The Oxford Knee Archive

Correspondence, research papers, anonymised patient case notes, engineering drawings, FDA applications, slides, negatives, photographs, journal articles,

According to its manufacturer, Zimmer-Biomet, the Oxford Knee™ is one of the most widely used and clinically proven partial knee replacements in the world. The prosthesis was first introduced in 1974 following eight years of collaboration, starting in 1966, between Mr. John William Goodfellow (1926-2011), a consultant surgeon at the Nuffield Orthopaedic Centre in Oxford and Professor John Joseph O’Connor (b. 1934) from the Department of Engineering Science at the University of Oxford. The Oxford Knee prosthesis was the first partial implant with an artificial meniscal bearing designed to glide freely throughout the knee's range of motion, more closely replicating the normal movement of a typical knee joint.

While the Oxford Knee is trademarked and refers specifically to the prosthesis and the surgery, the technical term for the procedure is called the Unicompartmental Arthroplasty with the Oxford Knee, often referred to simply as UAOK in the scientific literature. Throughout the last 45 years of academic and scientific literature the Oxford Knee has been referred to by many names among them “The Three Part Knee” and the “Meniscal Bearing Knee”. The knee has had three distinct phases referred to as Phase 1 (launched 1982), Phase 2 and Phase 3, but they are not always referenced as such among arthroplasty registries and has been an issue among scientific literature. In addition Roman and Hindu-Arabic numerals are used interchangeably when referring to the phases, not only by the various physicians using the device, but by the manufacturers and inventors.

After the passing of John Goodfellow in 2011 John O’Connor took possession of his papers, consisting of 16 plastic boxes, a portfolio of drawings, and loose article off-prints. Goodfellow had to combine four offices into one in 2000, therefore a selection of priority items from his perspective had already taken place. O'Connor donated Goodfellow's collection, alongside some papers from his own collection as well as physical artefacts to Thackray Museum of Medicine in 2013, with the archive arriving at the museum in 2014.

As well as many papers related to knee surgery and orthopaedics in general, the archive contains unique materials which reveal key stages of development in the Oxford Knee itself. In total the collection has a wide range of primary sources - technical drawings for the prototype and three phases of the prothesis, details of the clinical trial (1976-1983), product manuals and brochures, surgery manuals, journal articles, photo negatives, surgical training videos, product samples, FDA applications spanning 20 years (1983 to 2004), patent applications as well as letters, faxes and e-mails. Patient records form a major part of the collection, mostly from the late 1970s and 1980s, with follow-up assessments of nearly 20 years. The data from these patient records are used to argue the longevity of intact cruciate ligaments in multiple publications by the Oxford Knee team from late 1980s through to the early 2000s. There are also notes by and from John Joseph O’Connor, along with his correspondence with various engineering departments regarding the testing of various factors: pressure and movement, longevity and materials among others. Insight into the world of corporate level development can be seen in the letters between manufacturing companies and the inventors on design, cost, test results, advertisement and marketing. The archive essentially provides a blueprint that shows the background for the creation of a medical device.

Biographical information:

The story of the Oxford Knee cannot be told without the background information of its founding fathers - the two Johns - surgeon John William Goodfellow (1926 - 2011) and engineer John Joseph O’Connor (b. 1934). Goodfellow and O’Connor, and their collaboration in creating the Oxford Knee, has been the focus of newspaper articles and was presented in the Bodleian Library Great Medical Discoveries 2013-2014 exhibition at the University of Oxford.

John William Goodfellow was an orthopaedic surgeon, who among many other positions served as the President of the British Orthopaedic Association (1989 - 1990) and editor-in-chief for the British volume of the Journal of Bone and Joint Surgery (1990 to 1995). Before meeting O’Connor in 1966 Goodfellow had already built a solid career in the field of orthopaedic surgery. According to his obituary and Royal College of Surgeons of England ‘Plarr’s Lives of the Fellows’ entry, Goodfellow had studied medicine at the Guy’s Hospital in London. He then served as a medical officer to the 14th/20th Kings Hussars in Libya during his National Service as a Captain in the R.A.M.C. At Guy’s Hospital he was the house surgeon and assistant lecturer and later became registrar and senior registrar in the Accident Service and the Nuffield Orthopaedic Centre. He followed that up with being the Staff Surgeon at the Rancho Los Amigos Hospital in Los Angeles, California, USA. In 1962 he became First Assistant to Professor Josep Trueta i Raspall (1897 - 1977), a Spanish orthopaedic surgeon and researcher who was the third Nuffield Professor of Orthopaedic Surgery in Oxford. In 1965 Goodfellow was appointed Consultant at the Nuffield Orthopaedic Centre (previously the Wingfield-Morris Hospital). The Centre was, and remains, an internationally renowned orthopaedic hospital, providing routine and specialist orthopaedic surgery, plastic surgery, and rheumatology services, with strong affiliations with the University of Oxford. During his early orthopaedic career, he developed a particular interest in the mechanical influences underpinning osteoarthritis development. In 1966 Goodfellow was also an American-British-Canadian Traveling fellow of the American Orthopaedic Association.

John Joseph O’Connor (b. 1934) is a professor emeritus, fellow and tutor in engineering sciences at St. Peter’s College, University of Oxford, with an honorary degree of Doctor of Science from University College Dublin. He has worked across the fields of contact mechanics, biomechanics, and orthopaedics. In 1956 he received his University College Dublin Engineering degree with a BE in Mechanical & Electrical Engineering. Before receiving his PhD from the University of Cambridge in 1961 in contact mechanics, O'Connor worked in the engineering industry. He joined the University of Oxford, Department of Engineering Science in 1964 and was a fellow and tutor of the Engineering Science at St. Peter’s College at University of Oxford from 1965 to 2001. He was also the Dean of the Department of Mechanical Engineering at the University of Nigeria and received Ireland’s Royal Academy of Medicine Haughton Silver medal. He has served as the National University of Ireland (NUI) appointed external examiner in Mechanical Engineering for University College Dublin, NUI Galway and University College Cork from 1998-2000, as External Examiner for Mechanical Engineering at UCD from 2000 to 2003 and for the University of Limerick from 2002 to 2004.

At some point in the late 1980s David Murray joined the Oxford Knee team and by the early 1990s, after the retirement of Goodfellow, became the lead surgeon for the Oxford Knee. It is not clear from the archival why that was the case, perhaps Goodfellow had not found it important enough to keep personnel selection process details when moving offices. Taking into consideration that Murray had a degree in both engineering and medicine, later becoming Professor of Orthopaedic Surgery at the University of Oxford, it is not hard to imagine why having him on the team seemed like a good choice. The same could be said about another member of staff joining the team in 1990, Mr Christopher Dodd. Mr Dodd arrived at the Nuffield Clinic in 1990 and was a clinical reader until 1992. After that, he became a consultant orthopaedic surgeon. After 1997, when the first revamped Oxford Knee instructional course took place he was part of the surgical presentation team, conducting the live surgery alongside Mr David Murray. Murray was also the creator of the Oxford Knee Score, devised in the early 1990s and inspired by his Oxford Knee experience. The score assesses patients' experiences with all types of knee arthroplasty and while important for patient experiences, this thesis does not have the space to make the complicated and long history of knee scores justice.

Murray and Dodd are part of the developmental team for Phase 3 of the Oxford Knee.

Parts of the collection are restricted - please contact Collections department for more information.

Not permitted

Not expected