Life keeps us in perpetual motion and for as long as our bodies can carries us, we can
keep living life to the full and we can keep doing the things that we love doing each and
every day.
But for many as time goes on living life to the full becomes much harder.
Forty years ago, a breakthrough in medical science happened. Right here in the city of
learning and discovery, Oxford.
And has since allowed hundreds of thousands of people all over the world to carry on moving.
In the 1960s two men crossed paths right here in Oxford.
One, a consultant surgeon at the Nuffield Orthopaedic Centre and the other, a lecturer
in Engineering Science at the University of Oxford.
They were John Goodfellow and John O'Connor and together they would change the course
of medical history with the invention of the Oxford Knee.
So I met John Goodfellow in 1966 and we began this collaboration. There was really no well
established knee replacement available.
The devices that were available, most of them were demonstrating one, if not two, problems.
Either, the surfaces wore out quickly or the components loosened, fell out as it were,
or both.
So our objective was to create a device that first of all would treat the patients pain,
would not wear out, not loosen and would restore the patients function. That's what we hoped
we would achieve.
O'Connor and Goodfellow's breakthrough was considered so important to the medical sciences
that it featured in an exhibition of great medical discoveries here at the Bodleian Library
of Oxford University in 2014.
For people suffering with crippling knee conditions, such as osteoarthritis, the Oxford Knee was
a real game changer.
Before the Oxford Knee, knee replacements implants had a tendency to wear out. Primarily
because the plastic bearing used to replace the worn out cartilage was fixed in place.
The great idea was to make the bearing mobile, so that when the knee bends and extends, the
bearing slides back and forth spreading the load and reducing the wear and tear on the
knee.
The mobile bearing had another key benefit, it allowed the knee to twist from side-to-side.
Just like a normal healthy knee, allowing the recipient to have a greater range of motion.
In June 1976 the first patient received the first Oxford Knee and in the forty years since,
procedures have taken place all over the world including here, Nuffield Health Oxford, The
Manor Hospital.
So this is today's patient he's a 57-year-old gentleman. This is looking at his medial condyle
and you can see the white area here is bone edema and there is an area of significant
collapse right down in the lower part of the femur.
The first step is obviously the incision, getting down to the inside of the knee. For
90% of all partial knee replacements are on the inside of the knee between the femur and
the tibia. You retain the cruciate ligaments and all the other structures are normal.
That is really why the knee functions so well after an Oxford Knee. So the second major
step in the development of the Oxford Knee was to use it as just a partial or uni-compartmental
knee replacement. Having realised at the beginning that the Oxford Knee was rather difficult
to do, I became interested in trying to improve the surgical technique and the instrumentation
for the Oxford Knee.
But reflecting on the 40 years research, I think the most important thing is that patients
have been followed up in detail and it is based on identifying the problems that we
have been able to provide solutions.
Patients with minimally invasive surgery can recover twice as fast as surgeries performed
with a standard open knee incision, which was much bigger with the inversion of the
patella, and they can recover three times as fast as a total knee.
I was in such pain I could hardly walk even with a stick that facing even a distance of
300 yards was like facing a marathon and I can't imagine my life going on with the increasing
level of pain. So I've had two very successful operations and I've got my life back.
So the next step in the story was when we introduced the cement-less components. What
we have found with the cement-less components is it's much easier to implant the components
and the fixation is better, and the results are better.
So the Oxford Knee we consider to be a definitive knee replacement and we would say that 90%
of patients will have good or excellent results and won't need a revision. I don't know of
any other knee replacement, either a partial or total that's achieved such good results.
After 40 years of research and development the Oxford Knee is like so many of it recipients,
only getting better with age and refusing the slow down. With the innovation that has
driven that development still going strong, it's likely that future recipients are going
to be back to their feet and back to doing the things that they love doing faster than
ever before.