Abstract
John B Murphy (1857–1916) is known for many surgical contributions, perhaps most famously for his metallic ‘button’ designed in 1892 to secure safe bowel anastomosis after resection. 1 However, application of the ‘button’ was a short-lived phenomenon whereas his hip rongeurs or reamers, designed for interposition arthroplasty with fascia 2 and illustrated in 1912 (Figure 1), have remained with minor modifications the key instruments for a succession of hip joint reconstructions including current joint replacement procedures. Although Eugène Doyen (1859–1916) introduced a simplified rongeur in about 1906, this was limited to cartilage excavation of the acetabulum for children with congenital hip dislocation. Murphy's reciprocal instruments were designed for adults with disabling hip ankylosis following disease or trauma and they replaced imprecise curved chisels. Susequently Marius Smith-Petersen (1886–1953), John Charnley (1911–82), Crawford Adams (1914–2011) and others introduced different reamer sizes and various improvements for hand or powered application, and reamers with self-clearing blades and adjustable circumferences.
Hip reamers, described by Murphy as ?rongeur and neck conformer?; (below) an enlarged view of convex and concave cutting surfaces, reproduction of figure 37 in: Murphy JB. The Surgical Clinics of John B Murphy, MD at Mercy Hospital. Chicago Philadelphia: Saunders, 1912:243-255
John Murphy was born in Appleton, Wisconsin, of Irish immigrant farming stock and was educated locally before working in a medical practice, followed by study and qualification at Rush Medical College in Chicago. He specialized in surgery and toured German centres of excellence where he was greatly enthused before returning to Chicago as an assistant in private practice in 1884. Developing a wide spectrum of surgical activity helped by groundbreaking aseptic techniques, he introduced new procedures and in 1894 established his own practice. Often regarded with suspicion by his peers as an eccentric maverick, eventually his considerable contributions swayed them to elect him Professor of Surgery in Chicago and President of the American Medical Association. He died aged 58 of coronary artery disease. 3
Murphy's interest in orthopaedic problems is often overlooked, and yet his hip reamers and concept of interposing living tissue between reamed joint surfaces may be closer to an eventual biological solution of hip joint arthritis and in due course replace today's insertion of massive unbiological foreign bodies, despite their general toleration and often remarkable function.