Innovation or regulation – differing needs in different areas

The history of orthopaedic surgery is one of innovators – a star-studded cast stretching from Thomas with his splint through to Charnley with his hip and beyond. Like all histories, the history of orthopaedics is written by the victors. Think of the Judet family, and the acetabular views and decortication technique come to mind, not the poor-outcome acrylic hips. However the truth is that for every Charnley Low Friction Arthroplasty, there were many more ‘Delbet Rubber Femurs’, ‘Hey-Groves Ivory Hips’ and ‘Ring Metal-on-Metal’ hips. Innovation in the time of our forefathers was embraced and the truth is that it was acceptable to experiment on patients. This is of course no longer true. Established technologies such as hip replacement are now ‘designed’ with iterative changes hoping for ever improved results. It is easy to see why …