Outpatient surgical centers have been around since the 16thcentury.
Services provided by surgeons at that time were so straightforward and limited that they could be performed by a tradesman in a small shop. Surgical interventions focused on treating wounds, draining pus, and treating fractures.
Back then, all that a tradesman needed was the perfect reclining chair, a wash basin, and a clean blade. You still see these tradesmen today. They are known as barbers. After a successful operation, the barber would hang a blood spattered white bandage outside on a stick, as a sign of his trade. This is the origin of the red and white stick you still see hanging outside a barber’s shop even now.
This had all changed by the end of the 19thcentury.
The technological revolution of surgery started 150 years ago at the time of the Industrial Revolution. Many of these medical advances took place in Paris. This is when surgeons first started doing joint replacements.
One early pioneer performing joint replacements at that time was a renowned Parisian surgeon by the name of Jules-Emile Pean (Jule-a-meal Pee-ann). His first patient was a poor 37-year-old French baker by the name of Jules Pedoux. His shoulder joint had eroded from the secondary effects of tuberculosis. Tuberculosis starts in the lungs, but the bacteria slowly spreads throughout the body and eats away at bones and joints. It can form a tuberculosis abscess called a “cold abscess.” Once the abscess is removed it leaves a large cavity, and this is what happened to the baker.
Dr. Pean had two treatment options: First, amputate the whole arm, which meant his patient would no longer be a baker. Or, second, something new and innovative: a shoulder implant to replace that totally eroded shoulder joint. He chose option two, and with the assistance of a dentist, he replaced the shoulder with a new mechanical joint.
The implant was a rubber ball boiled in paraffin for 24 hours to harden it. There were two grooves on the surface of the ball at right angles, in which two platinum rings could move. The horizontal ring allowed for internal rotation and external rotation, and the vertical ring enabled abduction.
Brilliant design? Yes. The problem is, there is no recorded data regarding outcomes on whether this arm was functional or whether it was even able to move up or down.
The implant lasted two years. It is no surprise that it became infected and failed. The patient’s hospital stay lasted six months, as abscesses formed and needed to be drained numerous times. The words “sterile technique” did not exist at that time. First, the wound was closed with horsehair stitches. Second, they had not yet discovered that foreign bodies, like a rubber ball or platinum tube, would be incubators for infection. The prosthesis was eventually removed and is now on display at the Smithsonian Institute in Washington, DC.
So here we are today, standing in the 21stcentury version of that barber shop or Parisian hospital.
Things have certainly evolved, and technology is leading us in a new direction in orthopedic care. In our magnificent Surgery Center, we now offer the most advanced surgical center in the nation. This surgical center exemplifies orthopedic care for the 21stcentury. We have certainly come a long way!