John N. INSALL1930–2000

Who’s Who in Orthopedics

relation to sitting height was published in 1934.

A study of the intervertebral disc, in conjunction with Dr. Howard Naffziger, was completed during his residency and published in 1938. From that time forward a continuous stream of substantive reports was added to the medical literature.

Shortly after his classic report, “Observations on the Function of the Shoulder Joint,” appeared in The Journal of Bone and Joint Surgery in 1944, Dr. Inman was approached by the Committee on Prosthetic Devices of the National Research Council and urged to accept a federal grant for the purpose of improving artificial limbs. He joined forces with Dr. Howard Eberhart, Professor of Engineering, and they accepted the challenge.

Thus began the lower-extremity prosthetic devices research project in the School of Engi- neering, Berkeley, and the subsequent devel- opment of the Biomechanics Laboratory in the Department of Orthopedic Surgery, San Francisco.

The ensuing research activities solidified Dr.

Inman’s interest in biomechanics and consumed most of his creative energies for a period of nearly 30 years, during which nearly 40 major reports were published.

He lived the final decade of his life at a more leisurely pace. He and Irene found more time to spend at the family farm in the Santa Clara Valley, where Dr. Inman cultivated unusual plants and fruit trees. At the university he wound down his research activities and completed a monograph, The Joints of the Ankle, which was published in 1976. Death came quietly to Dr. Verne Thomson Inman on February 5, 1980, in San Francisco at the age of 74 after a brief illness. He was survived by his wife Irene, three sons, six grandchildren, and a multitude of friends, former students, and colleagues, all of whose lives have been wonder- fully enriched by his presence among them. Just 3 weeks before his death he met with his edito- rial staff to put the finishing touches on the exhaustive treatise, Human Walking.

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John N. INSALL

1930–2000

John Insall was born in 1930 in Bournemouth, England, by the sea. He was educated at the Uni- versity of Cambridge and at London Hospital Medical School, graduating in 1956. He received his training at St. Bartholomew’s Hospital in Kent and at the Royal Free Hospital in London. He then served as a resident in general surgery and ortho- pedic surgery at the Royal Victoria Hospital and at Shriners Hospital for Crippled Children in Montreal. In 1961, he was awarded a fellowship in orthopedic surgery at the Hospital for Special Surgery in New York City.

After 2 years of practice in England, he returned to the United States in 1965 as an attend- ing surgeon and director of the knee service at the Hospital for Special Surgery. He served as pro- fessor of orthopedic surgery at Cornell University Medical College from 1980 to 1996. In 1991, he joined with Drs. W. Norman Scott, Michael A.

Kelly, and Peter D. McCann to form the Insall Scott Kelly (ISK) Institute for Orthopedics and Sports Medicine at New York City’s Beth Israel Medical Center. He served as director of the ISK Institute and its fellowship program. In 1996, he was appointed clinical professor of ortho- pedic surgery at the Albert Einstein College of Medicine.

Dr. Insall was a founding member of the Knee Society in 1983 and became its president in 1987.

He was instrumental in the development of the

Knee Society scoring system. His colleagues rec-

ognized his many achievements by establishing the Insall Award, which honors an outstanding paper concerning clinical results and techniques at the annual open meeting of the Society.

John Insall’s contributions to orthopedic surgery are legendary. His articles appeared in The Journal of Bone and Joint Surgery over four decades, beginning with reports on his experience with valgus tibial osteotomy for the treatment of osteoarthritis of the knee. Subsequent articles dealt with techniques for the treatment of patellar chondromalacia and malalignment as well as ili- otibial band transfer for the treatment of knees with anterior cruciate ligament deficiency. His most outstanding publication is the classic book Surgery of the Knee (now in its third edition), coedited by his colleague and dear friend Dr.

Norman Scott.

Dr. Insall will be most remembered for his numerous contributions to knee arthroplasty. His work with the total condylar knee prosthesis began in 1974 at the Hospital for Special Surgery, and, with Albert Burstein, he designed the Insall–Burstein knee prosthesis, first implanted in 1978. With Michael Freeman, he pioneered the philosophy of excision of the cruciate ligaments and soft-tissue releases during knee arthroplasty.

Among his special talents was his ability to devise arthroplasty techniques that were forgiving yet effective, allowing countless otherwise crippled patients throughout the world to resume normal lives. His most recent design innovations in- volved mobile-bearing inserts and fixed bearings that allow high degrees of flexion.

Dr. Insall also developed exposure techniques (for example, the “quadriceps snip”), quadricep- splasty for the treatment of patellar instability, ligament releases for the treatment of angular deformity, and intraoperative guidelines for femoral component rotation. He was a pioneer in the two-stage revision for septic knee arthro- plasty. In addition, he was responsible for the design of many instruments used intraoperatively to facilitate the accurate implantation of pros- thetic components.

His long-term follow-up studies of clinical results in various populations of patients, such as those who are young, elderly, or obese and those who have diabetes, psoriasis, or poliomyelitis, are the gold standard against which all future results will be compared.

John Insall was an acknowledged master surgeon. His clinical skills were complemented by his equally strong ability to teach others by

both word and example. Some 60 surgeons, many now world-renowned themselves, served as his fellows. They formed the Insall Club in his honor and meet annually to share experiences and promote research in knee arthroplasty techniques.

His lectures were classics, and he served fre- quently as the keynote speaker at national meet- ings. He was an annual fixture, for example, at Seth Greenwald’s Current Concepts Meeting in Orlando, Larry Dorr’s Master Techniques in Los Angeles, and, of course, the ISK meeting in New York City. He adopted Leo Whiteside’s technique of video presentation in lieu of slides, delivering messages that were clear, precise, and, when appropriate, entertaining.

Both in public and in private, John Insall was a kind and good person; he was a gentleman and a role model for his colleagues and his friends. An avid reader, he could converse on virtually any topic. If he disagreed with you, he would not become argumentative, but his silence spoke volumes.

He loved golf and was a student of the game.

If your swing was off, he could tell you why, but he never offered advice unless asked. As one might expect, his own swing was controlled and graceful, and his short game was played with sur- gical precision.

His academic demands made him a world traveler. He profited from these opportunities to educate himself about the local culture, frequent- ing museums and historical sites. His boundless energy took him on many a long walk to experi- ence the environs of a new city and partake of the local cuisine.

In May 1999, the orthopedic community was shocked to learn that John had metastatic lung cancer. We were not surprised, however, at the strength and dignity that he showed over the next 18 months. Never complaining, he remained opti- mistic and as active as possible.

In his last year, John returned to the seaside in Connecticut with his beloved wife, Mary. There, when able, he walked the beach, read voraciously, and bonded with his young grandson, John. He still enjoyed a “proper meal” with a “proper wine” and offered wise counsel to his students to the end.

John N. Insall, considered by many to be the father of modern-day total knee replacement prostheses and techniques, died peacefully on December 30, 2000.

He is survived by his wife, Mary V.; his daugh- ter, Amanda; his son, John H.; his grandson, John

Who’s Who in Orthopedics

E.; and countless friends, students, and grateful patients throughout the world.

Trieste. There, Dr. Jacobs was assigned to care for orthopedic patients and was required to travel monthly to Belgrade, Yugoslavia, to treat members of the United States Military Mission.

Also as part of his United Nations service, he was liaison to the British Hospital in Trieste.

When the conflict was over and Trieste had been settled, Dr. Jacobs was transferred to Livorno, Italy, where he was assigned by United States Ambassador Clare Boothe Luce to lead a convoy of trucks carrying medications, food, and blankets to flood victims in Salerno. After a brief stay in Livorno, he was transferred to a large United States Army Hospital in Frankfurt, Germany, where he served as acting chief of orthopedics for 18 months. It was in Frankfurt that he became a United States citizen.

After being discharged from the army in 1955, Dr. Jacobs became an orthopedic surgical resident at the Hospital for Special Surgery in New York City, completing his training in 1959. During this time, he served as a fellow for 1 year on the bone- tumor service at the Memorial Sloan-Kettering Cancer Center. While in residency training, he was fortunate to have, as one of his teachers, the renowned neurosurgeon Professor Thomas Hoen.

In 1959, Dr. Hoen and Dr. Jacobs introduced a new operative technique, first described by Dr.

Ralph Cloward: a combined arthrodesis through an anterior approach for the treatment of cervical disc disease.

In 1962, Dr. Jacobs was appointed chief of orthopedics at the Bronx Veterans Administration Hospital, an institution with a lengthy affiliation with the Hospital for Special Surgery. His other hospital appointments included chief of the foot disorder clinic at the Hospital for Special Surgery.

In 1973, Dr. Jacobs and colleagues founded the Cervical Spine Research Society. In addition, Dr.

Jacobs was a member of the International Lumbar Spine Society, the Intradiscal Therapy Society, and the North American Spine Society. Also in 1973, he was appointed chairman of the Ortho- pedic Section of the New York Academy of Med- icine and the New York State Medical Society. He served as president of the Society of Orthopedic Surgeons in 1977 and was elected chairman of the Board of Councillors of the American Academy of Orthopedic Surgeons in 1979. A fellow of the American Academy of Orthopedic Surgeons, American Orthopedic Association, American College of Surgeons, International Society of Orthopedics and Traumatology, and New York Rheumatism Association, Dr. Jacobs served as a

Who’s Who in Orthopedics

Bernard JACOBS

1924–1992

Bernard Jacobs, an internationally known ortho- pedic surgeon and clinical professor of orthope- dic surgery at Cornell University Medical College, died on April 19,1992, at the age of 68 years. He had practiced orthopedic surgery until he became disabled, in 1990.

Bernard Jacobs was born in London, where he received his early surgical training, graduating from the University College Hospital Medical School in 1948. After working with the National Health Service for 2 years, Dr. Jacobs became dis- enchanted and, in 1950, he decided to emigrate to the United States by way of Montreal. In Montreal, he was appointed a visiting fellow to Professor Wilder Penfield at the Royal Victoria Hospital. Later that year, he moved to New York, where he was a surgical resident for 3 years.

In 1953, Dr. Jacobs received a request that he

enlist in the United States Army Reserve. During

the Korean War, he was assigned to the United

States Army Medical School in San Antonio,

Texas. Although scheduled to be sent to Korea,

he was instead, at the last minute, dispatched to

Trieste, Italy, to join a contingent of United

Nations peacekeeping forces that were attempting

to mediate a conflict between the Italians and

the Yugoslavians, who were seeking control of