in attendance was a surgeon from Oklahoma City, with a sixty-five-year-
old female patient in tow. Dr. Earl McBride was there to present an exhibit
about his new hip implant that was unlike anything that had ever been
conceived. Oddly, at his side was the first patient to undergo replacement
with a Vitallium head that was perched atop a long metal stem that was
positioned down the hollow femoral canal. Rarely done today, physicians
in the 1800s would parade patients before their colleagues to demonstrate
rare diseases or unusual outcomes. It’s safe to surmise that Dr. McBride
brought his patient all the way to Manhattan from Oklahoma City because
he wanted surgeons to see for themselves her remarkable outcome.
Within two years, his publication in the Journal of Bone and Joint
Surgery^12 detailed the use of his “door-knob” prosthesis, a joint
replacement where the implant was impacted down the canal of the femur.
This was the first time since 1890, when Dr. Gluck had stuffed ivory
implants into long bone canals, except of course that McBride was using
Vitallium. He wrote:
Even though she had essentially a full range of motion, no
pain, and was able to walk on the streets [of New York]
without support, there was a great variety of assertions such
as: “It just won’t work; Too much metal; The acetabulum
won’t stand up; There will be pressure necrosis; It will work
loose.”^13In the 1952 publication, all twenty-two patients (including the original
woman who accompanied him to New York) were doing well with no
infections and no dislocations. The naysayers were wrong. The threaded
stem of McBride’s implant would not stand the test of time, but the impact
of his innovation is best appreciated when you consider the rise of
stemmed implants for the hip and shoulder that exploded in the months
after the February 1950 meeting. It wasn’t until the 1970s that the United
States Food and Drug Administration (FDA) would have a Bureau of
Medical Devices to regulate such things. Until then, there was a free-for-
all with all medical devices, with the result being that any surgeon or
engineer could imagine, design, craft, and implant a device with
essentially no barriers. Not always good for patients, the restriction-free