John Charnley

Sir John Charnley, (29 August 1911 – 5 August 1982) was an English orthopaedic surgeon.

He pioneered the hip replacement operation, which is now one of the most common operations both in the UK and elsewhere in the world, and created the "Wrightington centre for hip surgery".

He also demonstrated the fundamental importance of bony compression in operations to arthrodese (fuse) joints, in particular the knee, ankle and shoulder.

John Charnley was born in Bury, in Lancashire, on 29 August 1911.

His father, Arthur Walker Charnley, was a chemist and had a chemist's shop at 25 Princess Street; his mother, Lily, had trained as a nurse at Crumpsall Hospital.

He also had a younger sister, Mary Clare.

John Went to the Bury Grammar Junior School in 1919, moving on to the Senior school in 1922.

He had a scientific aptitude and was encouraged to study chemistry and physics.

In the autumn of 1929 he gained admission to the Medical School of the Victoria University of Manchester, from where he graduated with a Bachelor of Medicine, Bachelor of Surgery and Bachelor of Science (Anatomy and Physiology) in 1935.

He participated in the British evacuation of Dunkirk and, subsequently, he was sent to 31st General Hospital at Hellingly, East Sussex.

He then moved to Davyhulme Park Hospital and later to the General Hospital at Garrioch.

Finally, he was sent to Cairo; there he spent most of his military service under the supervision of orthopaedic surgeon Dudley Buxton.

Buxton had a high opinion of Charnley and gave him more responsibilities by sending him to the 2nd Orthopaedic Centre and putting him in charge of the new orthopaedic workshop.

From 15 August 1935, Charnley was appointed a House Surgeon at the Central Branch of Manchester Royal Infirmary in Roby Street, and after three months he went to the main Infirmary where he completed his year as House Surgeon.

As his friend David Lloyd Griffiths remembers, Charnley considered the possibility of becoming involved with cancer research, but most of his professors thought it was a waste of time and dissuaded him.

He planned to achieve the status of Fellow of the Royal College of Surgeons as soon as possible and, after having attended the fellowship course at Guy's Hospital in London, he passed the final examination on 10 December 1936.

He obtained the post of Resident Surgical Officer at Salford Royal Hospital on 1 January 1937, and after 21 months he unsuccessfully applied for the similar post at Manchester Royal Infirmary.

He then realised the career opportunities presented by research work and was appointed as a demonstrator in physiology at King's College London in October 1938.

The opportunity to return to Manchester came when he was appointed a Resident Casualty Officer (RCO) in April 1939.

This work put him in contact with many orthopaedic specialists, since he was responsible for cases presenting at the daily morning fracture clinics.

During the afternoons and nights, he acted as the Resident Surgical Officer, operating on general emergencies.

By the end of 1939, Charnley's projects had been stymied by the outbreak of World War II.

He joined the troops as a volunteer in the Royal Army Medical Corps on 1 May 1940 and, after a training period, he was posted to Dover as a Regimental Medical Officer.

That experience probably encouraged him to apply for the orthopaedic school in 1942, with the support of his senior colleagues.

He was promoted to the rank of Acting Major on 2 December 1942.

He ended his military service in May 1944, when he joined the orthopaedics staff at Shaftesbury Hospital.

The end of the war was also the beginning of a national scheme for the cure of crippled children, which involved the use of open-air rural orthopaedic hospitals.

One of these was the Robert Jones and Agnes Hunt Orthopaedic Hospital at Gobowen, near Oswestry in Shropshire, and Harry Platt recommended that Charnley went there in order to improve his skills as an orthopaedic surgeon.

He was resident in the hospital for six months in 1946, during which he developed his interest in bone grafting.

In order to satisfy his curiosity about bony union, he persuaded a junior colleague to test a surgical procedure on his leg, which resulted in a wound infection that forced the colleague to bed for some weeks.

Thereafter, Charnley returned to Manchester, again with the support of Platt, who had brought to the Royal Infirmary a group of young and brilliant orthopaedic specialists, which included Lloyd Griffiths.

Charnley and Griffiths became joint honorary assistant orthopaedic surgeons in 1947.

They both needed more clinical independence, and Platt arranged that Charnley saw some more clinical patients in other hospitals.

In May 1948, he participated in a work trip to the United States, visiting hospitals there, together with other young orthopaedic surgeons.

The experience caused him to consider the possibility of basing himself in the USA, but that country's restrictions on experimental surgeries were unacceptable to him.

He was interested in two basic orthopaedic problems: the effect of compression on the healing of cancellous bone, and the lubrication of joints.

He was convinced that collaborations with mechanical engineers, with whom he developed strong relationships, were fundamental to expanding his knowledge and improving his work.

Charnley's research was based on two different aspects: clinical, for the treatment of patients with osteoarthritis, and biomechanical, with experiments to determine the fundamentals of bony union and the conditions governing the spontaneous regeneration of articular cartilage.

When he returned to Manchester after the war, the facilities available did not live up to his expectations.

Charnley also influenced generations of orthopaedic surgeons through his textbook on conservative fracture treatment which was first published in 1950.