Made in Exeter...the new hip which has helped more than two million people

PUBLISHED: 17:09 20 October 2020 | UPDATED: 17:13 20 October 2020

Professor Robin Ling, left and Dr Clive Lee receiving their honorary degrees from Exeter University in 2009 in recognition of their contribution to medical innovation. Photo: Exeter University

Professor Robin Ling, left and Dr Clive Lee receiving their honorary degrees from Exeter University in 2009 in recognition of their contribution to medical innovation. Photo: Exeter University

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Implant created by two Devon pioneers is now used worldwide on patients

Orthopaedic surgeon, Prof John Timperley demonstrates how the Mako robotic arm is used at the Exeter Nuffield in an Exeter Hip replacement. Photo: Exeter NuffieldOrthopaedic surgeon, Prof John Timperley demonstrates how the Mako robotic arm is used at the Exeter Nuffield in an Exeter Hip replacement. Photo: Exeter Nuffield

Once upon a time, an orthopaedic surgeon and a mechanical engineer had the vision to create a new hip implant. So successful was their collaboration, over the next 50 years their invention enriched the lives of more than two million patients worldwide.

That, in a nutshell, is the fairytale story of the Exeter Hip - invented here in Devon by Professor Robin Ling and Dr Clive Lee in 1969 and implanted for the first time in the autumn of 1970. It was originally called the “Ling Lee Hip”!

A former apprentice at Rolls Royce, Clive Lee was for many years Reader in Bioengineering at the University of Exeter and still lives close to the city after which his legacy is named. Ling and Lee’s invention is the epitome of precision engineering and could easily be mistaken for a minimalist, stainless-steel sculpture.

We chat in Dr Lee’s conservatory, surrounded by various commemorative trophies of the implant he helped to devise. He tells me, “One day we had a call from Robin Ling saying he’d like to meet up with a few of us at the university to see if we’d be interested in helping him.

Water sports enthusiast Dr Bel Bailey says being fitted with the Exeter Hip has transformed her life. Photo: Andy BaileyWater sports enthusiast Dr Bel Bailey says being fitted with the Exeter Hip has transformed her life. Photo: Andy Bailey

“He came to see four or five of us and outlined what he thought he wanted from us, then finished by asking ‘Would any of you be interested?’ I immediately put up my hand. I was the only one who did! The reason being, Robin was talking about working in orthopaedics - totally outside the experience of most engineers - but I thought, well hell, why not have a go?”

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This meeting of two exceptional minds was to have a profound impact not only on the careers of Professor Ling and Dr Lee but on the lives of millions of people across the world and their families. Now manufactured by Stryker, the Exeter Hip has become the most implanted cemented hip stem in the world and the surgical techniques that evolved in Exeter have transformed the way hip replacement surgery is carried out.

It’s significant on another level too, as a model of collaboration between Stryker and three leading local institutions: the University of Exeter, the Hip Unit at the Princess Elizabeth Orthopaedic Centre (Royal Devon and Exeter Foundation Trust) and Nuffield Health Exeter Hospital. Together they continue to research and innovate surgical techniques and peri-and post-operative care which transform the lives of people who have previously lived with excruciating and relentless hip pain.

A new report, coincidentally published in the Exeter Hip’s 50th anniversary year, shows their results are unsurpassed in national joint registries around the world. The stem is also recognised by Universities UK as one of the 100 greatest breakthroughs.

Professor John Timperley has both professional and personal experience of the implant’s success; a hip surgeon at both the RD&E hospital and at Exeter Nuffield, his mother has received two replacement hips in operations carried out by fellow surgeons.

He reveals, “There’s a whole fairytale about how this implant works, the way it self-tightens over time and transmits load to the bone. It’s now taught in all orthopaedic textbooks. These features weren’t known on Day One, but it’s due to the scientific rigour of Robin and Clive that they devised an implant that works so fantastically and the rest of the team has tried to build on that heritage.

“For the first five years, the implant was exclusively used in Exeter so that Professor Ling could monitor it and collect data. At the time the industry standard was for stainless steel to be polished and he subsequently discovered that this had real benefits - the polished surface worked much better with acrylic bone cement than a roughened one, which loosened slightly over time.”

While the basic geometry of the Exeter Hip is identical to 50 years ago, the way it is fitted has become increasingly hi-tech. Surgeons in Exeter have pioneered Stryer Mako robotic-arm assisted procedures, tendon-preserving hip surgery and other innovations which make for a phenomenal success rate.

As Clive Lee puts it: “People keep asking me when is the design going to be updated? But it works, you know, so why change it?

EXETER HIP GETS BEL BACK ON THE WATER

Water sports enthusiast Dr Bel Bailey, a 53-year-old GP who lives in Exmouth, says her hip replacement has given her her life back. She received an implant in November 2018 after being dogged by intolerable hip pain for three years.

She says, “It transformed my life. Being able to walk, sleep and sit without pain was amazing for me and my family.

“My recovery was quicker than I’d expected and also exciting as I noticed small improvements every day. It was a bonus to be back on the water within five months of my operation. I can’t thank the Exeter hip team enough.”

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