Oxford honours Irish engineer who brought pain relief to thousands

Seamus Heaney has long been one of Oxford University’s favourite poets. He was professor of poetry there from 1989 to 1994. Now Oxford has honoured another Irish professor – UCD graduate John O’Connor, whose invention of what is known as the Oxford Knee has brought relief from pain and a new lease of life to thousands.

If you find yourself in Oxford, drop in to the Bodleian Library’s current exhibition, Great Medical Discoveries.

There, you'll find Thomas Willis whose 17th century work on the anatomy of the brain introduced the word neurology. Alongside him is architect Robert Hooke, the first to study cells through a microscope.

There are other illustrious scientists including Alexander Fleming and Dorothy Hodgkin and yes, among all these stellar innovators shines another star – Dubliner John O’Connor, the Oxford Knee man.

Granted funding
First and foremost an engineer (mention of Engineering Society Yerrawaddie dances in the Olympic Ballroom back in the day brings a smile), he was granted funding at Oxford to pursue research into stress on joints and knee joints, in particular.

This attracted the attention of hip specialist John Goodfellow who, reading of O'Connor's research, contacted him, thus beginning a period of professional co-operation between medical doctor and engineer. This collaboration resulted, in 1976, in the first operation based on their study of the banjaxed knee or, to put it more professionally, the knee rendered painful and immobile as a result of osteoarthritis.

The breakthrough came when O’Connor’s painstaking research revealed that, in most cases, it wasn’t necessary to carry out a total knee replacement and that it was sufficient to replace only the worn bits.

This was far less evasive and made for a more rapid recovery. In fact, people who have the operation are usually invited to walk two hours after it.

“Knowing they can do this,” O’Connor tells me as we chat in an Oxford pub, “gives them confidence and that helps recovery.”

In lay person’s terms what happens is this: wear and tear results in a roughening of the surfaces of some of the kneebones so that the sliding bits, which allow the knee to bend and straighten, no longer move smoothly, thus slowing mobility and causing pain.

The job then is to open up the knee. This can be carried out without cutting through any ligaments, which is another plus. That done, the surgeon will use a drill to create a cavity.

Into the cavity are inserted two metal components which look a bit like a small yawning mouth, the top and bottom of which are cemented to the femur and the tibia respectively.

Then, into this small space, the surgeon snaps a small bearing made of white plastic which looks like a guitar plectrum.

This is the main innovative part of the invention for it is this bearing, smooth as silk,that slides to and fro as the knee bends and straightens.

The whole operation, performed under general anaesthetic, takes about an hour and a half and usually entails a two-day hospital stay. It is a huge improvement on the previous operation which involved, unnecessarily, a total knee replacement.

Specific training
But if you think this all looks simple, it's not. Great skill is needed and surgeons have to be given specific training in performing the operation.

The knee is a complex joint, far more so than the hip, and both bearings and metal components have to be made to fit.

Although the method used is the same as that used by John Goodfellow in 1976, present-day tools are now more advanced allowing for greater precision.

The exhibition in Oxford shows some of these tools including the drill which looks as if it might be more at home beneath the bonnet of a car.

One development – magic to an unscientific mind such as mine – is that cement is being replaced by a substance which contains hydroxyapatite, a chemical occurring naturally in the bone which means the two, recognising their affinity, meld together like long-lost cousins.

Though some 50,000 Oxford Partial Knee operations are performed annually worldwide including at five centres in Ireland, O’Connor is keen to emphasise that it’s not one that suits everyone.

Best course of action
If you have a troublesome knee, you should visit your doctor who will put you in touch with a specially trained surgeon who will decide the best course of action.

The Oxford Knee has made a name for itself in medical history so what was it like to be the co-inventor? John Goodfellow died a few years ago but O’Connor is always careful to include him in the story. Was there a sudden light bulb explosion, a double-helix moment of excitement?

O’Connor smiles: “No. A lot of things went wrong while we were working on it. And a great deal of time went in to building up a database.” But they got there.

John O’Connor is now Emeritus Professor of Engineering Science at St Peter’s College in Oxford, the city where he and his crime-writer wife, Gemma, have made their home.

How good would it be to hear him talk, in Dublin, about the engineering invention that, medically, has benefited so many people?

Great Medical Discoveries continues until May 18th. You can watch Prof O’Connor give an illustrated talk on his discovery at bodley.ox.ac.uk .