by Dr. J. Porter Michaels, a Parisian dentist. The shaft
component was made of a platinum cylinder with two ridges
and several holes for attachment of the periosteum and
muscles. There were screw holes at the distal end for
attachment to the bone stump. The head consisted of a ball of
rubber previously hardened by boiling in paraffin for twenty-
four hours. The rubber ball contained two equatorial grooves
arranged at right angles. Each groove contained a metal loop,
one attached to the glenoid and the other to the proximal end
of the shaft component. It was believed that this prosthesis
provided ample strength combined with freedom of
movement.^5In what initially appeared to be an unqualified victory, the first signs of
trouble appeared at one year, when the patient developed redness and
draining about the elbow. An operation was required to alleviate the
symptoms, and after three additional surgical debridements, it seemed as
though the infection was under control. A modern surgeon, upon
presentation of this case, would conclude that unlike Gluck’s experience,
the Parisian baker had not experienced a postoperative skin-borne
infection (such as staphylococcus), which would have led to draining pus
from the joint within days of the first operation, but instead, had
recurrence of the TB infection around the implant. With no antibiotics to
control the local recurrence, the implant was fated for failure.
Two years after implantation, a draining sinus of pus had developed
around the arm. No amount of antibiotics (even today) could reverse a
chronically draining prosthetic joint infection—only implant removal
could mollify the affliction. Before the surgeon Péan removed the
platinum and rubber implant, he did something else momentous: he took
an X-ray. Röntgen had discovered the illuminating power of
electromagnetic rays while working in Wurzburg, Germany, in 1895, and
in the world’s first arthroplasty X-ray, Péan took an image showing a “long
and resistant osseous shell around the prosthesis.”^6 The implant that was
removed in Paris 120 years ago, instead of being buried in some rubbish
pile, is in Washington, DC, at the Smithsonian Institution, ready for
viewing for anyone that wants to see the progenitor to all the millions of
implants that find their way into human bodies every month in our world.