"An era is coming to an end." With this statement, Joseph Schatzker, MD, former president of the AO (Arbeitsgemeinschaft für Osteosynthesefragen) Foundation, deplored the passing away of Maurice E. Müller, who died peacefully in the presence of his family on May 10, 2009, at the age of ninety-one. Professor Müller revolutionized the surgery of the locomotor system and was heralded as the "Orthopaedic Surgeon of the Twentieth Century" by SICOT, the Société Internationale de Chirurgie Orthopédique et de Traumatologie.
Born into a bilingual Swiss family, he benefited from French and German cultural influences, although his dreams were always in French. He started his medical training in Lausanne and finished in Zürich with a doctoral thesis on Legg-Calvé-Perthes disease. The amount of care and forethought that he put into the planning of his orthopaedic career is evidenced by his two years of travel, in the course of which he visited most of the important names in Europe at the time—today one would call this a traveling fellowship. Robert Danis of Belgium impressed him the most with his techniques of stable fixation of bone fragments. Müller immediately understood the immense potential of what he had seen. Back home at the Balgrist University Hospital in Zürich, he began to invest all his creativity and surgical skills in working on an overall concept of fracture fixation. In 1958, he presented his ideas to a small group of surgeon friends, which led to the founding of the "Arbeitsgemeinschaft für Osteosynthesefragen" (AO). Although the group came to face a period of harsh criticism, the stupendous results they achieved eventually led the orthopaedic establishment to accept a new way of fracture treatment. In the mid-1960s, Müller and his AO friends started to convey the concept to the New World, and, after some initial resistance, initiated an unparalleled and ongoing story of worldwide acceptance and success.
His second field of interest was the hip, and this interest was apparently triggered by the earlier work on his thesis. In 1957, he published a monograph, titled "Osteotomies of the Proximal Femur," which served for decades as the standard textbook. Influenced by the ideas of John Charnley, Müller again anticipated the great potential and future of what he was seeing, this time with regard to total hip replacement. His recipe for success was as follows: good implants, a perfected set of instruments, systematized steps of surgical execution, instructional courses that make use of the most modern techniques of teaching, and careful registration of the results.
Maurice Müller was also a visionary organizer and a fundraiser in the true sense. His maxim was that "Evaluation—Learning—Teaching" lay the foundation for progress in the medical sciences, and he liked to symbolize this as three interlinked circles. Documentation, fellowships, and postgraduate courses were, to him, the pillars for fostering orthopaedic surgery. To make this possible, he decided that the revenues from the technical developments, that is, the royalties from implants and instrumentation, should go to dedicated not-for-profit foundations; therefore, he and his friends established the AO as a nonprofit organization in 1960 and, in relation to his hip implants, the Maurice E. Müller Foundation for Continuing Education, Research and Documentation in Orthopaedic Surgery in 1974. This allowed the enormous economic success of these new techniques to be funneled into the promotion of orthopaedic surgery at a worldwide level. With his own foundation, he not only financed documentation and research institutes in Bern and Basel but offered assistance at the international level by establishing subsidiary foundations in Spain (1975) and North America (1983), and by endowing chairs and programs at Harvard Medical School, McGill University, and the University of Toronto. But his generosity went even beyond his science: he and his wife gave away much of their personal fortune to allow the construction of the impressive Zentrum Paul Klee in Bern, which opened in 2005 to give a home to the works of this great artist.
Maurice E. Müller was awarded highest prizes and recognitions as a scientist, including honorary doctorates from twelve universities and the Honorary Citizenship of Bern, the town of his main activities. With the support of his family and through teamwork with friends and loyal collaborators, he accomplished an extraordinary amount of work over the course of his lifetime. His skill of recognizing the potential of an idea or technology, and of bringing a vision to fruition with mental power, charisma, and charm, was singular. That he kept little for himself but generously shared his professional insights and skills and ultimately returned a good part of his earnings to society—all this marks the exceptional personality of Maurice Edmond Müller.
—R.G.
C.G.
E.R.W.