Munjed Al Muderis

Munjed Al Muderis (born 25 June 1972) is an Australian adjunct clinical professor in orthopaedic surgery, author and human rights activist. He has done pioneering work on prosthetics, especially on titanium devices.[2]

Munjed Al Muderis
Born (1972-06-25) 25 June 1972
Education1991: graduated from Baghdad College High School, 1997: graduated from Baghdad University[1]
Occupation(s)Orthopaedic surgeon, adjunct clinical professor, clinical lecturer

Al Muderis was born in Iraq to a rich family and became a surgeon under the regime of Saddam Hussein. He was a medical student in Basra at the start of the Gulf War in August 1990. As a junior surgeon, he emigrated from Iraq to Australia. He travelled through Indonesia and Malaysia and reached Australia where he was kept in at an immigration detention centre near Derby, Western Australia. He was released after 10 months and carried on his career in medicine, eventually specialising in osseointegration surgery.[3]

Al Muderis wrote the book Walking Free on his experiences in Iraq, in the Australian immigration detention system, and on his career in Australia.

Early life

Al Muderis was born under the regime of Saddam Hussein in Iraq.[4] His father was a former judge of the Supreme Court of Iraq and had authority in the Marine Corps, while his uncle was a descendant of the second royal family and Prime Minister, when Iraq was still a kingdom.[5] His mother was a school principal who had been demoted for refusing to join the Ba'ath Party.

Al Muderis graduated from Baghdad College High School in 1991, where he was a classmate of Qusay Hussein. He went on to study medicine at various universities, including the Baghdad University from 1991 to 1997, graduating with a Bachelor of Medicine, Bachelor of Surgery.[6]

At the beginning of the Gulf War he was a second year medical student in Basra. He fled the city in the early days of the war, returning later to see the aftermath of the Basra uprising.

In 1999, he was forced to flee Iraq when he was working as a junior surgeon at Saddam Hussein Medical Centre in Baghdad.[1] A busload of army draft evaders were brought into the hospital for the top of their ears to be amputated under Saddam's orders. The senior surgeon in the operating theatre refused the orders and was immediately interrogated and shot in front of several medical staff. Instead of complying with the orders, Al Muderis decided to flee.[7] He escaped the operating theatre and hid in the female toilets for five hours. Shortly after, he fled to Jordan before the authorities caught up with him and moved on to Kuala Lumpur. From there, he took a people-smuggling route to Christmas Island, where he was sent to the Curtin Immigration Reception and Processing Centre. He was detained there until his identity was verified, given the number 982. He was punished with solitary confinement and was repeatedly told to go back where he came from after fellow detainees who caused riots blamed him. Ten months after being sent to the detention centre, he was granted refugee status and freed.[2]

Upon release, he only landed a job at Mildura Base Hospital as an emergency unit and orthopaedic resident, after sending out more than 100 resumes. A year later, he moved to the Austin Hospital in Melbourne and travelled to many different countries, completing specialisation fellowships and attending short-term courses.[1]

Osseointegration

Al Muderis developed the new generation of implant, osseointegration prosthetic limb, which addresses several issues previously faced by patients.[8] This led Orthopedics This Week[9] to praise Al Muderis as "The Most Incredible Orthopedist You'll Ever Read About".[10] The Osseointegration Group of Australia Team is made up of specialists in various fields. News Corp Australia and The Australian Women's Weekly rank Al Muderis as one of the world's top osseointegration surgeons.[11][12]

Traditional and rigid socket based technology is now replaced with a surgery that inserts a titanium implant into the bone. Osseoperception occurs as the prosthetic is anchored directly to the bone which would transmit sensory signals, resulting in patients recovering a certain level of feeling. The implant's surface is also made of highly porous titanium, providing the user with balance and allowing for ingrowth of bone. A dual adaptor is designed with a smooth surface to minimise friction and coated with titanium niobium for antibacterial purposes. The adaptor is fixed to a control device and is connected to the exterior of the prosthetic limb. Putting on and taking off the limb can be done in less than ten seconds.[8] Osseointegration surgery aims to provide amputees with greater mobility and reduced discomfort.[13]

Al Muderis is spreading the word to make the technology available globally. Patients travel from around the world to see him for this groundbreaking surgery.[14]

Career

Al Muderis was a first year resident[1] at Saddam Hussein Medical Centre[4] in Baghdad before he fled Iraq and his career was disrupted. In Australia, he first worked at Mildura Base Hospital as an emergency unit and orthopaedic resident.[1] He moved to Melbourne four months later and worked at Austin Repatriation Hospital as a surgical registrar, followed by a year at Canberra Hospital.[1]

In 2004, he joined the Australian Orthopaedic Training Program. In 2008, he attained his surgical fellowship, FRACS (Orth).[15] He completed the following post specialisation fellowships:

  • Fellowship in Lower Limb Arthroplasty at the Sydney Adventist and Baulkham Hills Hospitals, Australia[6]
  • Fellowship in Hip and Knee Arthroplasty with Prof. Dr. Med Jorg Scholz at the Emil Von Behring Hospital, Germany[6]
  • Trauma Fellowship with Prof. Dr. Med. Axel Ekkernkamp at the Unfallkrankenhaus Berlin, Germany[6]
  • Robotic leg surgery post-specialisation training with Dr Horst Aschoff at Lubeck, Germany[6]

Al Muderis is a supervisor of the Australian Orthopaedic Trainee Registrar at the above-mentioned medical centres, and is a supervisor of overseas trained orthopaedic surgeons (Fellows) in hip and knee pathology.[6]

In 2010, Al Muderis commenced his private practice.[1] He is an orthopaedic surgeon and treats his patients at Macquarie University, Bella Vista, Drummoyne and Sydney Adventist Hospital clinics.[1] He is also appointed as an adjunct clinical associate professor in the School of Medicine, Sydney Campus at the University of Notre Dame Australia[6] and a clinical lecturer at Macquarie University Hospital and the Australian School of Advanced Medicine.[1] He also has appointments at the Sydney Adventist Hospital and Norwest Private Hospital.[1] He is a fellow of the Royal Australasian College of Surgeons and the Australian Orthopaedic Association.[6] He is also the founder of the Osseointegration Group of Australia.[6]

As an Australian orthopaedic surgeon, he specialises in hip, knee, trauma and osseointegration surgery,[1] focusing in hip arthroscopy, resurfacing, arthroplasty, knee arthroplasty and reconstruction of recurrent patellar dislocations.[1]

Al Muderis chaired the 2015 Osseointegration Conference[16] and was a guest speaker at Australian Orthotic Prosthetist Association Meeting.[17]

Al Muderis has been recognised by Queen Elizabeth II for his work with British soldier Michael Swain.[18] He was invited by Queen Elizabeth II to attend the ceremony in which Swain received his MBE medal.[19]

He also caught the attention of Prince Harry, who visited Al Muderis on 7 May 2015[20][21] to follow up on Al Muderis' work and meet some of the amputees he has helped, including a decorated British soldier who lost his legs in Afghanistan who was undergoing groundbreaking treatment to fit prosthetic legs at Macquarie University Hospital.[22]

Harry was amazed by the work Al Muderis and his team are doing, and believes the life changing surgery is "the way forward for single amputees or double amputees above the knee".[23] The Prince was keen to get Al Muderis to the UK for an extended period of time to make the procedure available to British ex-servicemen injured in combat.[23]

Al Muderis is hopeful that the royal's profile will give the procedure more exposure, and that as it becomes more well known this technology will become more available to the common day to day person.[21]

Al Muderis has connected prosthetic limbs to dozens of UK soldiers.[20]

The UK Ministry of Defence (MoD) is spending £2m on trials that were to begin in 2016 and involve 20 amputees who were to undergo Al Muderis' osseointegration procedure.[24] Al Muderis has trained five British surgeons and they were to perform the surgeries together, then monitor those 20 cases for two years. A similar project was in the works for Canada and Houston, Texas.[10]

Al Muderis has presented and published numerous research reports on osseointegration surgery for amputees, how to measure growth rate in children, limited incision plating technique in management of clavicle fracture and describing new patterns of distal clavicle fractures dislocation.[25]

He has written two books about his life and experiences, the first in 2014, called Walking Free, and later in 2019 Going Back published by Allen & Unwin.[1]

Al Muderis was nominated for 2020 NSW Australian of the Year award for his humanitarian work and contribution to medicine.[26]

Controversy

Al Muderis has been the subject of a number of claims.[27]

In 2016 a patient suggested Al Muderis had not appropriately obtained consent from a patient for a procedure to be performed on his behalf by a trainee doctor and robot. A complaint made to the New South Wales Healthcare Complaints Commission was dismissed in March 2018.[28]

In 2017 Justice Stephen Rothman awarded Al Muderis $480,000 for "a most vicious and vituperative series of publications" that "vilified" Al Muderis after an online campaign by a patient who ignored post-operative advice.[29]

In 2022, a joint investigation by The Age, The Sydney Morning Herald and 60 Minutes (all divisions of Nine Entertainment) alleged there were serious questions around Al Muderis's approach to patient selection and aftercare. Four patients described experiences ranging from life-changing to life-destroying. It was suggested that risks were minimised when their operations were explained to them, complications ignored and patients left wheelchair-bound or mutilated.[30]

Subsequently, a concerns notice was issued by lawyers for Al Muderis to Nine Publications, 60 Minutes, The Sydney Morning Herald and The Age newspapers, to commence defamation proceedings. Over 60 allegations were detailed in the 41-page notice. Nine and Fairfax failed to respond to the concerns notice, within the 28 days' notice period.[31] On 31 October 2022, Al Muderis issued defamation proceedings against Channel Nine, Fairfax Publications and the Age company in the Federal Court of Australia.[32]

Humanitarian work

Beyond the Boats

Al Muderis was involved in a high-level round table on asylum and refugee policy held on 11 July 2014 at Parliament House which led to the asylum and refugee policy report "Beyond The Boats: building an asylum and refugee policy for the long term".[33] He related his own experience as a refugee to discussions about a new approach to asylum seeker policy.[34]

Amnesty International

Al Muderis is passionate about campaigning to protect human rights through his work with Amnesty International, including leading the 2015 Human Rights Lecture.[35] He has spoken extensively about the plight of refugees and asylum seekers in various public speaking opportunities and lectures.

Red Cross

Al Muderis in 2015 became an Australian ambassador for the Red Cross.[36] He has spoken out about the misconceptions around seeking asylum in Australia and joined a panel at a live screening for the SBS program Go Back To Where You Came From[37][38] in the hopes of building a more compassionate and caring community.[39]

Iraq

Funded out of his own pocket, Al Muderis has taken a team to his former homeland of Iraq seven times, to help the victims of the conflict he fled, and has educated other orthopaedic surgeons in the osseointegration technique and in complex limb reconstruction.[40]

In 2023 Al Muderis returned to Iraq and saw over 150 patients.[41]

Unbroken

In February 2023, Al Muderis was made an ambassador to the "Unbroken" project in Ukraine after leading a team of Australian doctors who performed more than 20 extremely complex limb reconstructions and prosthetics operations at the hospital of the First Medical Association of Lviv.[42]

Other

He is a patron of the Asylum Seekers Centre, a not-for-profit that provides personal and practical support to people seeking asylum in Australia.[43]

Al Muderis visited patients at the Children's Surgical Centre in Cambodia on 20 September 2015 to provide their patients with osseointegration procedures.[44]

Successful surgeries

Al Muderis' clinics at Norwest Private Hospital, Macquarie University and Sydney Adventist Hospital in Sydney are known worldwide as centres of excellence, according to News.com.au.[45]

Personal life

Al Muderis has two sons and two daughters from previous relationships.[46] He is now in a de facto relationship with Claudia Roberts.

Books

Walking Free

Walking Free was published in October 2014,[1] written by Al Muderis and contributed to by Patrick Weaver.[47] It was published by Allen & Unwin.[1] In his book, he shared his life and experience in Iraq under Saddam Hussein's regime, his journey to seek asylum in Australia and how he worked towards being a world leader in osseointegration surgery.[48]

Going Back

His second memoir, Going Back, was published in 2019 by Allen & Unwin.[49] The book describes his return to Iraq after eighteen years, at the invitation of the Iraqi government, to operate on soldiers, police and civilian amputees wounded in the war against ISIS.

Munjed al Muderis: From refugee to surgical inventor

In 2020 as part of a series of children's books – Aussie STEM Stars – about some of Australia's top scientists and inventors chosen on the basis of their pioneering work, a book about Al Muderis was written by Dianne Wolfer.[50]

Scientific publications

2021

Professor Al Muderis published a thesis for the requirements for the Doctor of Medical Science - Osseointegration for Amputees: Past, Present and Future - Basic Science, Innovations in Surgical Technique, Implant Design and Rehabilitation Strategies.[51]

2023
  • Bone density changes after five or more years of unilateral lower extremity osseointegration: Observational cohort study. 2023.[52]
  • Transcutaneous osseointegration for amputees with burn trauma. 2023.[53]
  • Comparison of prosthetic mobility and balance in transfemoral amputees with bone-anchored prosthesis vs. socket prosthesis. 2023.[54]
  • Transcutaneous Osseointegration Reconstruction For Wheelchair-Bound Transfemoral Amputees (K0 Level). 2023.[55]
  • Transcutaneous Osseointegration for Amputees: What Is It, How Did It Evolve, and What May Develop? 2023.[56]

2022
  • Residual Amputee Limb Segment Lengthening - A Systematic Review. 2022.[57]
  • Long-Term Bone Mineral Density Changes for Amputees Following Transcutaneous Osseointegration. 2022.[58]
  • Association Between Osseointegration of Lower Extremity Amputation and Mortality Among Adults. 2022.[59]
  • Transcutaneous osseointegration for oncologic amputees with and without radiation therapy: An observational cohort study. 2022.[60]
  • Examining the complication and reoperation rates after osseointegrated reconstruction. 2022.[61]
  • Osseointegration following transfemoral amputation after infected total knee replacement: A case series of ten patients with a mean follow-up of five years. 2022.[62]
  • The Clinical History and Basic Science Origins of Transcutaneous Osseointegration for Amputees. 2022.[63]

2021
  • Transtibial Osseointegration for Patients with Peripheral Vascular Disease: A Case Series of 6 Patients with Minimum 3-Year Follow-up. 2021.[64]
  • Transcutaneous osseointegration for Amputees- Lessons from the past of relevance to the Future. 2021.[65]
  • Pelvic Osseointegration for Unilateral Hip Disarticulation. 2021.[66]
  • Amputation with Osseointegration for Patients with Intractable Complex Regional Pain Syndrome: A Report of Three Cases. 2021.[67]

2020
  • Osseointegrated reconstruction and rehabilitation of transtibial amputees: the Osseointegration Group of Australia surgical technique and protocol for a prospective cohort study. 2020.[68]
  • Motorized Internal Lengthening of Long Bones: Residual Limb Lengthening. 2020.[69]
  • Osseointegration for Amputees: Current Implants, Techniques, and Future Directions. 2020.[70]
  • Cementing Osseointegration Implants Results in Loosening: Case Report and Review of Literature. 2020.[71]
  • Periprosthetic osseointegration fractures are infrequent and management is familiar. 2020.[72]

2019
  • Proximal bone remodeling in lower limb amputees reconstructed with an osseointegrated prosthesis. 2019.[73]
  • Radiographic Evaluation of Bone Remodeling Around Osseointegration Implants Among Transfemoral Amputees. 2019.[74]

2018
  • Total hip arthroplasty by the direct anterior approach using a neck-preserving stem: Safety, efficacy and learning curve. 2018.[75]
  • Clinically relevant outcome measures following limb osseointegration; systematic review of the literature. 2018.[76]
  • Electromagnetic Transduction Therapy in Patients with Chronic Aseptic Osteitis Pubis. 2018.[77]
  • Two-Stage Osseointegrated Reconstruction of Post-traumatic Unilateral Transfemoral Amputees. 2018.[78]

2017
  • Osseointegration as Treatment for a Knee Disarticulation Because of a Congenital Femoral Deficiency: A Case Report. 2017.[79]
  • Osseointegrated Transtibial Implants in Patients with Peripheral Vascular Disease: A Multicenter Case Series of 5 Patients with 1-Year Follow-up. 2017.[80]
  • Randomized Placebo-Controlled Placebo Trial to Determine the Placebo Effect Size. 2017.[81]
  • Single-stage osseointegrated reconstruction and rehabilitation of lower limb amputees: the Osseointegration Group of Australia Accelerated Protocol-2 (OGAAP-2) for a prospective cohort study. 2017.[82]
  • Osseointegrated Prosthetic Limb for the treatment of lower limb amputations. 2017.[83]

2016
  • 19 years outcome after cementless total hip arthroplasty with spongy metal structured implants in patients younger than 65 years. 2016.[84]
  • Radiographic Assessment of Extremity Osseointegration for the Amputee. 2016.[85]
  • The Osseointegration Group of Australia Accelerated Protocol (OGAAP-1) for two-stage osseointegrated reconstruction of amputated limbs. 2016.[86]
  • Safety of Osseointegrated Implants for Transfemoral Amputees. 2016.[87]
  • Minimally invasive medial patellofemoral ligament reconstruction for patellar instability using an artificial ligament: A two-year follow-up. 2016.[88]
  • Direct skeletal attachment prosthesis for the amputee athlete: the unknown potential. 2016.[89]
  • Osseointegrated total hip replacement connected to a lower limb prosthesis: a proof-of-concept study with three cases. 2016.[90]

2015
  • Current evidence of extracorporeal shock wave therapy in chronic achilles tendinopathy. 2015.[91]
  • Osseointegrated total knee replacement connected to a lower limb prosthesis: 4 cases. 2015.[92]

Pre-2015
  • Arthroscopically assisted fixation of the lesser trochanter fracture: a case series. 2014.[93]
  • Percutaneous epidural lysis of adhesions in chronic lumbar radicular pain: a randomized, double-blind, placebo-controlled trial. 2013.[94]
  • Minimally invasive surgical technique in treating recurrent patellar dislocation. 2012.[95]
  • Cementless Total Hip Arthroplasty Using the Spongiosa-I Fully Coated Cancellous Metal Surface. 2011.[96]
  • Alternative Bearing Designs for Hip Resurfacing Arthroplasty. 2010.[97]
  • Zebra lines of pamidronate therapy in children. 2007.[98]
  • Primary septic arthritis of the knee caused by Neisseria meningitidis serogroup B in an elderly patient. Case report and review of the literature. 2003.[99]

Media

Both newspaper publications and radio talk shows have shared the story of Al Muderis, from his journey of fleeing Iraq to his job as an osseointegration surgeon in Sydney, Australia.

Public speaking
  • Ted X Sydney 2015 - Dr Al Muderis gave one of the most powerful speeches at the Sydney opera house in 2015 about his concept of the "Wheel of Fortune"[100] and how now that he is on top of his "wheel," he can assist people who are on the bottom. He shared his experiences as a refugee and the struggles he faced to get where he is today, and the passion that inspired him to develop and expand on the pioneering osseointegration surgery that is changing the lives of amputees around the world.[101] He talks about his story, from refugee to medical revolutionary.
  • Amnesty international speaking events in several cities around Australia[102]
  • Red Cross - Ambassador Al Muderis spoke on a panel at a live screening event held in Sydney[39] to kick off SBS' new series of "Go Back To Where You Came From"[37] to discuss the facts and misconceptions about seeking asylum in Australia.

Newspapers and publications
  • New York Times[103] Iraqi Surgeon Returns Home to Help the Wounded Get Back in the Fight
  • News.com.au[104] - The Terminator captured the imagination of a 12-year-old boy in 1984 who went on to become a leading orthopaedic surgeon. Pioneering osseointegration with titanium rod implants, his work has been recognised by the Queen of the United Kingdom and Prince Harry.
  • Sunday Morning Herald[2] - The astonishing journey of surgeon Munjed Al Muderis.
  • Daily Telegraph[20] - Prince Harry visited Macquarie University Clinic and Prof Munjed Al Muderis whose groundbreaking surgery has helped soldiers walk again after losing their legs.
  • News.com.au[21] - Prince Harry is helping to push the groundbreaking osseointegration technology.
  • ACT News[105] - Osseointegration helps above-the-knee amputees. The titanium rod is inserted in the bone and connected through an opening or stoma in the stump to an external prosthetic limb.
  • News Breakers[106]
  • The Advocate[107] - Red Cross welcomes Dr Munjed Al Muderis as new Ambassador.
  • The Guardian[108] - Refugees in Australia fear speaking out about asylum, according to Al Muderis.
  • The Advocate[109] - Refugee surgeon rises to hop.
  • Getty Images[110] - Prince Harry.
  • Medianet[111] - Macquarie University Hospital to welcome Prince Harry.
  • SBS World News[112][113] - A new paper drawing on wide expertise and all sides of politics is offering a closer look at Australia's asylum policies and possible alternatives.
  • Monthly Chronicle[114] - From refugee to surgeon.
  • field Fisher[115] - Prince Harry meets Osseointegration pioneer Munjed Al Muderis.
  • APHA.org.au[116] - The advantages of bionic prosthetics, life changing surgery for double amputee at Norwest Private Hospital.
  • Mid Devon Gazette[117] - Tiverton amputee Caroline heads to Oz for pioneering and life changing surgery.
  • International Business Times UK[118] - Afghanistan war hero remortgages home to undergo reconstructive surgery in Australia.
  • Precinct News[119] - Munjed Al Muderis, a bright young man, was determined to become a surgeon even in war-torn Iraq.
  • Orthopedics This Week[10] - A sharp mind - accompanied by a big heart; a humanitarian voicing the plight of refugees, and providing orthopedic services to disaster areas. Al Muderis. A pioneering surgeon in the field of Osseointegration.
  • Sunday People[120][121][122][123] - War hero Clive Smith to undergo ground breaking surgery in Australia. Munjed Al Muderis to fit bionic limbs.
  • Sunday People - War veteran Clive Smith takes first steps[124] and is able to walk unaided after one month.
  • Sunday People - Soldier who lost legs in Afghanistan to receive treatment from Al Muderis[125]
  • Precinct News[126] - Profiling Munjed Al Muderis[127]
  • The Telegraph[128] - Afghanistan war veteran has to remortgage home to fund limb surgery.
  • The Telegraph[129] - NHS delays leave injured Afghanistan veterans without working prosthetic limbs.
  • The Huffington Post[130] - Cate Blanchett: 'I Have Seen Firsthand The Determination Refugees Have To Protect Their Children'
  • The Weekly Review[131] - Mentors reveal their 7 ingredients for success[132]
  • TIRR Memorial Hermann Journal[133] - Osseointegration: A New Solution for Trans-femoral Limb-loss Patients[134]

Radio

TV

References
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