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JOINTS. Medicine is having considerable success with artificial joints. A plastic and steel copy of the ball-and-socket hip joint perfected by Britain's Dr. John Charnley in 1962 is being in stalled at the rate of 25,000 a year, mostly in patients with severe crippling arthritis. The cost (including hospitalization and doctors' fees): $2,500. Nor is this all that is being done for victims of this disease. Knuckle joints made of metal alloys are being used to replace damaged ones in thumbs and fingers. Doctors have implanted a metal and plastic device in the knees of several thousand elderly patients with degenerative arthritis, enabling some to walk for the first time in years. Ankle joints, although still highly experimental, have been installed in many patients, and work is under way on an elbow joint. Doctors at Chicago's Michael Reese Medical Center have restored mobility to two women with severely damaged shoulder joints. They have replaced the joints with stainless-steel and plastic prostheses. These in corporate a built-in safety feature: like ski bindings that release under leg-fracturing pressures, the joints are designed to dislocate rather than break under too much stress.
CIRCULATORY SYSTEM.
Tubes of synthetic fibers have been widely used to replace arterial parts since Georgetown University's Dr. Charles Hufnagel first applied the technique to humans. He fitted an Orion graft in the femoral artery of a Korean War veteran in 1953 and then applied the technique to the aorta, the body's largest blood vessel. Knitted Dacron is now commonly used for this purpose. Houston's Dr. Michael E. DeBakey and his former colleague, now rival, Dr. Denton Cooley, have performed thou sands of such grafts in patients whose arteries have been damaged or closed by atherosclerosis. They have also done more valve jobs than most auto mechanics. Cooley has implanted some 4,300 heart valves in his patients, DeBakey at least 3,000. Their heart valves consist of a pyrolytic carbon ball or disc in a titanium wire cage and cost about $5,000 installed. Says DeBakey: "Because of the development of these parts, there are thousands of people leading normal lives today who would otherwise be dead or suffering. Many of these people are economically self-sufficient because of them."
VOICE AND SENSE ORGANS. Dr. Stanley Taub, at the New York Medical College, is developing a device which is designed to improve the speaking ability of selected patients who have undergone a laryngectomy (removal of the larynx and vocal cords). Some of these patients cannot learn esophageal, or "burp" speech, which is achieved by swallowing air—and few who do learn it can speak clearly. Dr. Taub's patients wear a device that is not technically an implant, but a highly intimate explant; it consists of a small case, worn on the upper chest and containing a valve system that regulates the air flow from one opening in the side of the neck into another in the windpipe. With the aid of the system, expired air activates tissues in the esophagus to produce near-normal, if somewhat husky, speech.