mechanized emotional response to those patients was a fatalistic
acceptance of a life in a wicker wheelchair. The enterprising surgeons
practicing orthopedics circa World War II could envision the use of a
metal head to completely replace a necrotic and collapsing proximal
femur, and the first to do it was Dr. Harold Bohlman, of Baltimore and the
Johns Hopkins Hospital. He had read Venable’s and Smith-Petersen’s
publications with great interest, and within months of the Vitallium mold
arthroplasty paper, Bohlman was able to configure a Vitallium alloy ball
mounted on a metal stem, resembling a Tootsie Pop.
Within a year, surgeons around the world were scrambling to design
femoral head replacement prostheses similar to Bohlman’s, oftentimes
from metal but occasionally from newfangled polymers such as acrylic.
The initial enthusiasm would be tempered within a few years, when
surgeons started to see loosening, subsidence, and failure of the pegged
metal balls. Previously crippled patients, whose hip pain and disability had
been (temporarily) addressed with implantation of a Vitallium head, were
becoming disabled once again. Toward the end of World War II, just a few
years from the introduction of improved alloys, the other astonishing
development that emboldened surgeons was the discovery, and production
refinement, of penicillin. Although steam sterilization (developed in the
1880s) of surgical instruments and implants had mitigated the risk of
infection, antibiotics affected a change in every corner of the medical
world, further awakening an interest in more profound answers to hip
maladies. If infections with molds and small, pegged femoral heads were
relatively negligible, pioneering surgeons considered whether mega-
prostheses might perform better in the long-term.
The irony in science and technology is that many of the world’s greatest
innovations occurred in lonely, backwater locales by individuals who had
an inkling, an inspiration about how to solve a problem. For every Mozart
from Salzburg, there is a Bob Dylan from Hibbing, Minnesota. And when
it comes to surgery, groundbreaking divination emanates from unlikely
characters from places like Oklahoma City and Columbia, South Carolina.
The American Academy of Orthopedic Surgeons (AAOS) is the largest,
and most important orthopedic organization in the world. The AAOS has
an annual meeting, and for the first fifteen years it was usually held in
Chicago, its national headquarters. But in 1950, thousands of surgeons
attended the meeting at the Waldorf Astoria Hotel in New York City, and
marcin
(Marcin)
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