Who’s Who in Orthopedics
suade the giants of industry and commerce to con- tribute to the rebuilding and upkeep of the College.
Archie, as he was affectionately known to all his friends, was a great plastic surgeon and teacher. But he was also the most likeable of men, with an infinite capacity for enjoying life in the company of every stratum of society. Honors were given to him in abundance but, though accepted with obvious delight, they never altered his delightful character. He will be greatly missed by his many friends and colleagues all over the world—and not least by his patients, especially the badly burnt Royal Air Force boys of the Second World War, who banded together to form the Guinea Pig Club, which met annually at East Grinstead under his presidency.
Archibald McIndoe died peacefully in his sleep from a coronary occlusion on April 12, 1960, at the age of 59.
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Archibald Hector McINDOE
1900–1960
McIndoe was born in New Zealand, qualified in medicine at the University of Otago and did his postgraduate training in surgery at the Mayo Clinic, for which for the remainder of his life he had the greatest affection and admiration. Later he came to London and joined his cousin, Sir Harold Gillies, the great pioneer of plastic surgery, who outlived him by a few months.
Within a short time he was on the staff of St Bartholomew’s Hospital and his future in London was secure; indeed, for the last 20 years of his life, he was probably the most successful surgeon in any speciality in the metropolis.
He was a great friend of orthopedic surgery.
During the Second World War he was consultant in plastic surgery to the Royal Air Force. The writer became closely associated with him in the problems presented by burns combined with frac- tures, and in the management of patients with extensive skin and bone loss. This work, which started in Royal Air Force hospitals and at the Queen Victoria Hospital, East Grinstead, was continued at the latter hospital until his death.
On his election to the Council of the Royal College of Surgeons of England, he became intensely interested in the College, of which he had just ceased to be senior vice president when he died. There was little doubt that he would have been the next president and the first New Zealander to hold the highest order in British surgery. His loss is a sore one for, among his many qualities, was an outstanding ability to per-
George Kenneth McKEE
1906–1991
Ken McKee, a pioneer of joint replacement surgery, was born at Ilford, Essex, the son of a medical practitioner who had migrated from Northern Ireland at the turn of the century. McKee was educated at Chigwell School and St.
Bartholomew’s Hospital Medical College. He
then came under the influence of Elmslie, Higgs
and Brockman at Chailey Heritage; proceeding to
FRCS in 1934. McKee was appointed registrar at
the Norfolk and Norwich Hospital in 1932 and in 1939 joined H.A. Brittain on the staff as a consultant.
Orthopedic surgery proved to be a fertile field for a man who was fascinated by all things mechanical. His early interest in taking motorcy- cles and cars to pieces prepared him for an out- standingly inventive career. He himself admitted that “replacing worn joints was a fairly obvious treatment to me.”
Throughout the 1940s and 1950s he pursued his goal of hip replacement with little encourage- ment from his more conservative and sceptical peers. Their comments of the time were recorded by McKee: “£200 is very expensive for an oper- ation that is doomed to failure” and “prosthetic arthroplasty should be reserved for the over 90s.”
In later years he would often recall, with a twinkle in his eye, the eminent questioner at a Royal Society of Medicine meeting of 1957, who asked
“where do you put the grease nipple?” McKee noted but disregarded the hoots of laughter that followed. His first models had been made up in brass in 1940, but he delayed putting his ideas into practice until chrome–cobalt alloys became available. He presented his first cases of total hip replacement in a clinical demonstration at the British Orthopedic Association meeting in Cambridge in 1951.
At this time, the management of unilateral hip arthritis was highly controversial. H.A. Brittain, from whom McKee had remained distant, had published two editions of his book The Architec-
tural Principles of Arthrodesis, and Watson-Joneswas another proponent of hip fusion. Indeed, in 1948, McKee had invented his own variant of hip fusion using a lag screw and was pleased that the fixation eliminated the need for plaster of Paris.
He continued to be committed to total replace- ment and in 1953 he visited F.R. Thompson in the USA and adopted the Thompson stem for his femoral component, using this in articulation with his chrome–cobalt cloverleaf socket until 1960.
He reported a 50% failure rate of this combina- tion in the short term. McKee’s confidence in total joint replacement was not shared by others: even John Charnley was uncertain as late as 1957 and still advocated hip fusion.
John Charnley first used acrylic cement to fix a femoral prosthesis in 1958, and in 1960 he pub- lished his findings in The Journal of Bone and
Joint Surgery. This was recognized by McKee asthe breakthrough he was looking for. With his reg- istrar, John Watson-Farrar, McKee conceived the
metal-on-metal cemented hip joint, but unlike Charnley he did not restrict the use of his inven- tion. Metal debris and impingement were major problems and these were addressed by redesign of the Thompson component and by making the femoral head slightly smaller than the socket to diminish equatorial wear.
McKee recognized Charnley’s brilliant scien- tific and engineering skills but was always con- cerned about wear of high-density polyethylene and unimpressed by Charnley’s laboratory studies of friction. Curiously, he himself introduced a metal-on-polyethylene variant of the McKee–Farrar prosthesis in 1972. Ken McKee was pleased to know that orthopedic surgeons and engineers were, in 1991, taking a second look at metal-on-metal articulations.
McKee’s mechanical aptitude was not limited to total hip replacement. His interventionist approach to fracture treatment led to the use in 1941 of his own intramedullary nail for femoral fractures; A.R. Hodgson was his registrar at the time. A trifin nail and plate was developed for trochanteric fractures, and an external fixator incorporated in a Thomas splint was his novel way of treating tibial fractures. McKee also favored plate fixation for closed tibial fractures and even some open ones. He reported the use of molded plastic corsets for spinal pain and, in the wake of his hip replacement, he designed hinged prostheses for the elbow and the knee. He even experimented with acrylic cement as a replace- ment for intervertebral discs.
Ken McKee, though a bold and adventurous surgeon, was a quiet and discreet man, who found public speaking neither easy nor agreeable. His conversation was of cars, golf, skiing and sailing rather than orthopedics. His enthusiasm for golf was well known and he won the Robert Jones Cup of the British Orthopedic Association on three occasions. He also scored a hole in one at the age of 80.
Less well known in the profession was his con- version to Christianity, which occurred on a visit to Bethlehem during the Second World War—
“the most important event in my life.”
In 1972, in recognition of his services to ortho- pedic surgery he was appointed Commander of the Order of the British Empire and 3 years later received an Honorary Doctorate of Science of Cambridge University. He was awarded the Honorary Fellowship of the Royal Society of Medicine in 1986, a distinction of which he was particularly proud.
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Who’s Who in Orthopedics
Ken McKee died on July 18, 1991, at the age of 85. He was survived by his wife Dan and four children.
Dr. McKeever enjoyed hunting and fishing, and he was always delighted to be at his ranch.
McKeever was one of the founders of the Asso- ciation of Bone and Joint Surgeons and became its third president. He was also a member and active participant in many orthopedic organiza- tions and on local hospital boards and staffs.
On a rainy evening, October 13, 1959, when driving someone else’s car, he ran out of gas:
while filling the tank, he was struck by another car and killed.
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