WILLIAM WAUGH

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In 1956, when I was working at what was then the Wingfield-Morris Orthopaedic Hospital (now the Nuffield Orthopaedic Centre) in Oxford, I wrote to ask Charnley if I could visit him in Manchester to learn about the operation for stabilisation of the hip joint which he had devised at that time. He took me out to dinner and I well remember going with him to his laboratory at the Medical School later that evening. There he had an ankle joint swinging in a pendulum apparatus which was part of his investigation into the lubrication of joints and which led to his original concept of his low friction arthroplasty. The next day he demonstrated the stabilisation operation; this was an arthrodesis to stiffen the hip, rather than an arthroplasty to restore movement.

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Back at Oxford, Professor Trueta, whose assistant I was, allowed me to follow Charnley's technique. I had some difficulty (I cannot now remember precisely what) so I wrote to ask his advice. What I do remember is that I received, within a day or two, a long handwritten letter (with diagrams) which explained precisely what to do. Unfortunately, this correspondence is lost, but the impression created endured; it seemed remarkable that he was prepared to go to so much trouble to ensure that a junior colleague should understand exactly what he thought should be done.

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From then on, I followed his work with great interest and we often talked at orthopaedic meetings. It was not, however, until March 1969 that I visited the Centre of Hip Surgery at Wrightington Hospital with two of my colleagues from Harlow Wood Orthopaedic Hospital. We saw the new operation, as well as visiting the wards and a clinic; and, most important, the biomechanical laboratory.

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We were “approved” and our hospital was allowed to purchase the prostheses. The operation at first seemed complicated, but we knew that it had to be carried out correctly and we persevered with his instructions. Those familiar with hip replacement today may find it difficult to appreciate how exciting an innovation this was. When we had trouble with infection, Charnley was sympathetic and helpful. At a visit to discuss the problem in 1971 I remember his school-boyish delight at wearing his “space suit” for the first time. His enthusiasm was encouraging, and his attention to detail and his single-minded dedication were impressive. I remained convinced that Charnley's arthroplasty was the best, both in materials and method, and every assistant who worked with me during the next fifteen years always visited Wrightington to learn the technique at first hand.

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Two coincidental personal connections interested me as I began work on this book. First, I found that Charnley's research in London was done with my father-in-law, Professor R.J.S. McDowall who was professor of physiology at King's College, London. Second, my teacher in orthopaedics at King's College Hospital, Mr St. J. D. Buxton, had left his war diaries to the Royal College of Surgeons in London: these made it clear that Buxton, who was then consultant orthopaedic surgeon to the Middle East Forces, had picked out Charnley to be in charge of a newly formed appliance workshop in Cairo in 1941.

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It is acknowledged that Sir Harry Platt played a critical part in Charnley's orthopaedic career, but there is no doubt that Buxton recognised his ability very early on and ensured that he had facilities to pursue his mechanical and engineering interests. Towards the end of his life Charnley kept a record of his thoughts and activities, but his journal petered out after three months under pressure of other work which he must have considered to be of greater importance. However, he left a large number of published papers in orthopaedic and other journals, and at times these reveal glimpses of his personal opinions. I have quoted from his writing frequently to give an insight into his character.

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(Reprinted from “CHARNLEY THE MAN AND THE HIP” by kind permission of the Authors family)

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