A Remembrance of Harlan C. Amstutz (1931-2021)

Harlan C. Amstutz MD (Fig. 1), widely regarded as the father of hip resurfacing arthroplasty and an emeritus member of the Association of Bone and Joint Surgeons, died May 17, 2021, in Kauai, Hawaii, USA. He was just shy of his 90^th birthday.

Harlan C. Amstutz MD (Published with permission from Dr. David Levine).

“It is almost impossible to describe the magnitude of his personality,” Nicholas Bernthal MD, interim chair of the Department of Orthopaedic Surgery at the University of California, Los Angeles, told Clinical Orthopaedics and Related Research®. “He was a physically giant man, and his personality was twice as big.”

His most important scientific contributions were focused on “trying to improve the materials we use for joint replacement and [to] minimize the morbidity of the surgeries,” Dr. Bernthal said. “He was one of the true giants in the field.”

Dr. Amstutz was born on July 17, 1931, in Santa Monica, CA, USA. “He grew up in Southern California, and he was basically a beach boy,” Dennis Collis MD, an orthopaedic surgeon at the Slocum Center for Orthopedics and Sports Medicine, told CORR. “[Dr. Amstutz] was a sand volleyball player. He body surfed and had a typical Southern California [upbringing].”

After graduating from John Marshall High School in Los Angeles, CA, USA, Dr. Amstutz pursued an undergraduate degree at UCLA, where he majored in chemistry [4]. He was also an athlete, playing on the varsity basketball team for famed Coach John Wooden, who led the UCLA Bruins to a total of 10 NCAA basketball titles.

“Harlan was in [Coach Wooden’s] first recruiting class,” said Dr. Collis, a longtime friend of Dr. Amstutz. “Harlan didn’t stay because he went on to medical school pretty quickly.”

Dr. Amstutz remained at UCLA for medical school, completing his degree in 1956. He went to LA County General Hospital in Los Angeles for a rotating internship, and then in 1957, he completed a 1-year surgical residency at UCLA Medical Center in Los Angeles. A move to the East coast took him to the Hospital for Special Surgery (HSS) in New York, NY, USA, where he did his orthopaedic residency from 1958 to 1961 [1].

For the next 2 years, Dr. Amstutz served in the United States Air Force, achieving the rank of captain [1]. In 1963, he traveled to London as part a National Institutes of Health–funded fellowship at the Royal National Orthopaedic Hospital [4].

In 1965, Dr. Amstutz went back to HSS, where he would remain as a faculty member for the next 5 years [4]. During this time, he was appointed as the first Director of Bioengineering at the institution, according to David B. Levine MD, an orthopaedic surgeon and medical historian at HSS.

When Dr. Amstutz returned to UCLA in 1970, he became the Chair of the Division of Orthopaedic Surgery, a post he held until 1989. He quickly made his presence known.

“He established an esprit de corps, a culture, around our department that was something we all hope to support and to follow into this day,” Dr. Bernthal said.

This translated to a departmental focus on collecting objective surgical outcomes data and collaborating with basic scientists. To better assess surgical outcomes, Dr. Amstutz established the UCLA Clinical Evaluation Unit. Instead of relying on surgeons to evaluate the success of a procedure, Dr. Amstutz wanted to collect data—such as the results of biomechanical testing or physical function challenges.

“He really wanted objective methods for assessing how well we do in our surgeries,” Dr. Bernthal told CORR.

As a firm supporter of the marriage between orthopaedics and basic science, Dr. Amstutz established the bioengineering laboratories and the PhD program in Biomedical Engineering at UCLA. At that time, “it was very rare to have surgeons and true basic science PhDs working together on these topics,” Dr. Bernthal said. “Harlan believed in collaboration, he believed in science.”

Throughout his career, Dr. Amstutz was a key player in joint arthroplasty, especially hip resurfacing arthroplasty [2, 3]. “He [performed] some of the original hip resurface replacements in the United States back at the Hospital for Special Surgery,” Dr. Collis said.

He remained dedicated to this procedure, even when other surgeons doubted its viability, Dr. Collis said.

In addition, Dr. Amstutz was intensely focused on his patients, particularly those who underwent hip resurfacing arthroplasty. “Throughout his career, he followed his patients very diligently,” Dr. Collis said. When he traveled to a specific city, he would set up appointments with local patients.

“He would call patients, get them to come to a hotel, have x-rays taken ahead of time; he actually traveled to them to see them [for follow up],” Dr. Collis said. “He was intense … he really wanted to make this operation successful.”

He was equally passionate about orthopaedic research, having authored or coauthored 335 peer-reviewed articles, more than 500 abstracts, and 75 book chapters; several articles were in press at the time of his death. Dr. Amstutz gave more than 1000 presentations worldwide and 76 invited lectureships [4]. Dr. Amstutz was highly decorated for these contributions, winning the John Charnley Award six times [1]. He was one of very few American orthopaedic surgeons granted a fellowship to the Royal College of Surgeons of England, and he was elected an honorary membership in the German Orthopaedic Society. He held 13 patents [4].

A lifelong athlete, Dr. Amstutz played basketball, volleyball, and tennis; he also enjoyed backpacking and skiing [4]. Even after his retirement, Dr. Amstutz continued his athletic pursuits: cycling and body surfing, according to Dr. Collis.

“He told me three or four years ago [that] he made a really bad mistake,” Dr. Collis said. “He was in his [80s], and he thought he could body surf. He said, ‘I thought I could crash this wave just like I used to, and instead I crashed my knee.’”

An avid gardener, Dr. Amstutz had a particular fondness for growing orchids, according to Dr. Levine. His home on Kauai was situated next to the National Tropical Botanical Garden, of which Dr. Amstutz was a member for many years.

Dr. Amstutz is survived by his wife of 63 years, Patti; his three children, Dr. Julie Hodge, Mark Amstutz, and Katie Rampen; his seven grandchildren; and one great-grandchild.