Primary care providers (physicians, nurse practitioners, physician assistants) make decisions on a daily basis regarding treatment for musculoskeletal problems, including referrals to orthopedic surgeons and other specialists. Despite the large number of patients presenting with musculoskeletal complaints, primary care providers often feel poorly educated about how to assess and manage these conditions. Now in its fully revised second edition, Principles of Orthopedic Practice for Primary Care Providers continues to be a go-to resource for clinicians interested in the effective treatment of musculoskeletal disorders. Written by expert orthopedic, physical medicine and pain management specialists at major Harvard teaching hospitals, the second edition of Principles of Orthopedic Practice for Primary Care Providers represents a high-yield and succinct resource on the assessment and management of musculoskeletal conditions. Chapters overview specific body parts, typical presentations of disease, options for diagnostic testing, treatment paradigms, and anticipated outcomes of management both in the primary care setting and following specialist consultation. The text offers suggested pathways for working up and treating these problems with an emphasis on when referral to a specialist, or surgical intervention, is needed. While all previous chapters have been fully revised, this edition also includes nine brand new chapters, including chapters on pain management, hip-spine syndrome, adult spinal deformity, sports-related injuries, and cost and quality in musculoskeletal care.

The theme of this work is the application of the engmeermg theory of frictional torque to total hip replacement. The author adhered tenaciously to this theory, involving the use of a small-diameter femoral head, throughout the epoch when the large-diame ter, metal-to-metal design dominated the field. During that considerable period general satisfaction with the early results rendered criticisms of the large-diameter head unwelcome. There was a formidable array of counter criticism: the small head would pierce a film of synovial fluid; the small head would wear the socket too rapidly; the small head would always have a high risk of dislocation; detachment of the trochanter, to achieve precise orientation for the small head, was unacceptable. But all these objections have now been largely overcome. Lubrication of high molecular weight polyethylene (HMWP) on metal is now accepted as being mainly by the boundary regime with thick fluid films playing no part. We now know that HMWP can indeed tolerate the very high stresses imposed by the small head and in tribological theory there may even be some advantage in high stress. Dislocation is now known not to be an automatic sequel to the small head.

The First International Symposium on "Pain and Kampo (Japanese Herbal Medicine)" took place in Tokyo in October, 1992. More than 700 registrants participated, with 12 registrants from seven overseas countries. This book contains summaries of the presentations at this meeting and is published in order to provide up-to-date information to a much wider audience. In China, traditional herbal medicine has been used for more than 3000 years while in Japan, its use has been documented for more than 1000 years, albeit with some changes to the original Chinese formulations. Recently there has been a revival of interest in herbal medicines for several reasons. There is a rapid growth in the number of senior citizens who frequently require the attention of modern medicine. In particular, there has been an increase in the number of patients who suffer from chronic diseases which are difficult to treat, e.g., arteriosclerosis, Alzheimer's disease, chronic pain syndromes, etc. It has become evident that traditional Oriental herbal medicines could playa role in the management of these and other conditions.

The contents of this book are based almost exclusively on purely anatomical researches. These were stimulated by questions posed in clinical practice. The results are directed to practicing surgeons. Their chronological sequence leads to a step by step development of theoretical bases and to a progressive rejection of old conceptions. Especially in the field of orthopaedic surgery, a responsible attitude is possible neither without solid anatomical knowledge, nor without an idea of functional relationships. W. Roux had already demonstrated this and he wanted his works of functional anatomy to be considered from this point of view. He above all preoccupied himself with a uniform theory of functional adaptation. Thus it is understandable that the theories ofRoux formed the basis from which to start. Our own researches seemed at first to corroborate the ideas of Roux, at least in part. This is still evident in the monograph concerning fractures of the femoral neck. Later it appeared that ST. KROMPECHER had made a step forwards in the matter of chondrogenesis when he abandoned the shear theory postulated by Roux and held that compression was the only effective stimulus for the forma tion of cartilage. The research concerning the healing of fractures relies partly on the theory of KROMPECHER which was new at that time. But ultimately more and more discoveries could no longer be explained by this conception which was only slightly different from the older theories (1. WOLF, W. Roux, W."

For more than 100 years, congenital dislocation of the hip has been an area of concern in orthopedics. This publications on the subject are al most too numerous to count. Yet our knowledge of the basic principles of congenital hip dislocation and its management is constantly being expanded by new research. In Germanspeaking countries, Kaiser pub lished the last comprehensive textbook on congenital hip dislocation in 1958, and Schlegel followed with a comprehensive handbook in 1961. In the Angloamerican world, Coleman's monograph was pub lished in 1978, Somerville's in 1982, and Wilkinson's in 1985. In 1982 Tachdjian compiled a volume on congenital hip dislocation that con tained contributions from 44 authorities. The purpose of the present book is to provide an overview of our pre sent state of knowledge of congenital hip dislocation, covering basic principles, diagnosis, methods of closed and open treatment, and indi cations. In the process, an attempt is made to trace progress in the field from its beginnings to the present time. Many authors describe the diagnosis and treatment of congenital hip dysplasia and dislocation in terms of specific age groups. We believe it is more prudent to take an individualized approach based on arthro graphic findings and the degree of severity of pathologic changes. Less emphasis is placed here on the management of patients by age group."

As in any multiauthored textbook penned by When I was first approached by the publisher of this volume, Martinus Nijhoff, Boston, I writers of diverse backgrounds and interests, explored the possibility of writing a personal Modern Stereotactic Neurosurgery to some monograph on contemporary stereotactic extent suffers from incompleteness. Future surgery. After a review of available literature, volumes no doubt will include many additions several aspects became apparent. First, no cur from other authors who also are important rent, readily accessible, multiauthored text de specialists in the field. Because not all authors signed to survey the field was available. Those write in the same style (or even language), we books that were available tended to heavily have attempted to achieve a more cohesive text emphasize theory, physiology, and anatomy. in the editorial process. Each chapter has been Second, stereotactic surgeons were considered subdivided into pertinent headings for easier abstruse and for too long were relegated to a reference. Because of my own background, status outside of the mainstream of neuro some readers will note an Americanization (as surgery. This attitude probably reflected the opposed to anglicization) of the chapters. insufficient explanation of the practical uses While many chapters comprise primarily sum and advantages of stereotactic technique. maries of the authors' work within the field, Third, in recent years, the field has expanded each author was encouraged to review the liter so rapidly that it has become a major compo ature in that discipline if appropriate."

In recent years, arthrography of the knee, this area, defining for the reader the intricacies shoulder, and hip has become increasingly of the radiologic studies and detailing the important in the evaluation of the numerous nuances of technique which may expedite the disorders which affect these major joints. The quality of the examination and enhance the radiologist has assumed the essential role not diagnostic acumen of the radiologist. This only in providing for the orthopedic clinician work, in addition to its other many valuable an accurate diagnosis of abnormalities of these features, is truly a "how to do it" treatise for joints, but also in defining anatomical details in the radiologist. a manner hitherto unavailable and even un Of great interest are the chapters which deal suspected. In fact, it may be stated that the with arthrography in joints and areas often not developing radiologic techniques in arthrog considered an important part of the diagnostic armamentarium of the radiologist or even raphy have in part rewritten the anatomical texts relating to the normal joints. thought of by the orthopedic clinician. These In this excellent work by Murray K. Dalinka, include the ankle, hindfoot, elbow, wrist, and M. D., arthrography of a number of major joints small joints of the hand and foot. The chapter is considered in detail. Dr. Dalinka, a recog on arthrotomography of the temporomandib nized authority in skeletal radiology and par ular joint by Dr."

Aim of this book is to give an update on the main issues in sports traumatology and orthopedics, involving different body sections.

Exploring the most important aspects of sports medicine - from anatomy to normal movements description, from diagnosis to sports injuries treatment, from conservative to surgical treatments - it gives a global overview of the field, describing also diagnostic tools recently introduced in this field, such as hip arthroscopy, and taking into consideration related areas like nutrition, prevention, training and rehabilitation.

The single chapters deal with relevant problems such as emergencies on the field, pathologies of the upper and lower extremity, spine problems in athletes. Each injury is approached on the basis of both the specific body area and of the different sports/activities.

Written by a multidisciplinary team of experts, this volume will be a fundamental book for orthopedic surgeons, physiotherapists, general practitioners, personal and athletic trainers, offering them a useful tool for the management of most frequent injuries in sports medicine.

Our decision to dedicate several years to the writing of this Atlas was based on the professional acknowledgement of negative surgical results due to incorrect or incomplete approaches to the bones or joints requiring treatment. We are convinced that in order to obtain the best possible anatomic and functional results in surgery of the locomotor apparatus, it is necessary to obey several rules of behaviour con- stituting the basis for correct surgical execution: a) to respect the anatomy of the muscular and neural formations; b) to safeguard the vascularization of these anatomical elements and consequently of the osteoarticular apparatus; c) to use the most appropriate surgical approaches fully respecting the regional anatomy and the least traumatic exposure of the skeleton; d) to correctly perform surgery, thus creating the best conditions for the excel- lent recovery of the function of the limb. The anatomic findings and surgical approaches to the extremities described here are not complete: we have based our selection of the former on their frequency in the normal surgical activity of any specialised ward, and the latter on the surgi- cal approaches most commonly used by the 3rd Division of the Rizzoli Orthopaedic Institute. Wide surgical approaches for the surgical treatment of bone tumors have been excluded as they deal with specific "compartmental" methods which do not involve the anatomic rules to be followed in the normal treatment of orthopaedic and trau- matologic affections of the extremities.

The newborn child's immature nervous system makes early diagnosis of some neurological disorders difficult: it is often only the passage of time which clarifies the severity and pattern. Careful analysis of motor skills, vision, hearing and speech allows us to assess milestones. Progress from head control to sitting, standing and the maturation of gait should be orderly. Informed examination and the chapter on gait analysis highlight this development. Chapters in this book describe neural tube defects, the recognition and management of cerebral palsy and, lest we forget, poliomyelitis. The book is completed by considering the muscular dystrophies and arthrogryposis.

Sparing of the growth plate is an early feature of diaphyseal and meta-diaphyseal osteosarcoma. Capitalising on this characteristic, Jose Canadell has developed an innovative technique to preserve the epiphysis while resecting primary bone malignancies lying adjacent to the growth plate of skeletally immature patients. Using external ? xation devices, controlled distraction of the epiphysis from the growth plate permits iatrogenic separation of the epiphysis from the affected region. Subsequent resection is enhanced by a safe distal margin and Canadell's local control rates attest to the success of the procedure as an oncologically sound technique. The Canadell technique has been developed through rigorous examination of the behaviour of osteosarcoma, as well as an interrogation of the best modalities for assessing tumour invasion of the growth plate. Combining an innovative treatment philosophy with a sound knowledge of the behaviour of osteosarcoma and basic bone and growth plate biology, as well as an extensive experience with ancillary investigations and adjuvant therapies, Canadell has developed a robust surgical technique for the management of a challenging tumour in selected patients. This book is the culmination of Canadell's endeavours over the last two decades. It traces the steps that he has taken to validate the safety and ef? cacy of the Canadell technique as we know it today.

Now in a fully revised and expanded second edition, this practical text presents the current state of the art and latest advancements in the biomechanics, assessment, diagnosis and management of UCL injury in the elbow. In the years since this book's initial publication, significant developments have occurred on multiple fronts relating to elbow UCL injury, including injury prevention, less invasive repair techniques, more anatomical surgical reconstructions, and improved post-injury rehabilitation protocols. Chapters are once again arranged thematically, beginning with discussion of the relevant anatomy and surgical approaches, throwing biomechanics and overload mechanisms, epidemiology, history and physical exam. After a description of the radiological approaches to assessment, both conservative and surgical strategies are outlined and discussed in detail, from repair both with and without augmentation to reconstruction both arthroscopically and with newer minimally invasive techniques. Considerations for UCL injury in special populations - the young athlete and the female athlete - and sports-specific rehabilitation, return-to-play and prevention via wearable technology round out this thorough presentation. Enhanced with select video clips illustrating surgical techniques, Elbow Ulnar Collateral Ligament Injury, Second Edition remains a go-to resource for orthopedic surgeons, sports medicine specialists, therapists and trainers who work with athletes that suffer from these conditions.

During the recent transition between acute diseases caused by swarms of single planktonic bacteria, and chronic infections caused by bacteria growing in slime-enclosed biofilms, a general clinical consensus has emerged that pathologies with bacterial etiologies are frequently culture negative. Because biofilm infections now affect 17 million Americans per year (killing approximately 450,000), the suggestion that these common and lethal infections regularly go unnoticed by the only FDA-approved method for their detection and characterization is a matter of urgent concern. Biologically, we would expect that planktonic bacterial cells would colonize any new surface, including the surface of an agar plate, while the specialized sessile cells of a biofilm community would have no such proclivity. In the study of biofilm diseases ranging from otitis media to prostatitis, it was found that direct microscopy and DNA- and RNA-based molecular methods regularly document the presence of living bacteria in tissues and samples that are culture negative. The editors selected orthopedic biofilm infections as the subject of this book because these infections occur against a background of microbiological sterility in which modern molecular methods would be expected to find bacterial DNA, RNA-based microscopic methods would be expected to locate bacterial cells, and cultures would be negative. Moreover, in Orthopedics we find an already biofilm-adapted surgical group in which current strategies are based on the meticulous removal of compromised tissues, antibiotic options as based on high biofilm-killing local doses, and there are practical bedside strategies for dealing with biofilm infections. So here is where the new paradigm of biofilm infection meets the equally new paradigm of the culture negativity of biofilms, and this volume presents a conceptual synthesis that may soon combine the most effective molecular methods for the detection and identification of bacteria with a surgical discipline that is ready to help patients.

Histotechnology and histomorphometry are the major methodologies in bone and cartila- related research. Handbook of Histology Methods for Bone and Cartilage is an outgrowth of the editors' own quest for information on bone and cartilage histology and histomorphometry. It is designed to be an experimental guide for personnel who work in the areas of basic and clinical bone and cartilage, orthopedic, or dental research. It is the first inclusive and organized reference book on histological and histomorphometrical techniques on bone and cartilage specimens. The topic has not previously been covered adequately by any existing books in the field. Handbook of Histology Methods for Bone and Cartilage has six major parts and is designed to be concise as well as inclusive, and more practical than theoretical. The text is simple and straightforward. Large numbers of tables, line drawings, and micro- or macro-photographs, are used to help readers better understand the content. Full bibliographies at the end of each chapter guide readers to more detailed information. A book of this length cannot discuss every method for bone and cartilage histology that has been used over the years, but it is hoped that major methods and their applications have been included.

Ankylosing Spondylitis in Clinical Practice is a concise, practical guide on the diagnosis and management of this debilitating condition. This book is aimed at clinicians who treat Ankylosing Spondylitis. It provides an authoritative, accessible guide to the diagnosis, management and treatment of ankylosing spondylitis.

Now in a fully revised and updated second edition, this definitive text provides comprehensive coverage of all aspects of total ankle replacement (TAR), written by authors who are recognized experts in the field. Though the main focus is on total ankle replacement prostheses available for use in North America, the lessons learned and presented here are applicable to the growing volume of cases worldwide. Divided into five thematic sections, each chapter is a purposeful mix of theory, data, and tips/pearls with detailed illustrations, tables, and references. Appropriately evidence-based, they include bullet points for quick reference and rely heavily on step-by-step intraoperative photographs and radiology. Part I presents the history of TAR, implant considerations (mobile-bearing vs. fixed-bearing), and indications/contraindications for the procedure. The subsequent three sections discuss all aspects of primary TAR, procedures secondary to primary TAR, and revision TAR, respectively, bringing together the most recent evidence, implant options and surgical techniques. The final section covers topics related to limb salvage after failed TAR, including preventive measures, wound healing, and infection management. Generously illustrated and well-referenced, Primary and Revision Total Ankle Replacement remains the gold standard text on this topic for orthopedic surgeons, podiatrists and foot and ankle clinicians at all levels.

An evidence-based resource for effectively managing challenging orthopaedic infections Orthopaedic infections represent common, potentially devastating, and sometimes fatal complications that can occur after any surgery. Infections associated with orthopaedic trauma are especially prevalent, and there is an increasing incidence of bone infections linked to a greater number of joint arthroplasties being performed annually. Management of Orthopaedic Infections: A Practical Guide by renowned orthopaedic surgeon and researcher Antonia Chen is a practical clinical reference to assist clinicians in the diagnosis and treatment of challenging infections spanning the entire orthopaedic specialty. The step-by-step guide covers frequent organisms found in orthopaedics, molecular methods to improve organism determination, different antibiotic formulations to treat infections, various irrigation solutions used during surgery, and surgical dressings. Ten concise chapters cover surgical management of common infectious pathologies, including osteomyelitis, septic joint, periprosthetic joint infection, open fractures and infected nonunions, spine infections, and graft infections. Key Features High-quality figures and instructional surgical videos illustrate and enhance understanding of important concepts Multiple tables provide quick references and easy access to salient information needed to manage the care of patients with orthopaedic infections Practical tips from clinicians with vast expertise inform optimal treatment strategies and enable improved outcomes This is a must-have pocket resource for medical students, residents, fellows, and practitioners in orthopaedic surgery, as well as allied health personnel. This book includes complimentary access to a digital copy on https://medone.thieme.com.

This is a comprehensive textbook on the imaging of pediatric skeletal trauma. It gives radiologists and pediatric surgeons a detailed description of the techniques used as well as examples of the imaging findings and details of their clinical relevance. Each chapter is written by an expert in the field and includes a wealth of illustrations. The book provides invaluable advice on those features which will affect the orthopedic management of a child.

Bone Densitometry in Growing Patients: Guidelines for Clinical Practice, edited by Drs. Sawyer, Bachrach, and Fung, is a milestone book for all health prof- sionals concerned with bone health in growing patients. The book introduces and emphasizes the importance of attending to issues of bone health and development in childhood and adolescence as a way of maintaining such health and decreasing the epidemic of osteoporosis that we are now seeing in older adults. In doing so, the book offers a much-needed first set of standards of bone densitometry in growing patients. Given the numerous reports of serious interpretation errors in densitometry results in children, the development of this body of work is truly important. It is in this context that Bone Densitometry in Growing Patients: Guidelines for Clinical Practice presents the current evidence, including an assessment of the strengths and weaknesses in the data on assessing bone density in childhood and adolescence. In short, the editors and authors have done an outstanding job of or- nizing not only the key topics in this broad clinical discussion, but also, and most importantly, the evidence within these areas.

Here is a compendium of data pertinent to the methods and protocols that have contributed to both recent advances in molecular medicine in general as well as to molecular basis of rheumatic disease in particular. This two-volume work collects the contributions of leaders in the field who cover such exciting and cutting edge topics as imaging and immunohistochemistry, analysis of cartilage and bone catabolism, immunobiology, and cell trafficking.

This collection of articles by leading orthopedic and craniofacial surgeons and researchers comprehensively reviews the biology of bone formation and repair, the basic science of autologous bone graft, allograft, bone substitutes, and growth factors, and explore their clinical application in patients with bone repair problems.

This book comprehensively discusses the basic and practical aspects of foot and ankle surgery applied to all pathologies resulting from instabilities of these joints, a condition that remains underestimated. Uniquely, it not only addresses injuries to the lateral ankle ligaments, but also examines injuries to the deltoid-spring ligament complex, the syndesmotic and chopart joint ligaments, as well as peritalar instability - all pathologies that have often been neglected in the past. For each type of instability, it describes the anatomical basics and the biomechanical features, allowing readers to understand the injury pattern, the subsequent symptoms and clinical findings. Further, it offers guidance on selecting the most appropriate imaging tool for diagnosis and planning surgical reconstruction. Written by world-renowned pioneers in the field, and featuring a wealth of high-quality, intraoperative pictures, the book guides readers step-by-step through the latest, innovative technical surgical solutions for each condition. With its consistent structure, from the basics to the solution, its problem-oriented approach as well as its meticulously selected iconography, this book is a must-read for all orthopedic surgeons with an interest in foot and ankle surgery whishing to explore this promising field. Further, it is a valuable resource for residents, researchers and physiotherapists wishing to gain insights into foot and ankle instability and reconstructive surgery.

This book provides a perspective on the current status of bioimaging technologies developed to assess the quality of musculoskeletal tissue with an emphasis on bone and cartilage. It offers evaluations of scaffold biomaterials developed for enhancing the repair of musculoskeletal tissues. These bioimaging techniques include micro-CT, nano-CT, pQCT/QCT, MRI, and ultrasound.

Sports medicine and sports science are relatively new and rapidly developing fields of knowledge. During the past 2 decades, a significant body of scientific knowledge has been published in these areas. However, there is a demand for practical ref- ences which address sports medicine and science in the context of different sports. This demand is higher in some sports including combat sports, which are highly physically and mentally demanding, and cause challenging issues such as risk of blood-borne infections, weight reduction, head injuries, stress management, and safety for women and children. This book has been developed to meet the needs of the practitioners who work with combat sports athletes in order to improve their health and performance. Combat sports include four Olympic sports (boxing, wrestling, judo, and t- kwondo) and other popular sports such as karate, kick boxing, and Wushu. These sports are popular in most countries of the world, both at competitive and rec- ational levels. Combat sports are practiced by people of different ages for a variety of reasons such as to gain fitness and health benefits and to learn self-defense.