Artificial joints – a success story

Artificial joints - a success story

In 1890, the surgeon Themistocles Gluck implanted the first artificial knee joint, made of ivory and nickel-plated steel, into a patient in Berlin. The first artificial hip was implanted in 1938. In the following years, materials and techniques were improved to such an extent that joint replacement surgery could be safely and successfully carried out.

The British orthopaedic surgeon Sir John Charnley developed the prototype for the hip endoprostheses still used today. The prototype consisted of a small metal head, and a socket made of Teflon, which was later substituted with polyethylene. In 1958 Charnley carried out the first implantation of a total hip replacement (THR) using ‘acrylic cement’ (polymethylmethacrylate – PMMA for short). The ‘acrylic cement’ used back then is still used today and is often referred to as bone cement. However, contrary to how it initially sounds, bone cement is not actually a cement, but rather a plastic compound, known as a polymer, which enables stable anchorage of the endoprosthesis in the bone.

In 1972, the first bone cement with added antibiotics to support antibiotic prophylaxis was developed. The addition of antibiotic also means that the bone cement can be used for local antibiotic prophylaxis. Using an antibiotic-loaded bone cement can prevent potential infection of the prosthesis. Today, joint replacement procedures are common and the technology it uses is constantly being optimised. Thanks to modern surgical methods, joint replacement surgery can now be performed as an outpatient procedure, which means patients no longer need to stay in hospital. The focus is always on getting the patient mobile quickly and restoring their normal range of motion.