Role of Brothers Jean and Robert Judet in The History of Hip Replacements: From Acrylic Prosthesis to Porous Metal Cementless Prosthesis
Seance of wednesday 16 october 2019 (France, terre d'innovations en chirurgie orthopédique et traumatologique)
DOI number : 10.26299/q6fv-v568/emem.2018.2.012
Abstract
In September 1946, Jean and Robert Judet performed the first acrylic head replacement of the fémoral head. The patient who suffered osteo-arthritis was able to walk on the 8th postoperative day without pain. This early weight-bearing, true innovation in hip surgery at that time, spreads rapidly and largely among the orthopaedic world.The choice of acrylic material came from the experience of a friend, ENT surgeon ,who used it in his clinical practice. The tolerance tests were favorable and the first models were molded by hand. The head was extended by a pivot that got across the fémoral neck. First in acrylic it was soon reinforced by a central metal rod. The surgical technique used a mini-invasive anterior Hueter approach and an orthopaedic operating table for a good exposure of the femoral neck. The acetabulum was reamed if necessary to stabilise the prosthetic head.
There was a large panel of surgical indications : hip osteo-arthritis, fracture and non-union of the femoral neck, sequelae of infectious arthritis and congenital dislocation in adult.The first 400 clinical cases were reviewed in 1952 with good results for fractures and non-unions of the femoral neck , middling for osteo-arthritis and poor in congenital dislocations.
Except the fractures of the femoral neck pivot, the wear of the acrylic head will raise up the problem of the long-term holding of the implant. First femoral head replacement, largely used in the world, the acrylic head of the brothers Jean and Robert Judet has been a major innovation, opening the way for the great story of hip prosthesis.
Robert Judet has been one of the major actors of this story, introducing the concept of biological fixation by bone ingrowth in a rough metallic surface with the so called Porometal cementless hip prosthesis. In the same time, he defined the concepts witch are still, all around the world, the bases of cementless hip replacements : mechanical initial stability, metal-back acetabular component and neck prosthesis junction by the way of a morse taper.
There was a large panel of surgical indications : hip osteo-arthritis, fracture and non-union of the femoral neck, sequelae of infectious arthritis and congenital dislocation in adult.The first 400 clinical cases were reviewed in 1952 with good results for fractures and non-unions of the femoral neck , middling for osteo-arthritis and poor in congenital dislocations.
Except the fractures of the femoral neck pivot, the wear of the acrylic head will raise up the problem of the long-term holding of the implant. First femoral head replacement, largely used in the world, the acrylic head of the brothers Jean and Robert Judet has been a major innovation, opening the way for the great story of hip prosthesis.
Robert Judet has been one of the major actors of this story, introducing the concept of biological fixation by bone ingrowth in a rough metallic surface with the so called Porometal cementless hip prosthesis. In the same time, he defined the concepts witch are still, all around the world, the bases of cementless hip replacements : mechanical initial stability, metal-back acetabular component and neck prosthesis junction by the way of a morse taper.