A circle of hip surgery around four continents

Peter Arnold
Sydney, Australia

 

X-ray of hip replacement
X-ray of the hip. Photo courtesy of Peter Arnold.

My story begins in Sydney in late January 1980. A businessman in his mid-fifties (Mr. C.) had been on his way to source products in the UK. As his student son was traveling in Italy, he decided to visit him by stopping over in Rome on his way north.

When the young man arrived at his father’s hotel, he was told that his father had had an accident and was in hospital. While walking past The Hotel Majestic on the Via Veneto that afternoon, two men on a motorcycle had swung past him and grabbed his shoulder bag. Mr. C. resisted the sudden violence of the mugging, holding onto the strap of his bag until it ripped off.

In the process, he was knocked over, hitting his thigh on the curb. The impact resulted in a comminuted fracture of the upper half of the femur. The Roman operation succeeded in getting the bony fragments together again.

On returning to Sydney, he consulted several orthopedic surgeons because of intense pain. Each took one look at the ‘Eiffel Tower’ in his thigh and decided that the wisest course was to “do no harm.”

Having long been a reader of the British Medical Journal, I knew of the reputation of Sir John Charnley’s Centre for Hip Surgery in Wrightington, England. Mr. C. was delighted. My enquiry to Sir John was promptly answered. The operation took place on August 4, 1982.

A week or so later, I received a report from Sir John’s trainee. The operation had been a success. Should any follow-up be needed, one of Sir John’s former trainees was practicing in Sydney—Dr. Bruce Shepherd. In the UK, Bruce had become interested in Charnley’s total hip arthroplasty. Back in Sydney, he quickly established himself as a specialist in this operation.

Dr. Charnley’s 1982 trainee ended his report by stating that Sir John would have liked to have signed the letter himself, but had died the day after he had operated on Mr. C.

Bruce was influential in many orthopedic and other medical associations—such as the Australian Society of Orthopaedic Surgeons, the Council of Procedural Specialists, and the Royal Australasian College of Surgeons. In about 1992, Mr. C. needed revision of his surgery, and this was performed successfully by Bruce.

Another of Charnley’s protégés had been South African, Desmond Dall, who worked with Charnley in 1969. Returning to Cape Town, he practiced hip surgery exclusively. He was later appointed Professor of Orthopedic Surgery at the University of Southern California, Los Angeles, until his retirement in 1997.

Dall’s anesthetist in Cape Town was Basil Solomon. Basil’s medical student son, Michael, became interested in Dall’s work, assisted him in his research and published joint papers. Having decided to specialize in hip surgery, but not in South Africa, Michael emigrated in 1989 to Sydney, where he gained his orthopedic qualifications, furthering his expertise in hip surgery during fellowships in the US and the UK.

My story now advances through some three decades, well past Bruce’s and Desmond’s retirements and deaths, to June this year. Within a week of having an ache in my groin, my hip collapsed. Now it was my turn to benefit from John Charnley’s expertise. Michael promptly operated on me and my hip is back to normal. It completes my little circuit of personal experience of hip surgery, from Australia, Italy, England, and South Africa, and back to Australia.

 


 

PETER ARNOLD is a retired family doctor and professional editor in Sydney. Former Chairman, Australian Medical Association.

 

Summer 2021  |  Sections  |  Vignettes at Large