Lost a giant in Orthopedics, Dr. David Hungerford

ALL ORTHO MOURNS THE PASSING OF DR. DAVID S. HUNGERFORD (Orthopedics This Week)

When you ask friends and former colleagues about hip and knee replacement pioneer David S. Hungerford, M.D., 80, who passed away on Saturday, March 2, 2019 from complications of brain cancer related to melanoma, the three words that pop up the most are innovation, education and service. From his pioneering work in hip and knee replacement to his dedication to teaching and his philanthropic works, Hungerford will always be remembered for his generous spirit.

Here is a beautiful video that was produced by the American Academy of Orthopaedic Surgeons on the occasion of Dr. Hungerford receiving the prestigious AAOS Humanitarian award.

His Life & Work

Hungerford was born in Rochester, New York, to Samuel Hungerford, a school principal and his wife, Marjorie, and then raised in Sodus, New York. It was a serious burn injury as a child that inspired him to become a doctor.

After receiving a bachelor’s degree from Colgate University, he studied neurophysiology at the Institut Claude Bernard in Paris as a U.S. Public Health Service postgraduate fellow.

And then back in the U.S., he earned his medical degree at the University of Rochester School of Medicine and completed an internship and surgical residency at Strong Memorial Hospital at the University of Rochester.

Between 1966 and 1969, while with the Army Medical Corps, he worked in Germany, and also performed orthopedic surgery at the Nuffield Orthopaedic Centre in Oxford, England.

Hungerford first joined the Johns Hopkins Hospital in 1972 as a resident in orthopedic surgery. He also joined the faculty of John Hopkins University School of Medicine where he became full professor in 1986.

During his time at Johns Hopkins Hospital, he was chief of the scoliosis clinic and chief of the division of arthritis surgery. He also established an orthopedic surgery practice at the Good Samaritan Hospital in Baltimore, Maryland, where he led his team as the chief of orthopedic surgery.

Known for his unrelenting commitment to relieving his patients’ suffering and for becoming friends with many of them, it is no surprise that many generous contributions from his patients and others led to a professorship and chair in orthopedic surgery in his name at Johns Hopkins School of Medicine in 2000. He was also named professor emeritus by the Hopkins University Board of Trustees in 2014.

While he retired from both Johns Hopkins and Good Samaritan in 2011 after 38 years of service, Hungerford continued to play a significant role in orthopedic surgery and in missionary work. In 2013, he received the Humanitarian Award from the American Academy of Orthopaedic Surgeons for his outstanding humanitarian service.

Good Samaritan Hospital’s President Brad Chambers said in an official statement, “We are deeply saddened by the passing of Dr. David Hungerford, orthopedic surgeon and beloved husband and father. His medical career spanned several decades, and he was a pioneer for innovation in orthopedic surgery, developing a porous-coated anatomic artificial knee replacement with medical engineer, Robert Kenna. The technology enabled patients to grow bone cells that fit with their prosthesis and provided better mobility.”

He added, “He leaves a tremendous legacy at MedStar Good Samaritan Hospital. His life-long desire to relieve suffering prompted him to continually seek new treatment methods and investigate innovative ways to bring healing and comfort to his patients.”

Michael A. Mont, M.D., vice president of strategic initiatives for orthopaedic surgery and chief of joint reconstruction at Northwell Health in New York, who was a direct partner of Hungerford for over a dozen years told OTW, “He was a truly great clinician, surgeon, teacher, innovator, and researcher. Over a greater than 40-year career, he taught hundreds of residents and fellows and left a great lasting impression on all of them.”

Changing the Face of Orthopedics

Hungerford specialized in primary hip and knee joint replacements, complex revision surgeries, diagnosis and treatment of osteonecrosis and cartilage regeneration. The field of orthopedic surgery has grown and evolved in so many ways since he first became an orthopedic surgeon and his contributions have helped shaped it to what it is today, especially with regard to hip and knee replacement surgery.

Jay Khanna, M.D., a Johns Hopkins spine specialist and former colleague and mentee of Hungerford described Dr. Hungerford to OTW as a man before his time. He wanted to help so many more people than he could reach with his own hands and that was what attracted him to becoming an inventor and a researcher as well. He made significant contributions to the study of core decompression, and on the function and mechanics of the patellar femoral joint.

Hungerford and Robert Kenna, a medical engineer, together developed a porous coated anatomic total knee replacement which allowed the patient’s bones cells to grow into the prosthesis, which provided more stability and longevity for joint replacements. They also developed and produced a universal instrumentation system for use in knee replacement surgery.

According to former colleagues, as an inventor and a practicing surgeon Hungerford was always very cognizant of how important the real world applications of new products created in the cadaver lab were.

To help further innovation in joint replacement, Hungerford became a founding member of the American Association of Hip and Knee Surgeons and was the first editor-in-chief of the Journal of Arthroplasty at a time when hip and knee arthroplasty were still fledgling areas of research.

“Dave saw a need for a hip and knee arthroplasty-focused journal when the field and the study of the field was tremendously expanding in the 1980s. He carried out his vision by starting the Journal out of his office at the Good Samaritan Hospital in Baltimore. He gave all rights of administering the Journal to the [American Association of Hip and Knee Surgeons] in 1990 when we started the organization so we could call this already established journal ‘The Official Journal of AAHKS,’” John J. Callaghan, M.D., Journal of Arthroplasty editor–in-chief said in a statement.

Importance of 7 Daily Habits

His passion for teaching others important tenets in orthopedic surgery and in life is another thing Hungerford will be remembered for.

A. Seth Greenwald, DPhil (Oxon), founder of Current Concepts in Joint Replacement meetings and president of Orthopaedic Research Laboratories met Hungerford at the end of 1968 as he was coming to Oxford University as part of his military service, and he will never forget how passionately Hungerford shared all the nuances of orthopedic surgery with him.

“He even bought me a recorder at the PX to record it all. I still have it,” he told OTW.

Greenwald said that Hungerford both as a surgeon and teacher contributed so much to the orthopedics community and will be missed by all.

Greenwald remembers how Hungerford shared Thanksgiving 1969 with him and others in his home in an English town that interestingly shared his last name.

“He was always willing to share what he knew and frequently opened his home up to students and colleagues,” Greenwald said.

Jay Khanna, M.D., an orthopedic spine surgeon at Johns Hopkins also has many memories of Hungerford’s generosity as a teacher and mentor.

He first met Hungerford in 1998 when started his orthopedic surgical residency at Johns Hopkins. At the time Hungerford was a professor of orthopedic surgery and chief of joint arthroplasty and joint replacement there.

“I would see patients and perform surgeries with him. He was a gifted surgeon and physician and more importantly a gifted educator. He taught the science and art of orthopaedic surgery, and always emphasized the doctor-patient relationship and its importance in the overall care of a patient,” Khanna said.

Khanna left Johns Hopkins after completing his residency training in 2013 to complete a spine surgery fellowship at the Cleveland Clinic Foundation, but returned to John Hopkins as a faculty member in 2004 to work with Hungerford again.

“He continued mentoring me during the early stages of my career as faculty member and also guided me on how to develop a successful orthopaedic surgery practice. Specifically, he taught me how to allocate my efforts between the three missions of Johns Hopkins which are clinical care, education and research.”

He added, “He was also very generous with his home and would have me and other residents over for journal club and holidays. And what he did for me, he did for countless other medical students, residents, fellows and young faculty members over his 38-year career at John Hopkins.”

“I have fond memories attending his son’s wedding in their backyard and spending time with David, his wife and family. He will be missed,” he added. “He often asked me to call him ‘David’ but I would always revert back to calling him what I was more comfortable with, which was ‘Big H’ and I think and hope he liked that.”

One of the things Khanna is most grateful to Hungerford for is introducing him to the book, “The 7 Habits of Highly Effective People” by Stephen Covey.

“Hungerford was a strong believer in the concepts of this book. Each Monday he would meet with all of the residents and fellows that were rotating on the joint replacement service and would go over the 7 Habits. I had the chance to go over the whole book with him three times,” Khanna said.

“That book and his teachings were pivotal in my life not only as physician but as person. I will never forget the education, mentorship and guidance he gave me and many others not only as a leader in orthopaedic surgery but as an amazing human being.”

One of the 7 Habits Khanna learned from Hungerford was “Begin with the End in Mind.” Hungerford explained that many people grind away at their jobs and lives not fully aware of what they were working towards. This habit, which is number 2, really instilled in me how important it is to have clear goals from the start to be able to work more effectively towards whichever goals one might have,” said Khanna.

“Many clinicians can excel at one or two of Johns Hopkins missions, but it is very rare for someone to truly excel at all three of them. Hungerford was that rare exception who exceled at all three while still maintaining an amazing work/life balance for his wife Heide and their three sons.”

A Life of Service to Others

Hungerford’s generosity of spirit was not just experienced by his patients, colleagues and students. His philanthropic work has also touched many lives.

As a member of CURE International, a Christian nonprofit dedicated to providing medical care to children suffering primarily from orthopedic and neurological conditions, he trained orthopedic surgeons throughout Africa to treat various conditions like clubfoot, bowed legs and cleft lips. He also helped create hospitals in Latin America, Africa, the Middle East and the Caribbean which have gone on to treat countless underprivileged patients with advanced diseases of the musculoskeletal system.

He, his wife and kids developed charities of their own as well. One of them was The Tree of Life Foundation which offered financial support to small-scale entrepreneurs in Third World Countries. Hungerford funded it with the royalties from his medical patents.

From 1996 to 2008, he served as chairman of the board of Medical Assistance Programs (MAP), an organization that promotes the total health of people living in developing countries, and in 2009, Hungerford along with his wife Heide started A Common Path Alliance (CPA), an organization that promotes reconciliation between Muslims and Christians. CPA is now TRAC5.

He even co-authored “The Qur’an – with References to the Bible, A Contemporary Understanding,” a modern English translation of the Qur’an with more than 3,000 parallel references to the Bible.

Hungerford touched many lives as a physician, teacher, mentor, innovator, colleague, and philanthropist. His legacy will never be forgotten.