIR14 as used in the 1960 clean
air enclosure. Illustration provided by Howorth
Airtech Ltd. 78
Figure 26 Two Petri dishes from a slit sampler with a rotation
time of 60 minutes, c. 1960. Illustration provided by
Mr Harry Craven. 79
Table 1 Survival rates of Charnley, Stanmore and Exeter THR.
Extracted from Malchau et al. (2002): 9, Table 1. 75
vii
Appendix 3: Selected prosthetic hips
1938 Wiles Illustration provided by Sir Rodney Sweetnam. 101
1938 Smith-Petersen Reproduced by permission of the
Wellcome Trust. 101
1940 Judet Reproduced by permission of the Wellcome
Trust. 101
1951 Moore Illustration provided by the John Charnley
Trust. 102
1953 Thompson Illustration provided by the John
Charnley Trust. 102
1956– McKee Illustrations provided by the John
Charnley Trust. 102
1956– Charnley (a–c) the John Charnley Research Institute,
Wrightington Hospital; (d) the John Charnley Trust. 103
1963– Stanmore (a) Mr Michael Wilson; (b–c) Mr Alan
Lettin; (d) Wellcome Trust. 104
1968– Ring Illustration provided by Mr Peter Ring. 105
1970– Exeter Illustrations provided by the Exeter Hip Unit. 105
1972– ICLH Illustration provided by Professor
Michael Freeman. 106
1991– McMinn Illustration provided by Mr Joseph Daniel,
McMinn Centre. 106
viii
Abbreviations
BOA British Orthopaedic Association
BOSG British Orthopaedic Study Group
BSI British Standards Institution
CEN C omité Européen de Normalisation, the European Committee
for Standardization, Brussels, Belgium at www.cenorm.be
DoH Department of Health
FDA US Food and Drug Administration
HAC hydroxyapatite coating
HDP high-density polyethylene
ISO I nterational Organization for Standardization, Genève,
Switzerland at www.iso.org/isoenCatalogueListPage.
CatalogueList
LFA low-friction arthroplasty
MCA Medicines Control Agency
MDA Medical Devices Agency
MHRA Medicines and Healthcare Products Regulatory Agency
MRC Medical Research Council
NHS National Health Service
NICE National Institute for Clinical Excellence
NJR National Joint Registry for England and Wales
PMMA polymethylmethacrylate
PTFE polytetrafluoroethylene
RNOH R oyal National Orthopaedic Hospital, Stanmore, Middlesex at
www.rnoh.nhs.uk/about_the_RNOH/
ix
THA total hip arthroplasty
THR total hip replacement
UHMWPE ultra-high molecular weight polyethylene
UMIST University of Manchester Institute of Technology, which merged
with the Victoria University of Manchester to become the
University of Manchester in 2004.
x