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Last Updated: Thursday, 27 April 2006, 09:57 GMT 10:57 UK
The hip history of joint replacements
By Jane Elliott
BBC News health reporter

Each year 35,000 hips are replaced in England and Wales on the NHS, with more operations carried out in private hospitals.

Sir John Charnley
Sir John Charnley tested materials in his own leg

The manufacture of the joints is a multi-national business.

But their invention more than 50 years ago had more humble origins.

An exhibition, Hip Histories, looks at the fascinating characters who developed the first successful total hip replacement at the Wrightington Hospital, near Wigan.

Dedicated

None was bigger than surgeon Sir John Charnley, who tested materials in his own legs to ensure they worked before implanting them in a patient.

Dr Chris Faux, who is an orthopaedic surgeon at Wrightington, was a colleague.

He said Sir John and his team had created a clean-air system to protect patients during operations and clean trays to prevent cross-infection.

If someone died we would be sent to go and collect the hips and the lymph nodes to correlate the facts and to see how the joints had worked during the 13 or 20 years they had been in the body
Dr Chris Faux

"He was tough, but fair. He did not suffer fools, never mind gladly," Dr Faux said.

Sir John kept a close eye on each patient and, after their death, dispatched a team member to retrieve the hip to see how it had performed.

"He wrote to all his patients and said could he have the hips back when they died," said Mr Faux.

"Ninety-nine per cent of them were so pleased with the hip they said 'of course'.

"Then we had what we called the black box squad.

"If someone died, we would be sent to go and collect the hips and the lymph nodes to correlate the facts and to see how the joints had worked during the 13 or 20 years they had been in the body.

"He liked to see how the cement was working."

Hip histories - produced for the Royal College of Surgeons by the History of Science, Technology and Medicine Department at Manchester University - focuses on the patients', engineers' and manufacturers' stories.

Dr Francis Neary, curator of the exhibition, said: "The total hip replacement operation has been seen as a landmark in 20th-century surgery, and is now one of the most performed elective surgical procedures in the world.

"Since the early 1960s it has played an important role in alleviating pain and restoring mobility to millions of arthritis sufferers. It became a flagship operation, raising the status of British orthopaedic surgery.

"Its development was associated with innovation in materials, instruments and operative procedures - many of which have since been adapted to treat other joints and applied across a range of surgical specialties."

Innovation

Dr Neary said that, before Sir John's work, there had been partial hip replacements, known as hemiarthroplasties, developed in Europe and the US between 1920 and1950.

But the complete replacement was primarily a British innovation developed at specialist centres in Norwich, Stanmore, Redhill and Exeter, as well as Wrightington.

"Each of these centres made an important contribution of hip replacement but the exhibition focuses on the advances made at Wrightington Hospital, where the first successful operation was developed by Professor Sir John Charnley and his team.

"We have used objects, video and the personal accounts of innovators to reconstruct the story of the development of hip replacement from a variety of perspectives.

"This will be a unique opportunity to see how an important surgical innovation was developed through meticulous scientific research with a low budget in the early days of the NHS.

"We wanted to show how humble the origins were."

Hip Histories is on at the Hunterian museum's Qvist Gallery, at the Royal College of Surgeons, London, until July.


SEE ALSO:
In pictures: Hip exhibition
26 Apr 06 |  In Pictures
Celebrity Health - Bob Wilson
08 Apr 06 |  Health
First hospital op for woman, 102
27 Mar 06 |  Hereford/Worcs


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