The earliest recorded case of attempts to perform hip replacement procedures date back to as early as 1891 when Themistocles Gluck tried to use ivory implants to replace the femoral head.

In 1940, an American surgeon, Dr Austin Moore (1899–1963), performed the first metallic hip replacement at Columbia Hospital in South Carolina. Moore had designed a proximal femoral prosthesis with a large head made of Vitallium. The implant was around 12 inches in length and would be attached with bolts to the end of the femoral shaft, offering an early form of hemiarthroplasty or partial hip replacement.

Dr. Moore’s prosthetic implant gained popularity and the surgeon eventually developed an improved version referred to as the Austin Moore prosthesis, which is still in use today. However, today, the implant is inserted within the medullary canal of the femur, where bone growth eventually leads to its more permanent attachment.

It 1960, a Burmese surgeon, Dr San Baw, used ivory hip prostheses to correct a femoral neck fracture in an 83 year old Buddhist nun called Daw Punya. Between 1960 and 1980, Baw went on to perform more than 300 ivory hip replacements and he presented the paper “Ivory hip replacement for ununited fractures of the neck of the femur” at the British Orthopaedic Association conference in 1969.

Baw was finding that almost 90% of his patients were able to walk, squat, or play football within a few weeks of undergoing the ivory hip replacements. Ivory was probably used not only because it was cheap at the time but because it was thought to possess good biomechanical properties.