Word: charnley
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Dates: during 1970-1979
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That was only half of the mechanical problem. The ball must rotate in a socket, which in most such hip operations had been made of steel. Charnley disliked the steel-to-steel joint because it must be lubricated solely by body fluids, which are often inadequate. A plastic socket would require no lubrication. But what plastic? He tried Teflon, only to have it break loose and damage nearby bone. "One day," he says, "a salesman turned up with a sample of high-density polyethylene. I sent him away, telling him that we knew that polyethylene was useless. I hadn...
Since late 1962, Charnley has used the polyethylene socket, which is also cemented in place with methyl methacrylate. In an intensive follow-up of his first 500 cases, Charnley has found the cement holding perfectly. The polyethylene, originally 10 mm. thick, wears away at the rate of about 1 mm. in five years. "No discomfort should be noticed until at least 50% has worn away," he says, "and if that happens, we can always replace the socket...
Need to Shout. There remained the danger of infection, especially severe in hip surgery because so much tissue must be exposed. With Charnley's new plastic techniques, the infection rate was 4%. That was too high by his standards. Then he devised an elaborate suction system for his operating room. Each member of the surgical team was fitted with a flexible tube, long enough to permit free movement, that ran up his back and was connected to a narrow steel tube that encircled the face and had holes through which his exhaled breath was drawn away. "It makes communication...
...Angeles last month, surgeons at Hollywood Presbyterian Hospital who had studied Charnley's methods demonstrated their technique in a space-age adaptation of an operating room. The entire area around the operating table was covered with a plastic "greenhouse," into which ultra-filtered air flowed from above, fast enough to change the air completely ten times a minute. Within it, three surgeons, Doctors John Toma, Charles Bechtol and Charles Hutter, were dressed in space suits with helmets, like those worn by astronauts on the moon. The scrub nurse, who handles sterile instruments, was similarly attired. Their patient was Margaret...
...recent surgical staff meeting in Los Angeles, other former patients of Charnley and his disciples demonstrated their agility. A woman of 65, who had replacements for both hips, walked with neither pain nor limp. A former R.A.F. pilot, 46, handicapped for more than 20 years by a World War II injury, did a little "gogo" dance...