Authors: Richard A Brand
Publish Date: 2010/05/05
Volume: 469, Issue: 1, Pages: 3-4
Abstract
MacAusland was intrigued by clinical and basic questions and published in a wide variety of areas His first two papers dealt with the treatment of scaphoid fractures 8 and a combined experimental rabbits and clinical study of growth arrest 5 As with most orthopaedic surgeons at the time he had a wide range of interests but particularly related to arthroplasty His first paper on the topic published in 1914 dealt with arthroplasty of the elbow 6 Perhaps his last paper was the one we reproduce this month “Total Replacement of the Knee Joint by a Prosthesis” 7 MacAusland was not the first to report total knee replacement He acknowledged two previous efforts Borje Walldius in 1953 reported using a prosthesis made of acrylic resin joined by a steel rod to serve as a hinge 9 A description of this device its evolution and the findings in 23 patients appeared in an abridged version of his 1957 thesis in CORR as a Classic 10 Leslie Shiers in 1954 described a stainless steel hinged implant with a report of two patients In one the knee became encased in new bone by two months postoperatively and he performed an arthrodesis In the second patient motion was retained MacAusland’s device like that of Shiers was made of metal Vitallium His device had perforated flanges for bone ingrowth He reported one patient who had good motion and was “extremely pleased” at 11 months The next advances came with elimination of the hinge in the early 70s by Gunston in 1971 3 and by Freeman et al and Coventry et al in 1972 1 2 all three using differing design concepts Early pioneers such as MacAusland made great strides for patients while trying something that must have seemed radical at the time If many radical approaches fail to successfully address the problems for which they are intended most major advances that successfully address problems do seem radical at the time
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