507:(UHMWPE), which he rejected because of his lack of understanding of the problem; his assistant told him privately that he would endeavor to test it. It was serendipity, and he immediately grasped the potential of the HMWP; after some tests, Charnley implanted it for the first time in November 1962. Mindful of his previous failure with the PTFE socket, he waited for a year, during which time he carefully observed the status of his patients. Five years later, when he was convinced that HMWP was a safe material, he announced his discovery, making it possible for other surgeons to use it. As time went by, the number of operations increased, and Charnley designed a machine which mechanically built prostheses and sockets,as well as an apparatus for evaluating patients for their hip disorders before and after the operation.
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511:
418:. 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.
596:, whose family firm had been building air filtration systems since 1854, for help. Howorth adapted Charnley's enclosure to provide better air handling and incorporate a diffusion system that allowed the passage of a larger flow of filtered air. Charnley understood that another source of contamination was through the surgeon's gown, and he developed a full-body gown that incorporated an exhaust system. This came into use from the 1970s, and was ventilated so that the surgeon always felt comfortable, whilst maintaining a negative pressure to avoid contamination.
457:
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375:. 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. 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
527:
sockets himself, turning them on a lathe in his workshop at home. Later his technicians made instruments under close supervision and then
Thackray's manufactured them. As time went on, Thackray's contributed their own design suggestions; this continual exchange of ideas was a significant factor in the advance of the hip operation.
631:
John
Charnley is recognised as the founder of modern hip replacement. His contributions to the field are found in the hip replacement surgery method, in the optimization of the surgery flows and in the drastic infection rate decrease. Through his teaching activities, he transmitted his technique and
499:
At first, the result seemed to be satisfactory, however, approximately one year after the first operations (about 1960), it became clear that PTFE was not a suitable material. It showed signs of wear and, most importantly, its reaction with soft tissues caused the formation of granulomatous masses
439:
When he returned to
Manchester after the war, the facilities available did not live up to his expectations. From then on, he began to think of reducing the number of clinical sessions he was undertaking, in order to carry out his research elsewhere. He finally opted for this path in 1958, informing
421:
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
476:
is responsible for the low friction of the surfaces. Charnley disagreed with that theory; through his experiments, he was able to demonstrate that the low friction does not depend on the fluid presence. The studies led to the development of the Low
Friction Arthroplasty concept, which assumed that
471:
Charnley's first aim at
Wrightington was to build a biomechanical laboratory that could be used to test his instruments and inventions. He organised a fund raising campaign for this purpose and the laboratory opened on 23 June 1961. His first studies concerned lubrication of joints. At that time,
526:
in Leeds, whom he had first asked to make instruments for him in 1947. Charnley refined his hip replacement operation throughout his long association with
Thackray's and was still working on improvements when he died. At first Thackray's made the stainless steel stems, while Charnley made the
329:(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.
468:. Improved living conditions and pasteurisation of milk had caused a decline in the incidence of that illness and many hospitals were seeking new medical endeavors upon which to focus. In the case of Wrightington, it was Charnley's hip surgery centre that came to the fore.
562:
Charnley also realised that it was of fundamental importance to retrieve the artificial joints from patients who had died some years after the surgery, in order to study the wear of the materials and the tissue changes, thus enabling improvements in the procedure.
591:
such as gentamicin into the bone cement; the bacterial count decreased, but not enough. In 1961 he developed an enclosure that isolated the operating theatre from the rest of the room, into which filtered air could be passed. To improve his system, he asked
190:
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
488:(PTFE, also known as Teflon) seemed to meet this requirement. After some apparently successful experiments with the material, he adopted it for his hip replacement surgeries. They were carried out as follows: discarding the head of the
646:
for his contributions to surgical science. The corresponding Lister
Oration, given at the Royal College of Surgeons of England, was delivered on 26 May 1976, and was titled 'The Origins of Post-Operative Sepsis in Elective Surgery'.
429:, 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.
313:
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
1806:
799:
Bigliani, L. U.; Cofield, R. H.; Flatow, E. L.; Fukuda, H. A.; Hawkins, R. J.; Matsen Fa, F. A.; Morrison, D. S.; Rockwood Jr, C. A.; Warren, R. F. (2009). "Charles Neer: On the giant of the shoulder".
611:, he met Jill Heaver (1930–2016). Despite a twenty-year difference in ages - she was 26 and he was 46 - they married a few months later, on 15 June. They lived first in a house called "Naemoor" in
414:
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
632:
knowledge to a wide audience of international surgeons and thus his academic and scientific work was spread worldwide. As of 2011, many of his students were still teaching hip replacement.
583:
The huge number of wound infection cases after hip replacement operations pushed
Charnley to put effort also in the prevention field; he was involved in the research of a method to keep
394:
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
448:. The committee agreed to his request for a period of three years, after taking into account his skills and reputation. The decision was to be reviewed at the end of that period.
1665:
Early Development of Total Hip Replacement: The transcript of a Witness Seminar held by the Wellcome Trust Centre for the History of Medicine at UCL, London, on 14 March 2006
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the Manchester Royal Infirmary surgeons' committee that he wished to hand over three of his four clinical sessions in order to set up a hip surgery centre at
705:
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Charnley also influenced generations of orthopaedic surgeons through his textbook on conservative fracture treatment which was first published in 1950.
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Although not inclined to sporting pastimes as a child, Charnley became a passionate skier as an adult. In 1957, during his annual skiing holiday in
472:
some surgeons were supporting the hydrodynamic theory, which assumed that the two faces of a joint are not perfectly congruous, and that a film of
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492:; replacing it with a metallic implant that was fixed with acrylic cement; and, using a PTFE acetabular socket, insertion of the implant into the
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436:, with experiments to determine the fundamentals of bony union and the conditions governing the spontaneous regeneration of articular cartilage.
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that in almost all cases required a further operation to enable their removal. This setback in Charnley's research affected him for some time.
109:
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His determination pushed him to seek an alternate material. He continued to test various materials, until a salesman approached him offering
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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
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This discovery caused him to begin looking for a slippery substance that could be used for the socket of a total hip replacement operation.
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Both the enclosure and the body gown were redesigned and improved over time in order to make them more useful and easier to use.
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1678:"A Historical and Economic Perspective on Sir John Charnley, Chas F. Thackray Limited, and the Early Arthroplasty Industry"
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rather than as a glue and that interlocked the two parts. He believed that the cement had to have some essential features:
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research, but most of his professors thought it was a waste of time and dissuaded him. He planned to achieve the status of
130:
1025:
The closed treatment of common fractures. John Charnley. Churchill Livingstone. Third edition. Edinburgh and London 1974.
432:
Charnley's research was based on two different aspects: clinical, for the treatment of patients with osteoarthritis, and
968:
Lidwell, O. M. (1993). "Sir John Charnley, surgeon (1911-82): The control of infection after total joint replacement".
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in Roby Street, and after three months he went to the main Infirmary where he completed his year as House Surgeon.
925:
Donald, S. M. (2007). "Sir John Charnley (1911-1982): Inspiration to future generations of orthopaedic surgeons".
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The cement that reflected these features was produced by CMW Laboratories Limited and was called CMW bone cement.
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Jackson, J. (2012). "Father of the modern hip replacement: Professor Sir John Charnley (1911-82)".
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He was interested in two basic orthopaedic problems: the effect of compression on the healing of
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371:; there he spent most of his military service under the supervision of orthopaedic surgeon
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Eftekhar, N. S. (1983). "In memory of Sir John Charnley. August 29, 1911-August 5, 1982".
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Charnley was convinced that the best way to fix the prosthesis into the femur was to use
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in 1922. He had a scientific aptitude and was encouraged to study chemistry and physics.
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He ended his military service in May 1944, when he joined the orthopaedics staff at
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Lathe used by Charnley to make acetabular cups for hip replacements, on display at
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away from the wound during surgery. His first attempt consisted in introducing
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By the end of 1939, Charnley's projects had been stymied by the outbreak of
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remembers, Charnley considered the possibility of becoming involved with
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as soon as possible and, after having attended the fellowship course at
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to allow the surgeon the choice of different degrees of radio-opacity.
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The opportunity to return to Manchester came when he was appointed a
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of the facing materials, and only marginally on the fluid presence.
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Recipients of the Lasker–DeBakey Clinical Medical Research Award
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as a Regimental Medical Officer. He participated in the British
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Cameron Prize for Therapeutics of the University of Edinburgh
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Wrightington had formerly been a centre for the treatment of
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on 1 May 1940 and, after a training period, he was posted to
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Cameron Prize for Therapeutics of the University of Edinburgh
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and, subsequently, he was sent to 31st General Hospital at
195:(fuse) joints, in particular the knee, ankle and shoulder.
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Top 1000 Scientists: From The Beginning Of Time To 2000 Ad
703:(1984). "John Charnley. 29 August 1911 – 5 August 1982".
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302:, he passed the final examination on 10 December 1936.
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878:"Biographical Sketch: Sir John Charnley MD, 1911–1982"
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The package should include two measured quantities of
182:(29 August 1911 – 5 August 1982) was an English
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Biographical Memoirs of Fellows of the Royal Society
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It had to be prepared without unnecessary additives;
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Fellows of the Royal College of Surgeons of England
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1578:, Ann R Coll Surg Engl. 1975 June; 56(6): 339-340.
1371:"Chas. F. Thackray Ltd: suppliers to the surgeons"
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235:In the autumn of 1929 he gained admission to the
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575:Charnley's surgical exhaust suit, on display at
396:Robert Jones and Agnes Hunt Orthopaedic Hospital
258:
1777:Alumni of the Victoria University of Manchester
451:
1675:
698:
677:. Churchill Livingstone, Edinburgh and London.
668:. Churchill Livingstone, Edinburgh and London.
522:He collaborated very closely with the firm of
263:From 15 August 1935, Charnley was appointed a
110:Lasker-DeBakey Clinical Medical Research Award
1802:Commanders of the Order of the British Empire
828:
336:. He joined the troops as a volunteer in the
1676:Gomez, Pablo F.; Morcuende, Jose A. (2005).
221:. He also had a younger sister, Mary Clare.
545:The exact constituents should be published;
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882:Clinical Orthopaedics and Related Research
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548:It had to be sterilised with formaldehyde;
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837:"Professor Sir John Charnley (1911-1982)"
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666:The Closed Treatment of Common Fractures
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509:
505:Ultra-high-molecular-weight polyethylene
477:the low friction depended mostly on the
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273:
1662:Reynolds, L. A.; Tansey, E. M. (eds.).
1283:"AAOS 75th - Stories - Physician Story"
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292:Fellow of the Royal College of Surgeons
102:Gairdner Foundation International Award
1817:British Army personnel of World War II
1767:People educated at Bury Grammar School
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802:Journal of Shoulder and Elbow Surgery
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360:and later to the General Hospital at
1782:People from Bury, Greater Manchester
1762:20th-century English medical doctors
1718:The John Charnley Research Institute
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1621:. Springer-Verlag London Limited.
1619:John Charnley: The Man and the Hip
689:
635:In 1974, Charnley was awarded the
255:(Anatomy and Physiology) in 1935.
14:
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1822:Royal Army Medical Corps officers
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970:The Journal of Hospital Infection
243:, from where he graduated with a
241:Victoria University of Manchester
81:Victoria University of Manchester
1737:University of Manchester Library
1448:collections.thackraymuseum.co.uk
1349:collections.thackraymuseum.co.uk
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278:Manchester Royal Infirmary, 1957
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1444:"798.001 | Collections Online"
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1:
1345:"600604 | Collections Online"
854:10.1093/rheumatology/41.7.824
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460:Hip replacement Image 3684-PH
259:First surgery and war service
201:
1787:Fellows of the Royal Society
1772:British orthopaedic surgeons
1375:Socialist Health Association
982:10.1016/0195-6701(93)90125-j
758:Journal of Medical Biography
452:Wrightington and hip implant
7:
1682:The Iowa Orthpaedic Journal
577:Thackray Museum of Medicine
516:Thackray Museum of Medicine
138:Fellow of the Royal Society
10:
1838:
1369:Penny, Wainwright (1993).
835:Wroblewski, B. M. (2002).
269:Manchester Royal Infirmary
228:in 1919, moving on to the
226:Bury Grammar Junior School
206:John Charnley was born in
1640:. Book Guild Publishing.
894:10.1007/s11999-010-1547-6
814:10.1016/j.jse.2009.01.033
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327:Resident Casualty Officer
307:Resident Surgical Officer
267:at the Central Branch of
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1733:John Charnley Collection
927:Scottish Medical Journal
657:
642:He was awarded the 1975
367:Finally, he was sent to
338:Royal Army Medical Corps
305:He obtained the post of
1723:The John Charnley Trust
1636:Barker, Philip (2002).
1617:Waugh, William (1990).
770:10.1258/jmb.2011.011021
675:Compression Arthrodesis
673:Charnley, John (1953).
664:Charnley, John (1950).
358:Davyhulme Park Hospital
939:10.1258/rsmsmj.52.2.43
719:10.1098/rsbm.1984.0004
580:
519:
486:Polytetrafluorethylene
461:
311:Salford Royal Hospital
279:
1812:20th-century surgeons
1728:Wrightington Hospital
876:Brand, R. A. (2010).
574:
524:Chas. F. Thackray Ltd
513:
459:
442:Wrightington Hospital
346:evacuation of Dunkirk
320:King's College London
284:David Lloyd Griffiths
277:
214:, on 29 August 1911.
1596:Ann R Coll Surg Engl
479:friction coefficient
379:on 2 December 1942.
245:Bachelor of Medicine
1602:(3): 252. May 1976.
356:. He then moved to
253:Bachelor of Science
249:Bachelor of Surgery
186:. He pioneered the
184:orthopaedic surgeon
155:Orthopaedic surgeon
1566:, p. 185-196.
1494:, p. 160-161.
1482:, p. 154-157.
1409:, p. 143-144.
1334:, p. 126-128.
1322:, p. 128-129.
1310:, p. 122-124.
1272:, p. 120-121.
1260:, p. 105-108.
1248:, p. 102-104.
1236:, p. 116-117.
1224:, p. 114-115.
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390:Back to Manchester
280:
219:Crumpsall Hospital
1647:978-81-7371-210-4
1628:978-3-540-19587-0
888:(12): 3147–3148.
567:Against infection
322:in October 1938.
318:in physiology at
224:John went to the
167:Sir John Charnley
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145:Scientific career
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1289:on 19 April 2015
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1606:
1605:
1580:
1568:
1556:
1544:
1532:
1520:
1508:
1506:, p. 162.
1496:
1484:
1472:
1470:, p. 150.
1460:
1435:
1433:, p. 142.
1423:
1421:, p. 143.
1411:
1399:
1397:, p. 141.
1387:
1361:
1336:
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1058:
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1034:
1018:
995:
960:
917:
868:
847:(7): 824–825.
827:
808:(3): 333–338.
791:
764:(4): 151–156.
748:
687:
686:
684:
681:
680:
679:
670:
659:
656:
628:
625:
621:Mere, Cheshire
604:
601:
568:
565:
557:
556:
549:
546:
543:
474:synovial fluid
453:
450:
391:
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296:Guy's Hospital
282:As his friend
260:
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237:Medical School
203:
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162:
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98:
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87:Known for
84:
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57:(aged 70)
51:
47:
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36:
34:29 August 1911
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24:
15:
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2:
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1554:, p. 92.
1553:
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1218:
1212:, p. 85.
1211:
1206:
1200:, p. 84.
1199:
1194:
1188:, p. 83.
1187:
1182:
1176:, p. 48.
1175:
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1158:
1152:, p. 36.
1151:
1146:
1139:
1134:
1127:
1122:
1115:
1110:
1104:, p. 16.
1103:
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1092:, p. 15.
1091:
1086:
1080:, p. 14.
1079:
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1031:0-443-00119-7
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650:Charnley was
648:
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603:Personal life
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594:F. H. Howorth
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434:biomechanical
430:
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416:bone grafting
413:
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373:Dudley Buxton
370:
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62:
53:5 August 1982
52:
48:
43:
39:
33:
29:
25:John Charnley
22:
19:
1685:
1681:
1664:
1637:
1618:
1611:Bibliography
1599:
1595:
1583:
1576:Lister Medal
1571:
1559:
1547:
1535:
1523:
1511:
1499:
1487:
1475:
1463:
1451:. Retrieved
1447:
1438:
1426:
1414:
1402:
1390:
1378:. Retrieved
1374:
1364:
1352:. Retrieved
1348:
1339:
1327:
1315:
1303:
1291:. Retrieved
1287:the original
1277:
1265:
1253:
1241:
1229:
1217:
1205:
1193:
1181:
1169:
1157:
1145:
1133:
1121:
1109:
1097:
1085:
1073:
1068:, p. 9.
1061:
1056:, p. 4.
1049:
1044:, p. 1.
1037:
1021:
1004:
998:
973:
969:
963:
933:(2): 43–46.
930:
926:
920:
885:
881:
871:
844:
841:Rheumatology
840:
830:
805:
801:
794:
761:
757:
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710:
704:
701:Woodruff, M.
674:
665:
649:
644:Lister Medal
641:
634:
630:
606:
598:
582:
561:
558:
529:
521:
502:
498:
483:
470:
466:tuberculosis
463:
438:
431:
424:
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393:
381:
377:Acting Major
366:
334:World War II
331:
324:
316:demonstrator
304:
281:
262:
234:
223:
216:
205:
197:
166:
165:
144:
131:Albert Medal
124:Lister Medal
55:(1982-08-05)
18:
1757:1982 deaths
1752:1911 births
1293:28 February
976:(1): 5–15.
713:: 117–137.
589:antibiotics
532:bone cement
412:Harry Platt
384:Shaftesbury
354:East Sussex
69:Nationality
1746:Categories
1564:Waugh 1990
1552:Waugh 1990
1540:Waugh 1990
1528:Waugh 1990
1516:Waugh 1990
1504:Waugh 1990
1492:Waugh 1990
1480:Waugh 1990
1468:Waugh 1990
1431:Waugh 1990
1419:Waugh 1990
1407:Waugh 1990
1395:Waugh 1990
1332:Waugh 1990
1320:Waugh 1990
1308:Waugh 1990
1270:Waugh 1990
1258:Waugh 1990
1246:Waugh 1990
1234:Waugh 1990
1222:Waugh 1990
1210:Waugh 1990
1198:Waugh 1990
1186:Waugh 1990
1174:Waugh 1990
1162:Waugh 1990
1150:Waugh 1990
1138:Waugh 1990
1126:Waugh 1990
1114:Waugh 1990
1102:Waugh 1990
1090:Waugh 1990
1078:Waugh 1990
1066:Waugh 1990
1054:Waugh 1990
1042:Waugh 1990
683:References
494:acetabulum
446:Lancashire
408:Shropshire
386:Hospital.
212:Lancashire
202:Early life
193:arthrodese
61:Manchester
42:Lancashire
1688:: 30–37.
1453:28 August
1354:28 August
786:207200585
654:in 1977.
350:Hellingly
63:, England
44:, England
1704:16089068
1380:11 April
955:23252729
947:17536642
912:20852975
863:12096235
822:19393927
778:22319187
743:42716782
735:11616002
652:knighted
617:Cheshire
585:bacteria
422:to him.
404:Oswestry
362:Garrioch
1695:1888784
1013:6368477
1007:: 1–6.
1005:The Hip
990:8095948
903:2974887
402:, near
400:Gobowen
239:of the
72:British
1702:
1692:
1644:
1625:
1029:
1011:
988:
953:
945:
910:
900:
861:
820:
784:
776:
741:
733:
727:769822
725:
627:Career
410:, and
300:London
288:cancer
151:Fields
134:(1978)
127:(1975)
120:(1974)
113:(1974)
105:(1973)
97:Awards
1669:(PDF)
1592:(PDF)
951:S2CID
782:S2CID
739:S2CID
723:JSTOR
658:Books
615:, in
536:grout
490:femur
369:Cairo
342:Dover
210:, in
177:
175:,
1700:PMID
1642:ISBN
1623:ISBN
1455:2024
1382:2014
1356:2024
1295:2016
1027:ISBN
1009:PMID
986:PMID
943:PMID
908:PMID
859:PMID
818:PMID
774:PMID
731:PMID
613:Hale
609:Zurs
251:and
208:Bury
50:Died
38:Bury
31:Born
1690:PMC
978:doi
935:doi
898:PMC
890:doi
886:468
849:doi
810:doi
766:doi
715:doi
406:in
398:at
309:at
298:in
179:FRS
172:CBE
1748::
1735:,
1698:.
1686:25
1684:.
1680:.
1600:58
1598:.
1594:.
1446:.
1373:.
1347:.
984:.
974:23
972:.
949:.
941:.
931:52
929:.
906:.
896:.
884:.
880:.
857:.
845:41
843:.
839:.
816:.
806:18
804:.
780:.
772:.
762:19
760:.
737:.
729:.
721:.
711:30
709:.
691:^
639:.
623:.
496:.
444:,
364:.
352:,
247:,
169:,
40:,
1706:.
1671:.
1650:.
1631:.
1457:.
1384:.
1358:.
1297:.
1015:.
992:.
980::
957:.
937::
914:.
892::
865:.
851::
824:.
812::
788:.
768::
745:.
717::
579:.
518:.
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