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Jack C. Hughston, MD 1917-2004

S., C.G.

doi: 10.2106/JBJS.8709.ob1

Jack Chandler Hughston had a favorite saying that epitomized his life: “When you're green, you're growin'. When you're ripe, you're next to rotten.” Hughston, who was born to Madeline and Talmadge Hughston in Florence, Alabama, on April 17, 1917, and who died at eighty-seven years of age at his home in Columbus, Georgia, on September 6, 2004, was a down-to-earth man who dedicated his entire life to “growing.” Most of his growth occurred in Columbus, Georgia, where he moved at the age of seven when his mother married Edgar Mayo, or “Little Pop,” as Hughston affectionately called his stepfather. Columbus became his permanent home again after his formal medical training and a stint in the United States Army Medical Corps during World War II.

Education was the foundation of Hughston's life. For him, growing meant being educated and educating others. He attended Columbus High School and Riverside Military Academy and later graduated from Auburn University in 1938. He received his medical degree from Louisiana State University in 1943. After an internship at Charity Hospital in New Orleans, Hughston served in the United States Army Medical Corps from 1944 to 1946. In 1946, he became a National Foundation for Infantile Paralysis Fellow in the orthopaedic training program at Duke University School of Medicine.

While at Duke, Hughston's interest in the anatomy of the knee began in earnest. His fascination continued throughout his career and was the stimulus for his considerable educational and professional efforts. He published many scientific articles and books on the subject—one of the last was his book, Knee Ligaments: Injury and Repair, which was published in 1993.

After his fellowship at Duke, he spent two years at the Shriners Hospital for Crippled Children in Greenville, South Carolina. Dr. J. Leonard Goldner, a longtime friend and colleague, wrote recently of Hughston's relationship with J. Warren White, the late chief of the Greenville Shriners Hospital, “Jack idolized Warren White and followed his aphorisms, clichés, work habits, and imagination in solving orthopaedic problems during his entire career.”

Jack Hughston idolized one other person more than White—his wife of sixty-two years, Sarah Hardaway Hughston. They married on June 13, 1942, while Hughston was a medical student at Louisiana State University, and they continued to “grow” together until the names Jack and Sarah were synonymous to friends and colleagues.

On returning to Columbus in 1949 as the first trained orthopaedist in the community, Hughston opened his office and soon established The Hughston Clinic. Over the years to come, he became one of the country's most respected practitioners of orthopaedic surgery and sports medicine. With his trademark bow tie, he introduced himself to everyone as Jack Hughston. “Doctor Jack” was beloved by his patients, staff, and colleagues. To residents, fellows, and his partners, he was a role model, an educator, a scientist, an innovator, a motivator, and at times an inquisitor and a castigator. Above all, he was a mentor and a friend.

Hughston was a visionary in the truest sense of the word, but, unlike many visionaries, he had a tenacity of purpose like few others we will ever know. His vision emerged in part from the polio epidemic of the late 1940s. In early 1950, he became a leader in establishing the Crippled Children's Clinic of the Public Health Department in Georgia. Because of his concern for the future of the children he cared for, he also developed an interest in the welfare of high-school and college athletes. His involvement with Auburn University athletics began in 1952 when the late Ralph “Shug” Jordan became the head football coach at Auburn. Hughston convinced him that the team was in need of an orthopaedist and that the orthopaedist should be in attendance on the sidelines at games. Thus began Hughston's role as one of the first team physicians and as a pioneer in the field of sports medicine. At the same time, he also began organizing and providing pre-participation screening examinations and sideline care for high-school athletes in the local area. This program expanded through the years and is known today as the Institute of Athletic Health Care and Research. The organization provides yearly screenings for approximately two thousand high-school athletes in the Columbus area.

Nationally and internationally, Hughston's expertise and reputation grew, and, in 1965, he became chairman of the Sports Medicine Committee of the American Academy of Orthopaedic Surgeons. He served in that capacity from 1965 through 1975. In 1976, he was named “Mr. Sports Medicine” by his colleagues and, in 1977, was cited in Sports Illustrated as one of the world's top three surgeons in his field. He was one of the founders of the American Orthopaedic Society for Sports Medicine (AOSSM) and was an honorary founder of the National Athletic Trainers' Association. He believed strongly that orthopaedic surgeons should be part of an international community. Hughston endeavored to share his knowledge with orthopaedists abroad and was instrumental in founding the International Society of the Knee, now known as the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS). He welcomed the world's orthopaedic community to his clinic and foundation to exchange ideas. He and others recognized a need for and started the American Journal of Sports Medicine, of which he was editor from 1972 through 1989. The Journal became one of his greatest passions. He envisioned the Journal as a tremendous opportunity to bring together a vast amount of knowledge in orthopaedic sports medicine and to create a forum for new advancements in the field. His careful leadership ensured the growth of the Journal with its promising future and a continuing legacy of his pioneering efforts. In 1970, Dr. Hughston was appointed Clinical Professor of Orthopaedics at Tulane University School of Medicine, and his clinic and the Hughston Sports Medicine Foundation participated in the training of Tulane orthopaedic residents for more than twenty years. He received an honorary doctor of science degree from Auburn University and was an adjunct professor at Auburn University School of Veterinary Medicine.

Jack Hughston's concept of a foundation for teaching and research in orthopaedics and sports medicine as a necessary part of the clinical practice of orthopaedics became a reality when he established the Hughston Sports Medicine Foundation. The young men and women who trained with him learned how to examine, listen to, and have respect for the patient and to always remember that “no knee is so bad that surgery can't make it worse.” He believed that a good rehabilitation program could help many patients avoid surgery and that if surgery became inevitable it could help speed recovery. His residents, fellows, and visitors learned from him that research depends on careful documentation of one's observations. Another result of his lifelong dedication to orthopaedic sports medicine is the Hughston Sports Medicine Hospital, the first specialty hospital of its kind, which was built by the Hospital Corporation of America in Columbus, Georgia, in 1984. In August of that year, Hughston performed the first surgery at the new hospital, which thrives today and still bears his name.

Always conscious of the need to “grow” and of what he had to teach others, Hughston wrote several books and numerous scientific articles that were published in peer-reviewed medical journals. He is well known for his work on treating knee injuries; the “Classification of Knee Ligament Instabilities” was published in two parts in the March 1976 issue of The Journal of Bone and Joint Surgery. Hughston is also remembered for being the first to establish postdoctoral fellowships in sports medicine that allow physicians who have completed their formal medical training to increase their exposure to orthopaedic sports medicine. Hughston began this fellowship program at The Hughston Clinic in 1960, and since that time more than 250 fellows have completed the program.

Hughston lived with his wife, Sarah, on a 300-acre farm called Hayfields. It is a place where the Hughstons liked to raise dogs and quail, to garden, and just to walk. Jack Hughston is survived by his wife, three children, and three grand-children. He will be missed by all who knew him and learned to “grow” from him.

Copyright © 2005 by The Journal of Bone and Joint Surgery, Incorporated