1893

Paris surgeon Jules-Emile Péan opens his Hôpital International, and implanted shoulder prosthesis for a 37-year-old baker dying from tuberculosis of the right shoulder. The artificial joint was invented by the dentist J. Porter Michaelis of Paris , and consisted of a rubber ball and platinum tube. Two years after the implant, the patient returned with his persistent elbow fistula, and Péan removed the prosthesis: “ . . . an ossified mantle had formed around the prosthesis. The scar tissue of the original cold abscess had festered and had been transformed into bone tissue. It was a complete mess. . . . The story of the baker and the history of joint prostheses indeed shows that the acceptance of foreign materials by the body depends on the absence of infection. If bacteria attach to something foreign . . . they are apparently beyond reach of the immune system. Prosthetic material will therefore only be accepted if it is fitted under absolutely sterile conditions” (Van de Larr, ch 24; Zilber). “This was probably the first metal articular prosthesis ever implanted, as Themistocles Glück, the pioneer of joint replacement, was still using ivory and cadaveric bone for his prostheses” (Zilber).