Longevity of hip implant: 45 years life span for a hip replacement!!

Josephine

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I was just sent this article from the Norwich Evening News (2007) which is the city where McKee and Watson Farrar did their pioneering work in hip replacements in the 50s and 60s. I worked with these two chaps in the early 60s and saw them making a lot of the early improvements.

"A pensioner who was given a hip replacement by a pioneering surgeon more than 40 years ago may have broken the world record for the longest standing hip replacement.

The patient was just 28 when she was told she would need the operation in 1966 and has since become the owner of one of the longest lasting hip replacements in the world. After a car accident at the age of 10, she was left temporarily unable to walk and underwent several operations on her hip before she was told she would need the replacement when she developed complications after the birth of her first daughter.

The revolutionary surgery was carried out by Kenneth McKee at the former Norfolk and Norwich Hospital. Mr McKee pioneered primary hip replacements in Norwich in the 1950s.

The patient, now 70 and a retired nurse, lives with her husband, 80, and has two children, 45 and 43. She said "It has not stopped me doing anything and I'm always out of the house. I used to ride a bike to work before I could drive and I used to drive the ambulances. I've brought up my wonderful family and I used to do a lot of swimming too. It's been fantastic. I'm a great believer that if you can get your legs out of bed in the morning then enjoy the day."

The average hip replacement design lasts a decade and Mrs .... has surpassed this by more than 30 years. She said it has never stopped her from being active and, at the request of surgeons, often demonstrated the benefits of her hip to others thinking of having the operation. She said "I used to have to go to the hospital to demonstrate what I'd had done but I had a young family and it was difficult to keep it up."

Mr McKee started experimenting with model hip joints in 1938, working with dentists and a local engineer firm to create the original brass mock-ups. He carried out his first hip replacement on a patient in 1951. A bronze bust of the surgeon was installed in the hospital in 1994".
 
Re: 40 years life span for a hip replacement!!

Thought you might like to see some pics of the surgeon and his prosthesis. Note that the prosthesis is one which has been removed after 38 years in use!! The damage to the rim of the cup would have been caused by the cup rubbing on the neck of the femoral prosthesis - the shiny abrasions can just be made out - which would probably have been the reason for the replacement. These early implants were made of cobalt chrome (trade name Vitallium©)

gk_mckee.jpg
McKee2small.jpg
 
Re: 40 years life span for a hip replacement!!

The Mckee/Farrah hip (along with the Peter Ring metal-on-metal thr) were the inspiration for McMinn, the developer of modern hip resurfacing, this original hip was a metal-on-metal (same as materials as modern resurfs) but at the time had a high failure rate. However, years down the line some of these hips, like the one in the article were still going or being removed after incredible time frames.

The original hips failed apparently (it is recognised now,) because of poor engineering and obviously some were engineered better than others. The McKee hip was discontinued and the Charnley metal-on-poly used more widely. McMinn recognised how effective the McKee hip could have been given todays standards of engineering and adopted the same materials for his modern resurfacing.

jane
 
Re: 40 years life span for a hip replacement!!

This is true. The early run of Mckee Farrars were machined BY HAND! And also matched in pairs. There was an ID number on the cup and the stem which we had to double check as getting them mixed up would mean they weren't a matched pair and might not articulate properly.

However, the majority of failures in the McKee-Farrar was a simply lack of education. McKee placed a short article in the Journal of Bone and Joint Surgery around 1963. Many surgeons decided to have a go based purely on the scant information in that article. I know this because their theatre sisters used to phone our theatre asking for information! It was, in retrospect, no surprise when many of the early cases performed by others were failues whilst McKee and Watson Farrar's were not.

On the other hand, Charnley insisted that surgeons attend a 2 week course at the Wrightinton before they could buy the kit from the manufacturer, Thackrays. The deal was, anyone could buy the instruments but the prostheses were only released after the surgeon has written permission from the man. It became known as "Charnley's blessing"!

Was the same with the Ring. Was good in the hands of the master, but in the hands of others, it had a catastrophically high failure rate simply because their technique was faulty.

 

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