Hip replacement surgery has been a work in progress for more than 80 years. Dr. Marius Smith-Petersen in Boston developed the cup arthroplasty in the 1920s and 1930s. Damaged bone from the hip joint was removed and a metal cup was placed over the head of the femur. While this wasn’t truly a replacement, it was an attempt to put new surfaces in a damaged joint. The cup arthroplasty remained the primary surgical treatment for an arthritic hip for 25 years.
The first partial hip replacement was performed by Dr. Austin Moore at Johns Hopkins University in the early 1940s. Only the femoral head was replaced, not the socket. It consisted of a large metal ball with a stem that fit inside the shaft of the femur. The Austin Moore prosthesis was modified in the 1950s and became the standard treatment for certain types of hip fractures. The modern total hip replacement was pioneered by Sir John Charnley at Wrightington, England in 1962. For this surgery, a small metal ball and stem that fit inside a plastic or polyethylene socket were used. Both components were inserted in bone and held in place with bone cement.
The femoral head was smaller than normal so as to create less friction and wear in the socket. Dr. Charnley called his procedure “low friction arthroplasty.” Even though cement is now used less frequently, the concept of a metal femoral head articulating with a polyethylene socket remains the gold standard in hip replacement to this day. In the United States, more than half a million hip replacement procedures are done annually.
According to data from the Department of Health and Human Services National Hospital Discharge Survey, 231,000 total and 251,000 partial hip replacements were per-formed in the United States in 2006. An additional 38,000 revision procedures were done on hips that had previous surgery. This represented an increase of more than 200,000 surgeries in an 8-year period. As our population ages and medical advances help people to live longer it is expected that the number of hip replacements done annually will continue to grow.