them in Cidex (glutaraldehyde) overnight. Later, his manufacturing
partner, Thackray, manufactured the cups and irradiated the poly with
gamma irradiation (others recommended immersion in ethylene oxide—
still controversial). He continued to implant the new HMWP cups by the
hundreds, never using systemic antibiotics and only using stainless steel
stems (and not cobalt chrome, like we use today). Charnley waited to
publish his results, fearful of an unexpected Teflon disaster repeating
itself, but it never happened.
In fact, John Charnley hardly changed a thing over the next twenty
years, performing thousands of hip replacements in Wrightington (and
later, in Midhurst as well), operating almost till the day he died, suffering
a heart attack at age seventy. Even today, with more modern manufacturing
processes, advances in metallurgy and polymer sciences, improvements in
surgical techniques, and educational innovations, no one has ever
demonstrated superior results compared to Charnley. The surgeon-
biologist from a tiny town in rural England not only changed orthopedics,
introducing materials that would be implanted millions of times every
year in our world, but, as much as any person in the world, helped change
the mindset that receiving a foreign substance into your body is
extraordinary.
I should know: I am one of the millions of people who have had their
hip replaced. And I’m extremely grateful to Sir John Charnley for
immeasurably improving my life and relieving my previous suffering.
Charlie Neer first reported on the use of a polyethylene shoulder socket
component in his 1974 article. His first use of the component was in 1973,
and in a 1982 Journal of Bone and Joint Surgery article, Neer reported on
273 patients who had undergone total shoulder arthroplasty by him over a
nine-year period.^9 A decade of use of polyethylene in the hip had
transpired before Neer attempted its use in the shoulder, in part because
fixation in the shoulder was much trickier in the unforgiving, small
shoulder socket. It boggles the mind that Charlie Neer was one of the few
surgeons in the world performing shoulder replacement even three decades
ago, especially in light of the fact that over 100,000 shoulders are replaced