long-standing tuberculous joint infections (which typically do not generate
pus), but following surgery, all of his patients were doomed to infections
of another kind: draining-puss and red-hot joints which could lead to
systemic bacteremia (bacteria in the blood), sepsis, and even death. In
response to Gluck’s desire to present his findings at the Society, the
president of the German surgical association wrote him, saying, “As the
leader of German surgery I cannot allow that you discredit German
science in front of a platform of international surgical specialists. My
pupils and I will fight you with all means.” Gluck was forced to abandon
not only his presentation, but the work on arthroplasty in its entirety.
Medical societies function well when avant-garde ideas are treated with
skepticism; it is the long-lens of history that allows for careful analysis of
revolutionary treatments, and Gluck’s innovation of replacing a joint with
a hand-fashioned ivory apparatus was truly too ahead of its time, predating
antibiotics, modern metallurgy, and implant sterilization. While
Themistocles Gluck never tried replacing a joint again, he pursued other
advances in general surgery, enjoying a long career. Later in life, the man
who rightly is regarded as an “unrecognized genius” and the “first
arthroplasty surgeon,” observed, ‘‘We can certainly make the observation
in medicine, as often also in other scientific disciplines, that certain facts
have been known as such for a long time before their value is truly
recognized.’’^4
No one is sure if Gluck ever implanted one of his ivory implants in a
shoulder, but there is no doubt that Jules-Emile Péan implanted the first
metal shoulder replacement in a human in Paris on March 11, 1893. Dr.
Péan was a celebrated surgeon in Paris, renowned for his dexterity,
inspirational teaching, and dramatic flair. The French had elevated
medicine from a lowly professional status in the early 19th century to a
respected scientific enterprise, but had relinquished the role of ascendancy
in medical thought to the Germans in the last half of the century. As
recalled in the Journal of Shoulder and Elbow Surgery, Péan made a
lasting contribution to the world of shoulder surgery when he implanted a
custom-made platinum shoulder implant in a thirty-seven-year-old baker
who was dying from a severe TB infection:
The prosthesis was designed and constructed with some speed
(after Péan had earlier resected part of the infected humerus)