Metabolic bone degeneration (osteoporosis) affects millions of people--primarily postmenopausal women--and is directly responsible for debilitating hip, vertebral, and limb fractures in the elderly. Incorporating advances made within just the past five years, The Osteoporotic Syndrome: Detection, Prevention, and Treatment serves as an up-to-date, practical guide to the major clinical aspects of osteoporosis. The text is liberally illustrated with detailed figures.
As a resource for the clinician dealing with metabolic bone degeneration, this book represents an excellent source of information on the diagnosis and day-to-day management of osteoporosis.
Topics covered include
* Therapy with Vitamin D metabolites, sodium fluoride, thiazides, and isoflavones
* Biochemical markers of bone turnover
* Calcium, Vitamin D, and bone metabolism
* Estrogens and tissue selective estrogens for prevention and treatment of osteoporosis
* The effects of osteoporosis on orthopaedic surgery
* The therapy of glucocorticoid bone disease
* Effects of aging on bone structure and metabolism
* Management of osteoporotic patients in our health care delivery system
* The genetics of osteoporosis
* Bisphosphonate therapy for osteoporosis
* Calcitonin
* Bone mass measurement techniques in clinical practice
* Osteoporosis and the bone biopsy

This book is an essential handbook on bisphosphonates, the most widely used new class of drugs for osteoporosis therapy. It reviews basic physiology in addition to the indications and adverse reactions of these drugs. Bisphosphonates in Bone Disease, 4E, discusses the compounds' chemistry, mechanisms of action, and animal toxicology before presenting a clinical picture of the diseases treated by bisphosphonates. The book provides a table listing the trade names of the commercially available bisphosphonates, registered indications, and the available forms for various countries. The revised Fourth Edition contains approximately 50% new material, including information on all of the latest drugs.
* The revised fourth edition contains approximately 50% new material
* Includes information on all the latest drugs

This book is an introductory text to spinal disorders. Based on the highly successful forerunner to this volume, Practical Orthopaedic Medicine, the book still retains the original philosophy of this text which is to systematically cover all the joints discussing examination, diagnosis and treatment. The full spectrum of therapies is covered with particular emphasis on Maitland's widely practised spinal manipulation techniques - how they are assessed clinically and their role in the management of spinal problems. A complete review of the current literature has been undertaken and a valuable new chapter on the spine in sport has been added. This book will be essential reading for students and practitioners involved in sports medicine, orthopaedic medicine and physiotherapy.

Osteoarthritis is the most common joint pathology which primarily affects the older population. The disease is characterized by unique pathological changes in some synovial joints, predominantly affecting the articular cartilage, but also entire joints, including the synovial tissue and subchondral bone. The remarkable growth of research on normal and abnormal biology of tissues in the articulating joint, including the application of novel molecular biological approaches and new imaging techniques, is reflected in this volume. It describes the current state of knowledge and helps to further understand the etiopathology of osteoarthritis, hopefully leading to early detection of the disease and novel treatment modalities. The volume contains contributions and discussions from a select group of investigators, all experts in this field, who met at the conference "The Many Faces of Osteoarthritis," held in June 2001 at Lake Tahoe, to acknowledge Klaus E. Kuettner and his contributions to osteoarthritis...

This text highlights the value of a team approach to appreciating the commplexity of spinal pain and a range of treatment approaches. Contributions from epidemiology, anatomy, pathology, biomechanics, clinical medicine orthopaedics, chiropractic, osteopathy and physiotherapy are presented. Each section is written by an experienced practitioner and provides a summary of pertinent material, seeking to improve the reader's understanding of the causes of cervical spine pain The volume is part of a series of three books bringing together a multidisciplinary approach to the management of mechanical spinal pain.

Metabolic Bone Disease, Third Edition is the new, expanded edition of the classic text, featuring the latest advancements and research information in this fast-moving field. The Third Edition includes the most up-to-date information on molecular mechanisms, basic biology, pathophysiology, and diagnosis and management strategies of metabolic bone disease.
Key Features
* Edited by "fathers of the field"
* An expanded version of a classic AP text
* Complete coverage of a fast-growing field

Back Pain and Spinal Manipulation: a practical guide presents a highly-illustrated, didactic guide to the diagnosis and manipulative treatment of back pain. Based on a diagnostic approach to back pain the text is extremely practical and includes how-to-do-it-yourself tips based on the authors' many years of practical experience. The second edition of this popular text has been extensively revised and updated to include the developments that have taken place within the field in recent years. New illustrations have been added, and the format has been redesigned to produce a text that makes the information more easily accessible. New for the second edition: * manipulation techniques for the thoracic spine * sacro-iliac disorders and treatment * muscle stretching techniques * muscle energy techniques Features includes: key check points, classification of techniques, charts on technique/directness/specificity and do's and don'ts, and position of the patient/position of the therapist. With an emphasis throughout on practical information that is easy to follow, the book is essential reading for all practitioners, physiotherapists, chiropractors and osteopaths involved in the diagnosis and treatment of back pain.

The neuromuscular diseases comprise the disorders of peripheral nerves, the neuromuscular junction, and muscle. Both pre- and post-synaptic elements of the neuromuscular junction may become targets of autoimmune attack in different diseases. This book addresses the immunologically-mediated neuromuscular diseases, including Guillain-Barre syndrome and other autoimmune neuropathies, the Lambert-Eaton myasthenic syndrome, myasthenia gravis, and the autoimmune diseases of muscle. Two chapters are devoted to the vasculitic and HIV-mediated neuromuscular diseases. The experimental models of neuritis and myasthenia gravis are addressed in separate chapters. An introductory chapter provides a general background to autoimmunity. This book aims to be a useful overview for all neurologists, rheumatologists and immunologists both in research and clinical practice.

This book has been written by established Orthopedic Surgeons who have become dedicated specialists within their particular subspecialty. They have contributed by writing highly detailed chapters that educate the reader with the basic science, accepted fundamentals and most recent trends within the full range of orthopedic management of upper and lower limb orthopedic disorders.It is intended that this well illustrated and highly informative text book to provide orthopedic surgeons in training with comprehensive and relevant core knowledge on all aspects of orthopedics of the upper and lower limb, and will become an essential guide for surgeons in training, providing step by step approaches to performing initial diagnosis, surgical procedures and post operative management.

With the growing incidence of fragility fractures in Europe and North America over the last three decades, bone loss and osteoporosis have become active areas of research in skeletal biology. Bone loss is associated with aging in both sexes and is accelerated in women with the onset of menopause. However, bone loss is related to a suite of complex and often synergistically related factors including genetics, pathology, nutrition, mechani cal usage, and lifestyle. It is not surprising that its incidence and severity vary among populations. There has been increasing interest to investigate bone loss and osteoporosis from an anthropological perspective that utilizes a biocultural approach. Biocultural approaches recognize the inter-relationship between biological, cultural, and environmental variables. Anthropological studies also highlight the value of evolutionary and population approaches to the study of bone loss. These approaches are particularly suited to elucidate the multifactorial etiology of bone loss. The idea for this volume came out of a symposium organized by the editors at the 70th annual meeting of The American Association of Physical Anthropologists in Kansas City, Missouri. Many of the symposium participants, along with several additional leading scientists involved in bone and osteoporosis research, are brought together in this volume. Each chapter focuses on a different aspect of bone loss and fragility with a fresh and stimulating perspective."

Connective tissue diseases demand study because of their frequency, morbidity and mortality. They present intriguing challenges in the fields of diagnosis, management and research. Their range has now expanded enormously so that no individual can master the whole subject, particularly as this relates to their immunological basis. Immunology of Connective Tissue Diseases has been written by experts who are either clinical or basic scientists. The book presents up-to-date reviews of the immunological basis of connective tissue diseases as it impacts on diagnosis, pathogenetic concepts, disease monitoring and management. The book is aimed at physicians interested in understanding the immunological basis of these diseases, and at immunologists who are either entering this field for the first time and would like to have a convenient state-of-the-art account of its status, or who are researching in one area and would like to acquaint themselves with the developments which have taken place in others.

Newly revised and updated, this book provides geriatricians and orthopedic surgeons with the most vital tools to treat elderly patients who sustain a variety of fractures. The text uniquely encompass the etiologies of fracture in the elderly, perioperative management, the surgical treatment of common fractures in the elderly, as well as rehabilitation and prevention in the older patient. It focuses on the most current data and opinions regarding assessment and management of geriatric conditions that predispose the elderly to fracture, perioperative complications and subsequent functional decline. Unlike any other text, experts in both orthopedics and geriatrics review the content of each chapter for readability and appeal to his/her respective discipline, making this the physician's ultimate guide to treating elderly patients with injuries. Fractures in the Elderly, Second Edition is a valuable resource for geriatricians, orthopedic surgeons, physiologists, and rehabilitation specialists.

In the last decade, remarkable advances have been made in bone marrow transplantation (BMT), which is now becoming a powerful tool in the treatment of diseases such as leukemia, aplastic anemia, and congenital immunodeficiency. In animal experiments, it has been found that BMT can be used to treat not only systemic autoimmune diseases but also organ-specific autoimmune diseases. In humans, it has recently been shown that rheumatoid arthritis, ulcerative colitis, and Crohn's disease can be successfully treated after BMT. This volume contains new information on how to prevent graft rejection, how T cell functions can be completely restored, and how concomitant BMT can prevent the rejection of organ allografts without the use of immunosuppressive agents. BMT will become an increasingly useful and powerful treatment for various currently intractable diseases, and this book will contribute by providing details of the latest research in the field.

Edited by two leading orthopedic surgeons who are specialists in the treatment of hemophilia, Orthopedic Surgery in Patients with Hemophilia shows all the surgical techniques needed for surgical treatment of musculoskeletal complications of hemophilia. A practical guide, designed for use on the ward or in the office, this book draws on the experience of numerous specialists worldwide, from developed and developing countries. As well as orthopedic surgery, it also covers research, hematology, and rehabilitation. Although of primary interest to the orthopedic surgeon, rheumatologist, and physiotherapist, this book will also be relevant to the hematologist responsible for the care of the hemophiliac patient. Written for: Orthopedic surgeons, hematologists, physiotherapists, rheumatologists

Describes the genesis, pathology, clinical features, presentation, syndromes, clinical examination, investigation procedures, treatment, prophylaxis, and surgery of common vertebral joint problems.New edition of a highly successful, widely acclaimed book Completely updated to take account of recent developments in research and practice The Gray's Anatomy" of spinal musculoskeletal pain - now the essential reference for all involved in the treatment of vertebral conditions The only single book to offer a comprehensive survey of the whole field Covers the genesis, pathology, clinical features, presentation, syndromes, clinical examination, investigation procedures, treatment, prophylaxis, and surgery of common vertebral joint problems Gives the reader a thoughtful and critical digest of more than 2500 references - two-thirds of theseSuperbly illustrated: 412 photographs and 206 line illustrations"

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.

This book represents the proceedings from a conference that took place in Dallas in the spring of 1999 which was entitled "Pediatric Gender Assignment - A Critical Reappraisal." Some participants rightfully argued that the conference really focused on the issue of pediatric gender assignment, and that reassignment was not applied in most cases. Their comments were reflected in the title of this monograph. This multidisciplinary meeting was sponsored by a conference grant from the National Institutes of Health, and a broad inquiry into this complex topic took place from many points of view. Basic scientists offered insight into mechanisms of sexual differentiation of the gonads, physical phenotype and imprinting of the central nervous system. Endocrinologists reviewed their experience in diagnosis and management, surgeons described traditional as well as innovative approaches, and there was strong representation from the ethical and behavioral sciences. In putting together such a panel, it was essential that we identify a cast of speakers who could address their viewpoints with strong convictions, and yet not let their passions render the meeting counter productive. We were not disappointed. While many differing points of view were firmly expressed by the panelists and audience, all viewpoints were accorded the respect they deserved. The concept behind the meeting and this book really originated in 1997 shortly after Diamond and Sigmundson published their long term follow up study of the John/Joan case.

Modern society is altering the lifestyle and longevity of its members much more quickly than evolutionary adaptation to these changes can take place. The problem of calcium deficiency in the population is compounded by the growing percentage of aged individuals with relatively fragile, less massive skeletons. Current-day civilizations are much more effective in prolonging human life in a state of relative debility than even a few decades ago. This reality is unlikely to change and mandates that we develop strategies to prevent aging-related diseases like osteoporosis before they become manifest. Osteoporosis: Genetics, Prevention and Treatment places emphasis on the (1) genetic predisposition, (2) early recognition and (3) prevention of osteoporosis. The intent is not to move the practitioner's attention away from intervention therapy of osteoporosis, but rather to expand their view of this disease as one beginning at birth and one in which susceptibility is manifest at the conclusion of adolescence, not at menopause. The book concludes with an informed view of the future in terms of the recognition, prevention and management of osteoporosis.

A comprehensive description of macroscopic, microscopic, and radiological methods for the diagnosis of bone diseases. The book presents all the procedures involved in diagnosis, using not only radiological and histological techniques, but also modern immunohistochemical and scintigraphic methods. Succinct and well-structured therapeutic recommendations are provided for an array of bone diseases, making this a practice-oriented reference work for pathologists, radiologists, rheumatologists, and orthopedists.

The scope and importance of hip fractures is almost incomprehensible. With a world wide incidence of close to 2 million cases per year, these fractures pose a daunting challenge to our ability to affect and treat this epidemic. The incidence of these fractures is predicted to grow to 6 million in 2050 including a near term baby boom spike. Add the hospital mortality rate of up to 4% and the one mortality of from 8% to 20% and the life ending effect of these fractures becomes a glaring reality. Of those who initially survive their fracture, about 50% never walk the same again. The social problem in the care of these elderly people is enormous. Of course, any real solution to this problem will include education, prevention, surgical and hospital treatment protocols, long term rehabilitative efforts, social - justments and a generous contribution of money. This publication is primarily directed to the amplification of a new treatment modality that addresses only a fraction of the problem. It is, however, a quantum leap in the evolution of fixation with compression hip screws which are still the gold standard for surgical stabilization of pertrochanteric hip fractures. The Dynamic Martin Screw (DMS) addresses the issue of adjustability of the fixation angle with appropriate mechanical strength characteristics that were la- ing in its historical predecessors.

The second congress of the Paci?c Asian Society of Minimally Invasive Spine Surgery (PASMISS) held in Phuket,Thailand,August 5-6,2002,was highly s- cessful. Dr.Akira Dezawa, the president, had worked hard in organizing the congress,which was well attended.All scienti?c papers presented were of the highest standard and were worthy of publication in book form.This scienti?c meeting brought to light the practice of this modern surgical technique as it is being performed by spine surgeons in the Asia-Paci?c region.Dr.Dezawa has made a great effort to collect the papers from the congress,and to have them edited and published as a text that covers all aspects of the minimally invasive spine surgical approach. Minimally invasive spinal surgery will be a highlight of operative approaches in the twenty-?rst century and already has been popularized worldwide.This procedure will provide surgical options that address several pathological conditions in the spinal column without producing the types of morbidity commonly seen in open surgical procedures. The contents of this book provide highly relevant and detailed information. I certainly believe that it will be a great bene?t to all orthopedic surgeons who are interested in performing minimally invasive spine surgery. Charoen Chotigavanich,M.D. Chairman,Spinal Section The Royal College of Orthopedic Surgeons of Thailand V Preface Recent decades have been characterized by revolutionary changes in spinal surgery. Concurrent progress in implant technology and functional en- scopes and the improvement of less invasive surgical techniques has opened a new dimension for spine surgery.