Total Hip Replacement Surgery at HSS: Then and Now

Adapted from the Spring 2013 issue of Discovery to Recovery

A Q&A with Philip D. Wilson, Jr., MD, surgeon-in chief emeritus (1972-1989), about the evolution of the total hip replacement procedure at HSS.

When did total hip replacement become a treatment option for patients at HSS?
Our interest really developed in the early 1960s, following reports of the pioneering work of Sir John Charnley in England. In 1965, I attended a biomechanics meeting in London where groundbreaking developments in ball and socket “total” hip replacement were presented and discussed. Charnley, one of the presenters, so impressed me with his work that I later returned for visits to his service, as well as other services in England and Europe. Meanwhile, Dr. Harlan C. Amstutz, who was leading HSS’s biomechanics laboratory, had advanced his studies in hip replacement surgery to a point where we were able to begin the application of total hip implants in patients. We implanted the first one here in 1967.

How do total hip replacement patients fare today versus forty years ago?
In the early days, hospital stays were 10 to 14 days and recovery was measured in months. Today, patients go home in two to three days or less and start rehabilitation much sooner. They have much less pain and are able to resume an active lifestyle much earlier. This procedure has made a significant difference in the lives of patients.

How have total hip patients changed over time?
Advances in anesthesia have permitted us to offer the surgery to younger patients with inflammatory disease, and older patients with osteoarthritis or hip degeneration related to aging. I’m proud of the fact that we’ve developed a safe environment for hip replacement at HSS, one that has enabled older patients to live more comfortably and younger patients to function better.

What does the future hold for total hip replacement?
I think we will continue to see improvements in basic material structure and implant design. Scientists, engineers, and surgeons continue to work on creating conditions that extend the durability and functionality of the artificial hip, including looking at ways of engineering devices that encourage bone to grow directly into the implant to reduce the risk of implant loosening and wear.

Originally published in Discovery to Recovery, Spring 2013 issue.


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