This book has become necessary as a consequence of the rapid expansion of the surgical procedures and implants available for spinal surgery within the "AO Group". We have not attempted to write an in-depth book on spinal surgery, but one which will help the surgeon in the use of AO concepts and implants. We con sider the practical courses held all over the world essential for the teaching of sound techniques so that technical complications and poor results can be avoid ed for both the surgeon and, in particular the patient. This book is a practical manual and an outline of what is taught in the courses. It is intended to help the young spinal surgeon to understand the correct use of AO implants. The indi- tions given will aid the correct use of each procedure. . It must be strongly emphasized that surgery of the spine is technically de manding. The techniques described in this book should only be undertaken by surgeons who are trained and experienced in spinal surgery. Certain techniques, in particular pedicle screw fIxation and cages, have not yet been fully approved by the FDA in the United States. However, throughout the rest of the world, the use of pedicle screws has become a standard technique for the spine surgeon, since it has been shown to improve fIxation techniques and allow segmental correction of the spine. The use of cages has become more and more popular, specifIcally as a tool of minimally invasive spinal surgery.

here, two well-known knee experts have assembled a group of leaders in the field to present a book encompassing the best techniques for total knee arthroplasty. Concise chapters cover indications, contraindications, complications, results, instrumentation, infection, preop planning, prosthetic choice, revision arthroplasty, and more -- with the emphasis on the best techniques and surgical "pearls". Supported by line drawings, intraoperative photographs and radiographs, this definitive volume will serve as the complete and quick reference on total knee arthroplasty.

In this rapidly changing health care environment, a challenge today's physical therapist faces is finding, evaluating, and implementing current best evidence into practice, an integral part of health care professional educational programs. With that goal in mind, Physical Therapy Management of Patients With Spinal Pain: An Evidence-Based Approach provides a comprehensive research-based overview of the examination and physical therapy interventions of the spine. Inside Physical Therapy Management of Patients With Spinal Pain, Drs. Deborah M. Stetts and J. Gray Carpenter evaluate the current evidence related to spinal pain and present it in a format that allows for an easy transition to the clinical environment. By providing effective clinical interventions, rather than relying on habits or tradition, patients benefit from an increased likelihood of improved quality of life with the least potential of personal and financial risk. Some features include: over 650 photographs, images, and tables; access to a supplemental video Web site with new book purchase; best practice for evaluating and treating the lumbar spine, thoracic spine, and cervical spine; comprehensive coverage of the clinical presentation of spine-related pathologies from evaluation to treatment. Each chapter outlines the history, physical examination, physical therapy diagnosis, evidence-based management guidelines, and case studies for each topic. Case studies will challenge the reader's clinical reasoning skills with the use of current best evidence throughout the initial examination and subsequent treatment sessions. Also included with Physical Therapy Management of Patients With Spinal Pain is access to a supplemental Web site featuring 8 PowerPoint presentations containing more than 375 video demonstrations corresponding to the tests and measures, examination, evaluation, and intervention procedures covered within the text. Physical Therapy Management of Patients With Spinal Pain: An Evidence-Based Approach is the go-to reference text and accompanying Web site for the physical therapy students, or clinicians who are reaching for best practice through providing the highest level of evidence-informed care in the evaluation and management of patients with spinal pain.

With this proliferation of arthroscopy and other minimally invasive approaches due to the greater demands for day case surgery, there is much interest among orthopedic surgeons for quick reference guides to assist with minimally invasive techniques. Describing the techniques and, importantly, the indications for minimally invasive procedures for the management of forefoot disorders, this book will explain the management of various conditions and how they can be approached using minimally invasive techniques. However, rather than only concentrating on minimally invasive surgery of the forefoot, the book will examine the options open to surgeons operating in this area - both open surgical and arthroscopic - and explaining the benefits of each. Extensive radiographs, diagrams, and intra-operative pictures will illustrate the procedures described.

Drs. Guhl, Parisien and Boynton, pioneers in the development of modern arthroscopic techniques have invited a prestigious group of contributors to prepare the third edition of Foot and Ankle Arthroscopy. This comprehensive work will address the most recent and valuable developments in foot and ankle arthroscopy and will be a valuable resource for orthopaedic surgeons, general orthopaedists, sports medicine practitioners and podiatrists. Target group: orthopaedic surgeons, sports medicine practitioners, podiatrists

Among all the extensor mechanism pathologies, lateral patellar instability is of great interest not only for the knee specialist, but also for the general orthopedic surgeon and trainee. The procedure that is most frequently performed to treat lateral patellar instability is the medial patellofemoral ligament (MPFL) reconstruction. The reason for this great interest in this procedure is obvious. Medial patellofemoral ligament reconstruction is the most frequently performed procedure in the extensor mechanism. It also is the most predictable and has the best clinical results of all the procedures in the extensor mechanism. In this handbook we analyse the different reconstruction techniques, step by step, for the MPFL reconstruction, as well as other techniques less frequently used in the patient with lateral patellofemoral instability. We also analyse the treatment of medial patellofemoral instability. It is a very practical book, aimed at the general orthopedic surgeon and also the ones specialized in the knee.

Sports Medicine is now a specialty in its own right. The Olympics are coming to the UK which has focused interest in the field, and pain in elite sport is an unresolved issue. Sports Medicine is an area that has expanded dramatically in the last 5 years, and demand for educational materials to help bridge the gap in the literature are highly sought-after. This book utilises the excellent sports medicine section originally published within International Advances in Foot and Ankle Surgery and present it in a quick reference format for residents and trainees in orthopedic sports medicine. The information presented covers current accepted techniques with scientific rationale and will appeal to all surgeons and health care professionals with an interest in sports medicine. This is a truly international, multidisciplinary manual of foot and ankle surgery in sports medicine by the specialty's leaders and most experienced surgeons. Current up to date trends and techniques using a scientific approach including evidence based guidelines where applicable are included. The reader will be exposed to a step-by-step approach to each procedure presented.

As it is quick, inexpensive, and non-invasive, ultrasound is the modality of choice for guidance of interventional procedures in the soft tissues. Furthermore, the rising mean age of the general population is being accompanied by increasing demand among patients for minimally invasive procedures to treat painful chronic and degenerative syndromes of the musculoskeletal system. This handbook is a clear, practical guide to ultrasound-guided minimally invasive treatments of musculoskeletal pain in the upper limb. Each chapter is clearly structured, with brief but comprehensive descriptions of the disease to be treated and of the materials and drugs needed. High-quality images and easy-to-follow schemes explain the best approach in each situation, and practical tips and tricks of value in daily clinical routine are provided.

This unique clinical guide will explore specific evidence-based literature supporting physical therapist guided exercises and interventional treatments for commonly prevalent orthopedic spine and extremity presentations. Using this book, the sports medicine and interventional pain physician will be better able to coordinate therapy exercises after interventional treatments with their physical therapy colleagues. This will include a treatment course that will monitor progress in restoring and accelerating patients' function. A myriad of musculoskeletal conditions affecting the spine, joints and extremities will be presented, including tendinopathies, bursopathies, arthritis, fractures and dislocations - everything a clinician can expect to see in a thriving practice. Each chapter, co-authored by a physician and a physical therapist, will follow a consistent format for ease of accessibility and reference - introduction to the topic; diagnosis; medical, interventional, and surgical management - and will be accompanied by relevant radiographis, figures and illustrations. Additional topics include osteoarthritis, rheumatic disorders, entrapment syndromes, the use of orthobiologics, and more. Comprehensive enough to function as a learning tool, but practical and user-friendly enough for quick reference, Clinical Guide to Musculoskeletal Medicine will be an essential resource for sports medicine physicians, interventional and physical therapists.

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.

Minimally Invasive Surgery for the achilles tendon represents a novel approach to treatment of orthopedic problems in the Achilles tendon. The gradual change of philosophy in the management of ankle surgery means that patients require a less invasive approach to surgery and a consequent improvement in recovery time. Describing the techniques and, importantly, the indications for minimally invasive procedures for the management of achilles tendon ailments, this book explains the management of various conditions and how they can be approached using minimally invasive techniques.This handbook provides an instant reference source for specialists and trainees alike, for those needing a 'to the point' companion when performing when treating disorders of the achilles tendon.

An in-depth understanding of a comprehensive approach to the management of radius fractures and their complications. The authors -- world renowned experts in the field -- present practical, clinical information from their extensive experience in the treatment of these fractures. Topics include the authors' classification as well as decision- making and tactics in the conservative and operative management of all types of radius fractures. Topics covered include: bending fractures of the metaphysis, shearing and compression fractures of the joint surface, avulsion fractures, radio-carpal fracture and dislocation, combined fractures, high velocity injury and malunions. In addition, chapters deal with surgical techniques and approach as well as with complications. With over 500 illustrations, this is the definitive volume on these challenging fractures, their complete treatment, and the management of complications.

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."

In Rheumatoid Arthritis: Risk Factors, Health Effects and Treatment Options, the authors open by discussing discuss which bDMARDS and tsDMARDS might be preferred in particular situations, for example in the setting of previous malignancy or in those with an increased risk of infection. Emphasis will be placed on practical solutions for the busy clinician. Following this, they discuss the prevalence and implications of co-morbid depression in RA patients and sub-groups, focusing on ethnic minorities. The barriers to identification of depression and the reasons for low utilization of mental health care resources among specific ethnic groups are analyzed, taking into account patient perceptions of depression and its association with RA. Lastly, the current knowledge about the contribution of smoking as a risk factor for RA development and the possible mechanism of action is reviewed. In addition, the authors highlight the association of smoking habits with clinical, serological, radiographic damage statuses and comorbidities of RA. The benefits of designed smoking cessation intervention on RA outcomes will also be discussed.

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.

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.

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."

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.

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.

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.