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The revolutionary orthopaedic implant is celebrating its 50th birthday, so what makes it so unique?
The Exeter Hip, created by orthopaedic surgeon Professor Robin Ling and University of Exeter engineer Dr Clive Lee, was first implanted in 1970.
With Lings’ specialist interest in hip surgery and Lee’s mechanical engineering background, their collaboration has produced a remarkable implant. Its long-term success is largely due to its polished finish, tapered design and its ability to behave like a wedge or self-locking taper which has benefited many patients and prolonged many surgeries’ life expectancy.
Robin Ling’s legacy will live on through his ingenuity and passion for hip surgery, embodied by the Exeter Hip. Ling and Lee put Exeter on the map for orthopaedic hip surgery and through the Exeter Hip, they have enhanced the lives of more than two million patients worldwide. The Exeter Hip team at the Princess Elizabeth Orthopaedic Centre at the Royal Devon & Exeter Foundation Trust and Nuffield Health Exeter Hospital continue its legacy of innovation.
Professor John Timperley, Consultant orthopaedic surgeon at Nuffield Health Exeter Hospital commented: “In testament to Ling and Lee’s revolutionary invention, the Exeter Hip stem has remained largely unchanged. We as surgeons however continue to evolve and develop new surgical techniques for its implantation to deliver even better outcomes for patients. Robotic arm assistance is the latest step in this journey of innovation.”
The Exeter Hip Team
Farewell to our founder Prof LingProfessor Robin Ling, who has died at the age of 90, was a hip surgeon, innovator and scientist whose contribution to hip replacement surgery has improved the quality of life for millions of people around the world. Ling became interested in hip replacement surgery following his appointment as consultant orthopaedic surgeon at the Princess Elizabeth Orthopaedic Hospital in Exeter in 1963. There were very few types of hip replacement available in the 1960s and Ling sought to create an implant that could be securely fixed to the bony skeleton using acrylic bone cement. He collaborated with Dr. Clive Lee, an engineer at the University of Exeter, and designed a different geometry of implant that he believed would optimise fixation and thereby the long-term success of a hip replacement. The first Ling-Lee hip was inserted in 1970 and the Exeter hip, as it is now known, is today the most implanted cemented hip replacement in the world due to its outstanding long-term function. More than one million operations had been undertaken by the end of 2010 and more than 100,000 Exeter stems are now implanted annually. His observation of how the implant worked in the human body led to extensive research in the laboratories at the University of Exeter. A philosophy of “taper-slip” fixation ensued; all major hip manufacturers now market an implant that function in this way. Ling’s work was not just confined to the implant itself – he also developed sophisticated cementing techniques to improve the clinical result. These techniques constitute contemporary practice and over the decades thousands of surgeons from around the world have travelled to Exeter symposia and workshops to learn the principles and techniques he developed. As hip surgery became more widely carried out there became a need to innovate methods to revise implants that had failed, often with severe destruction of bone. Ling developed a technique known as Femoral Impaction Grafting during which bone graft is impacted into the large bone defects. He showed that the graft heals to augment the skeleton if it is loaded correctly allowing patients to return to long-term pain-free function. Ling’s interest in hip surgery did not prevent him contributing in other areas of professional life. He was President of many bodies including the British Orthopaedic Research Society, the British Orthopaedic Association, the British Hip Society (which he co-founded) and the International Hip Society. He was honorary professor of bioengineering at the University of Exeter. He was appointed officer of the Order of the British Empire in 1992. Robin Sydney Mackwood Ling was born on 7 September 1927 and brought up in the West riding of Yorkshire where his parents and grandfather were doctors; his grandfather was known as “old Dr. Ling” and his father, “Dr. Billy”. His mother, Mona, ran the four-man medical practice during the war. Educated in Chelmsford Hall in Eastbourne, Ling was dispatched at the outbreak of war to Canada with his two younger brothers where they lived with the Koerners, a philanthropic family who had emigrated to Canada from central Europe to escape the Nazis. On returning to the UK he read medicine at Magdalen College, Oxford and St Mary’s Hospital in Paddington. It was at St Mary’s that Ling met Mary Steedman, a casualty nurse born in South Africa, who was preparing to return to Cape Town to read medicine having been awarded a scholarship. They married after a brief courtship and enjoyed 62 years of a happy and fulfilled marriage. Throughout his life Ling had a passion for sport. His love of sailing started during his residency at Shawnighan Lake school on Vancouver Island and he and his brothers later persuaded their parents to buy a classic yacht, Veronique. He was involved in several Fastnet races. On retirement, he moved to the Dart estuary and fulfilled his ambition of owning his own sailing boat, aptly named Enfin. Ling was a surgeon who carried the respect of all those with whom he worked and of the patients he treated. His intellect and contribution to hip surgery is widely acknowledged and he had the wonderful attributes of personal warmth and modesty. He is survived by his wife, Mary, and two daughters, Jenny and Katy, as well as four grandchildren. Jenny is an orthodontist in Wells and Taunton. Katy is an interpreter for the European commission in Brussels. Professor Robin Sydney Mackwood Ling. Born September 7th 1927, died October 9th 2017.
The Exeter Hip Unit
Pioneers in Total Hip Arthroplasty The Exeter Hip Unit is located at The Royal Devon and Exeter Hospital, and are the creators of the Exeter Hip, a long term outstanding hip replacement that can benefit all patients – even the young. Some of the most pioneering techniques are developed here in Exeter and our work is used in many places throughout the world. Learn More The Exeter Hip Unit Team are responsible for the innovative development of the Exeter Total Hip Replacement implant system and techniques for implantation and fixation in total hip replacement. The team run several courses a year, teaching surgeons from around the world. The Unit hosts surgeons in Exeter for periods of observation and training. The Team are invited to speak at hip surgery teaching events all over the world and run an extensive education programme out of Exeter and all over the world. Learn More
Attending her 50 year followup appointment at the RD&E, Exeter
The Exeter Hip Unit has just been reported in the National Joint Registry as having the best Health gains in Total Hip Replacement of any hospital in the country
Still Climbing with my Exeter Hip
The Exeter Hip enabling me to walk my dogs and tend my garden aged 93!
I am 93 and sail my boat, ride my horse, tend my garden. Now I’m not sure which hip I had operated on as it gives me no trouble. Grev Learn More
Two new Exeter Hips and riding!
The Exeter Hip has enabled me to redefine my riding life. I never thought I would actually be able to ride my horse better than I did before ! Once again I was able to jump in huntertrials and showjumping competitions aged 65 plus. Anne Learn More
Information on non surgical treatments and surgery hip preservation.Learn More
The most common cause of hip joint damage is simple wear and tear, when the lining of the joint (the cartilage) starts to wear away. This is known as osteoarthritis of the hip joint.Learn More
The type of revision hip operation required will depend on the method of failure of the first hip replacement.Learn More