John Charnley


Book Description

Hip replacement operations have become commonplace during the past ten years, but none the less it is well to remember the struggle to overcome the initial difficulties before the achievement of the successful results which are confidently expected today. Certainly, in the 1950s attempts to relieve pain and restore movement to an arthritic hip frequently failed. Such operations which were practised often involved a prolonged period of immobilisation which would now not be tolerated. For progress to be made orthopaedic surgeons had to rely on the loyalty and stoicism of their patients who allowed untried procedures to be carried out on themselves, often without appreciating the possible outcome. These surgical experiments resulted in progress being made, and the failures led to a greater understanding of the problems involved. The importance of collaboration with bio-engineers was also recognised, and the search began for suitable materials with which to make an artificial joint. Progress was made in many centres throughout the world, and surgeons in the United Kingdom were at the forefront in devising original techniques. Although others also produced new models, John Charnley was a pioneer and an innovator who influenced the development of hip relacement more than any other individual. In telling the story of his life this book is inevitably also the story of the operation, but it is not intended to be a scientific evaluation of his work.




Low Friction Arthroplasty of the Hip


Book Description

The theme of this work is the application of the engmeermg theory of frictional torque to total hip replacement. The author adhered tenaciously to this theory, involving the use of a small-diameter femoral head, throughout the epoch when the large-diame ter, metal-to-metal design dominated the field. During that considerable period general satisfaction with the early results rendered criticisms of the large-diameter head unwelcome. There was a formidable array of counter criticism: the small head would pierce a film of synovial fluid; the small head would wear the socket too rapidly; the small head would always have a high risk of dislocation; detachment of the trochanter, to achieve precise orientation for the small head, was unacceptable. But all these objections have now been largely overcome. Lubrication of high molecular weight polyethylene (HMWP) on metal is now accepted as being mainly by the boundary regime with thick fluid films playing no part. We now know that HMWP can indeed tolerate the very high stresses imposed by the small head and in tribological theory there may even be some advantage in high stress. Dislocation is now known not to be an automatic sequel to the small head.




Personalized Hip and Knee Joint Replacement


Book Description

This open access book describes and illustrates the surgical techniques, implants, and technologies used for the purpose of personalized implantation of hip and knee components. This new and flourishing treatment philosophy offers important benefits over conventional systematic techniques, including component positioning appropriate to individual anatomy, improved surgical reproducibility and prosthetic performance, and a reduction in complications. The techniques described in the book aim to reproduce patients’ native anatomy and physiological joint laxity, thereby improving the prosthetic hip/knee kinematics and functional outcomes in the quest of the forgotten joint. They include kinematically aligned total knee/total hip arthroplasty, partial knee replacement, and hip resurfacing. The relevance of available and emerging technological tools for these personalized approaches is also explained, with coverage of, for example, robotics, computer-assisted surgery, and augmented reality. Contributions from surgeons who are considered world leaders in diverse fields of this novel surgical philosophy make this open access book will invaluable to a wide readership, from trainees at all levels to consultants practicing lower limb surgery




Vanishing Bone


Book Description

Vanishing Bone unravels the mystery of a totally novel disease which causes the massive destruction of bone in individuals with total hip implants. Although initially considered 'rare, ' at its peak the disease affected over a million patients. This book takes readers through a detective adventure in contemporary medical science, identifying the cause of the disease the body's reaction to tiny wear particles from the prostheses, followed by the complex process of affecting its cure, the invention of a unique, wear-resistant plastic.




Charnley Low-Frictional Torque Arthroplasty of the Hip


Book Description

This book reviews the principles and concepts underlying Professor Sir John Charnley’s original work Low Friction Arthroplasty of the Hip: Theory and Practice (Springer, 1979) in the light of more extensive clinical experience with results, incidence and indications for revisions highlighted throughout. The studies, combined with the examination of explanted components carried out with the backing of Universities, indicate the avenues for further research and the development and introduction of new ideas into clinical practice. The time span (1962 – 2015) involved has allowed a number of these very long-term studies not only to be brought to conclusion, but has given the benefit of their clinical application with meaningful results. This is not a sudden diversion into new and speculative areas of hip replacement surgery. It is a carefully collected, documented and executed work of the evolution of the Charnley low-frictional torque arthroplasty of the hip based on sound principles, supported by long-term studies with benefits derived.




The Rise and Fall of Modern Medicine


Book Description

In the years following World War II, medicine won major battles against smallpox, diphtheria, and polio. In the same period it also produced treatments to control the progress of Parkinson's, rheumatoid arthritis, and schizophrenia. It made realities of open-heart surgery, organ transplants, test-tube babies. Unquestionably, the medical accomplishments of the postwar years stand at the forefront of human endeavor, yet progress in recent decades has slowed nearly to a halt. In this judicious examination of medicine in our times, which has won the Los Angeles Times Book Prize, medical doctor and columnist James Le Fanu both surveys the glories of medicine in the postwar years and analyzes the factors that for the past twenty-five years have increasingly widened the gulf between achievement and advancement: the social theories of medicine, ethical issues, and political debates over health care that have hobbled the development of vaccines and discovery of new "miracle" cures. While fully demonstrating the extraordinary progress effected by medical research in the latter half of the twentieth century, Le Fanu also identifies the perils that confront medicine in the twenty-first century. "[From] a respected science writer . . . important information that . . . has been overlooked or ignored by many physicians." —New Republic "Provocative and engrossing and informative." —Houston Chronicle




UHMWPE Biomaterials Handbook


Book Description

UHMWPE Biomaterials Handbook describes the science, development, properties and application of of ultra-high molecular weight polyethylene (UHMWPE) used in artificial joints. This material is currently used in 1.4 million patients around the world every year for use in the hip, knee, upper extremities, and spine. Since the publication of the 1st edition there have been major advances in the development and clinical adoption of highly crosslinked UHMWPE for hip and knee replacement. There has also been a major international effort to introduce Vitamin E stabilized UHMWPE for patients. The accumulated knowledge on these two classes of materials are a key feature of the 2nd edition, along with an additional 19 additional chapters providing coverage of the key engineering aspects (biomechanical and materials science) and clinical/biological performance of UHMWPE, providing a more complete reference for industrial and academic materials specialists, and for surgeons and clinicians who require an understanding of the biomaterials properties of UHMWPE to work successfully on patient applications. - The UHMWPE Handbook is the comprehensive reference for professionals, researchers, and clinicians working with biomaterials technologies for joint replacement - New to this edition: 19 new chapters keep readers up to date with this fast moving topic, including a new section on UHMWPE biomaterials; highly crosslinked UHMWPE for hip and knee replacement; Vitamin E stabilized UHMWPE for patients; clinical performance, tribology an biologic interaction of UHMWPE - State-of-the-art coverage of UHMWPE technology, orthopedic applications, biomaterial characterisation and engineering aspects from recognised leaders in the field




The Gentleman's Magazine


Book Description




The Body


Book Description

NEW YORK TIMES BESTSELLER • A must-read owner’s manual for every body. Take a head-to-toe tour of the marvel that is the human body in this “delightful, anecdote-propelled read” (The Boston Globe) from the author of A Short History of Nearly Everything. With a new Afterword. “You will marvel at the brilliance and vast weirdness of your design." —The Washington Post Bill Bryson once again proves himself to be an incomparable companion as he guides us through the human body—how it functions, its remarkable ability to heal itself, and (unfortunately) the ways it can fail. Full of extraordinary facts (your body made a million red blood cells since you started reading this) and irresistible Brysonesque anecdotes, The Body will lead you to a deeper understanding of the miracle that is life in general and you in particular. As Bill Bryson writes, “We pass our existence within this wobble of flesh and yet take it almost entirely for granted.” The Body will cure that indifference with generous doses of wondrous, compulsively readable facts and information. As addictive as it is comprehensive, this is Bryson at his very best.




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Book Description