Osteoarthritis (OA), the most common form of arthritis, is generally characterized by a slowly progressive degeneration of articular cartilage, particularly in the weight-bearing joints. It has a stronger prevalence in women, and its incidence increases with age. OA is a major and growing health concern in developed countries, owing to steadily increasing life expectancy and the demand for better quality of life. Because of its chronic nature and nonfatal outcome, OA affects the growing population of the elderly over an increasing time span. Moreover, despite its relatively benign character, OA is one of the most disabling diseases; it is responsible for increasing financial and social burdens in terms of medical treatments, forced inactivity, loss of mobility, and dependence. Despite a growing awareness of OA as a medical problem that has yet to reach its maximum impact on society, there is a surprising absence of effective medical treatments beyond pain control and surgery. So far, only symptom-modifying drugs are available, while there remains a major demand for disease-modifying treatments of proven clinical efficacy. This demand will hopefully be met in the future by some of the drugs that have been pressed into development and are now at different stages of clinical investigation. Nevertheless, the current lack of effective treatments reflects a still insufficient knowledge of cartilage with respect to its metabolism, interactions with other joint tissues, and causes and mechanisms (possibly of very different nature) leading to failure of its turnover.

A cutting-edge review of the biochemical, physiological, pharmacological, genetic, and molecular interactions involved in the development and homeostasis of the skeleton. Topics range from chondrogenesis, chondrocytes, and cartilage to skeletal dysmorphology, and include the control of skeletal development, osteoblastic cell differentiation, and bone induction, growth, remodeling, and mineralization. The authors' understanding of bone physiology-and how it is modified throughout all the stages of life-offers novel approaches for improving the endurance of load-bearing implants, achieving life-long optimal bone strength, overcoming microgravity situations (space flight), and hastening the healing of fractures, osteotomies, and antrodeses.

The last decade has seen a tremendous advance in our understanding of bone biology. The genes responsible for the majority of rare inherited bone disorders have been identified and much progress has been made in the identification of genes in polygenic disorders such as Paget's disease and complex multigene diseases such as osteoporosis. Transgenic technology has identified further genes, sometimes unexpectedly, with profound effects on bone. This wealth of new genetic information will undoubtedly lead to extensive cell biological studies to understand the mechanisms by which these gene products affect bone mass and bone strength. In Bone Research Protocols a catalogue of protocols has been assembled to perform such mechanistic studies. In the tradition of the Methods in Molecular Medicine series, the chapters are practical laboratory protocols that should enable the reader to carry out the techniques from scratch. To our knowledge this is the first time such a truly practical manual on well-established bone methods has been assembled, and this volume aims to be complementary to and follow on from the more theoretical Methods in Bone Biology, edited by Arnett and Henderson (1).

The physical examination of the elbow, wrist, and hand can be a complex topic for professionals with all levels of clinical experience. How can advance concepts be taught in a user friendly, clear format, while still providing necessary information for effective diagnosis and treatment of the elbow, wrist, and hand? Musculoskeletal Examination of the Elbow, Wrist and Hand: Making the Complex Simple by Dr. Randall Culp answers these questions. Written by experts, this easy-to-carry book provides a thorough review of the most common pathologic elbow, wrist, and hand conditions, techniques for diagnosis, as well as the appropriate treatment for each condition. Musculoskeletal Examination of the Elbow, Wrist and Hand: Making the Complex Simple contains clear photographic demonstrations, tables, sidebars, and charts throughout its pages, allowing a thorough and concise examination of the elbow, wrist, and hand. A glance at what is covered inside: * Physical Examination * Basics and specific tests of the elbow, wrist, and hand * General Imaging * Basics of general imaging of the elbow, wrist, and hand * Common Conditions * Tendinopathy, arthritis, wounds, soft tissue injuries, and more Musculoskeletal Examination of the Elbow, Wrist and Hand: Making the Complex Simple contains essential information to successfully take a complex subject, and bring it to a level that will be welcomed by all orthopedic residents, attendings, physical therapists, athletic trainers, medical students in training, and other health care providers.

There is currently no single book with up to date information on osteoclast function and bone resorption.

A useful collection of information, not readily available in a concentrated and convenient form on the market.

Provides a comprehensive overview of the field.

Bone research in recent years has generated much new knowledge, in large measure because of the broad public health implications of osteoporosis and related bone disorders. Bone Formation, the first in a series entitled Topics in Bone Biology, evaluates this new information and formulates novel insights and hypotheses within the broad framework of current knowledge. An easy-to handle and to read work, with concise reviews that are extensively referenced, the chapters in this book are written by internationally known authorities. Particular emphasis is on osteoporosis and related disorders of diminished bone formation. Among the general topics treated is a chapter on biomechanical aspects of bone formation, not often considered in relation to diseases of bone formation. The book constitutes essential reading for those entering the field of bone biology and those who wish to become familiar with up-to-date information in a particular area of bone research.

This volume discusses the background and various clinical applications of radiation therapy in the treatment of non-malignant diseases. It documents the radiobiological and physical principles of treatment and the rationale underlying the use of radiotherapy for various disorders of the CNS, head and neck, eye, skin and soft tissues, bone and joints, and vascular system. In so doing, it draws attention to and elucidates the scope for application of radiotherapy beyond the treatment of malignancies. Both the risks and the benefits of such treatment are fully considered, the former ranging from minor clinical problems to life-threatening diseases.

Edited by two leading authorities in the field, this volume is a technique-oriented "how-to" guide to an increasingly performed procedure, corrective surgery for the failed total knee arthroplasty. With more than 350 illustrations - 60 in full color.

No other book covers as extensively all aspects of peripheral nerve surgery. This includes the pathology and pathophysiology of compression neuropathies, traumatic nerve lesions and nerve tumours, and their treatment with various techniques. All body regions are described adequately. The second part of the book deals with palliative surgery for reconstruction of lost function. This includes a comprehensive array of muscle and tendon transfers, functional muscle transplantation and intramuscular neurotisation.

Because of the relatively low incidence of involvement efforts to enhance the diagnosis and management of elbow pathology are not common. Nonetheless, because of a rapidly expanding knowledge base,both with regard to a more - fined understanding of elbow pathology, coupled with exciting and emerging approaches and options for management, it is appropriate and timely to - dress this deficiency in the orthopedic literature. This volume, therefore, was produced in order to provide current and relevant information with content that is drawn from a very well received symposium of the same name as this book and convened in Modena, Italy recently. As with the symposium, the s- cific goals of this text are to provide the most updated concepts in the m- agement of a full spectrum of elbow pathology. The content, therefore, is c- prehensive in nature,but with a focus on emerging options in the management of traumatic conditions as well as reconstructive options for the sequelae of trauma. These topics are covered in detail in the 31 chapters which comprise this text. The focus of each chapter was specifically designed to address the topic in the most timely fashion and with less of an emphasis on the historical context and more focus on current thinking. The references documenting c- tent are intended to be efficient and focused. In addition, the popular and - propriate expectation of the orthopedic community of enhanced explanation of technique are featured in the appropriate chapters.

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.

Plain radiography is still alive. In many institutions, including ours, conventional radiography has been replaced by digital systems including imaging-plate-based computed radiography and fat-panel detector-based digital radiography. Even for the education of radiation technologists, conventional flm-screen radiography has been de-- phasized, and their education is concentrated on digital systems. Spatial resolution of a conventional system is still far better than the current digital systems, although the dynamic range is wider in the latter system. Industrial flm radiography with small grain size and direct exposure has an even higher resolution, and such hi- resolution systems are something we lost in the transition from the conventional system to the current PACS-friendly system. I am pleased to know that Giuseppe Guglielmi and Wilfred Peh have published this textbook of high-resolution hand radiographs that cannot be obtained with any other techniques. Radiography has always been the most important modality in the evaluation of the hand, and, moreover, high-resolution industrial flms are extremely efective in the evaluation of the hand, particularly for assessing subtle erosions. Hands are not just one of the peripheries of the human body. Tey refect conditions of the whole human body. Not only the metabolic status, but also many congenital disorders are manifested in the hand. Radiographic fndings of the hand are ofen specifc, and contribute to the diagnoses a great deal. Tere have been several publications concerning the radiology of the hand, and they have been well accepted.

This book is an organized approach to understanding bone growth and disease. It integrates anatomic and radiologic knowledge of enchondral and membranous bone growth and emphasizes the similarities of the physis and acrophysis in development. The artwork, jointly produced by artist and author, illustrates the concepts described. The identification of abnormality is aided by the explanations of the causes in terms of pattern recognition.

For the first time, this book offers a critical review of the calcification process of the organic and inorganic phases of mineralized tissues focusing on the earliest phases. It includes a methodological chapter which provides the necessary practical information for making appropriate choices. The book is set to become an important reference source for the shelves of bone densitometry labs across the world.

This is the first book to cover minimal-invasive treatment of osteoporotic, tumorous and traumatic vertebral fractures in the English language. In addition to detailed descriptions of the techniques, including tips and tricks from experts, the book contains a chapter about the medical treatment of osteoporosis, which is indispensable in the interdisciplinary approach to osteoporosis. This acclaimed innovative concept unites several treatment aspects. More conservative treatment methods are also presented in this work.

All chapters reflect new developments and clinical findings in the field of orthopaedics, surgery, traumatology and neurosurgery.

The third edition of this book has been comprehensively rewritten and rearranged. In addition to the bone and joint diseases described in the two earlier editions, it now encompasses hitherto unpublished novel applications of pinhole scanning to the diagnosis of a broader spectrum of skeletal disorders. The book has been considerably expanded to discuss five new themes and is complemented by the addition of some 90 recently acquired cases.

It is indeed a pleasure to prepare the foreword for vidual surgeons. In addition, it can be read from this text, mainly because I am now a senior ortho- front to back as a history of orthopedics. We are pedist who has known so many of the great ortho- all indebted to S. B. Mosto? for this fascinating pedists who are described in such great detail in book. It is truly a text for everyone who has an this book. Some of the named physicians have interest in orthopedics, and surely should be read been my very close personal friends, many have by orthopedic trainees, faculty members, and been my teachers, professors and colleagues. practicing orthopedists. I suggest it be placed in Indeed, these physicians through their contribu- every library in medical institutions and hospitals. tions have made the ?eld of orthopedic surgery what it is today worldwide. Charles A. Rockwood, Jr. , MD This is a wonderful source of information on University of Texas Health Science Center the interesting lives and contributions of the indi- San Antonio, TX, USA vii PREFACE My obsession with history goes back a long way. To keep the book readable and reasonable in Some years ago I began to focus my curiosity on size, I sadly had to cut down the number of individuals whose names are attached to orthope- entries.

When the kidney fails its intended mission to manage the body 's waste products, physicians must perform multi-level and simultaneous adjustments to replicate kidney function. The management of the body 's absorption, reabsorption, utilization and excretion of calcium and phosphate requires constant fine tuning. This book provides an overview of the state-of-the-art clinical and basic science aspects of abnormal calcium and phosphate metabolism and its management.

Are you looking for concise, practical answers to those questions that are often left unanswered by traditional foot and ankle references? Are you seeking brief, evidence-based advice for complicated cases or controversial decisions? Curbside Consultation of the Foot and Ankle: 49 Clinical Questions provides quick answers to the tricky questions most commonly posed during a "curbside consultation" between orthopaedic surgeons. Drs. George B. Holmes, Jr. and Simon Lee have designed this unique reference which offers expert advice, preferences, and opinions on tough clinical questions commonly associated with the foot and ankle. The unique Q&A format provides quick access to current information related to the foot and ankle with the simplicity of a conversation between two colleagues. Numerous images, diagrams, and references allow readers to browse large amounts of information in an expedited fashion. Curbside Consultation of the Foot and Ankle: 49 Clinical Questions provides information basic enough for residents while also incorporating expert advice that even high-volume clinicians will appreciate. Practicing orthopaedic surgeons, orthopaedic residents, foot and ankle specialists, and medical students will benefit from the user-friendly, casual format and the expert advice contained within. Some of the questions that are answered: * When do you do an allograft or autograft talar transplantation graft for a failed osteochondral talar lesion? * How do you treat an athlete with chronic lateral foot overload and peroneal tendonitis with a cavovarus foot? * How do you fix your syndesmotic injuries? Can I use tight-ropes now? * I have a 63 year old patient who had an ankle fracture 20 years ago. They are ready for a major procedure now. Should I perform an ankle arthrodesis or should I refer her out to someone for a total ankle arthroplasty? What are your criteria for a total ankle arthroplasty? * Do I need to use bone graft in foot and ankle surgery, autologous or allograft? What graft should I use?

The molecular and cellular approaches to the relationship of joint and bone problems distinguish this from other books on the topic. Advances in bone and joint biology enable practitioners to approach clinical problems more comprehensively. Emphasis on genetics and on newer viewpoints and approaches, exemplified by the possible effect of subchondral bone on osteoarthritis, gives a wider viewpoint to the reader and may enable novel approaches to solving a clinical problem.

Psychoprosthetics is defined as the study of psychological aspects of prosthetic use and of rehabilitative processes in those conditions that require the use of prosthetic devices. Psychoprosthetics: State of the Knowledge brings together, into one easily accessible volume, the most recent and exciting research and knowledge in this new field

This concise third edition offers hands-on guidance for identifying and treating the most commonly seen orthopedic problems in children and adults. Convenient as a study source for medical students, its many photographs and illustrations will also serve as a useful clinical reference for young surgeons, residents, nurses, and physician assistants. Each of the many topics is covered in depth and is designed to educate medical students and steer them towards formulating excellent diagnoses and treatment plans. As a further aid, multiple-choice questions are included at the end of each chapter, and there is a section devoted to case studies.

A representation of the skills and expertise of leading surgeons in the field, this reference serves as a step-by-step instructional resource on arthroscopic and minimally invasive surgery of the shoulder and elbow. With full-color illustrations throughout, each chapter focuses on specific techniques and will contain strategies to enhance recovery, reduce patient pain, and provide improved function over traditional surgical procedures.

Disorders of the Achilles tendon are universal, affecting people in a wide range of age groups. Because the Achilles tendon is one of the most pow- ful musculotendinous structures in the body, the impact of an injury to the Achilles tendon becomes magnified. There is a wide range of disorders or problems that can involve the insertional region, where pathology may rest with bone, tendon, or bursae. A completely different set of pathologic entities resides in the noninsertional region, one of which may include the frustrating degenerative tendinopathy. As our growing population ages but remains phy- cally active longer into life, the incidence of these disorders will continue to increase. I am proud to be given the opportunity to write the foreword to this text, which is intended for foot and ankle surgeons worldwide. Seldom does a book on a single entity become a current concepts review, as this work has. Too often, textbooks are not published for several years after the chapters have been written, making them obsolete upon publication. Not so with this book, which deals with timely topics on the Achilles tendon. Dr. James Nunley has compiled this work in slightly over a year, thus providing the reader with sta- of-the-art material. Dr. Nunley had the foresight to create a much needed techniques-oriented book dealing with the complexities of the Achilles tendon. His approach was to develop a comprehensive guide to managing Achilles tendon problems.

Over the past decade, major advances have taken place in the management of osteoporosis. Newdasses of pharmaceutical agents have been developed, tested, and used to treat millions of patients; education and early detection programs have been instituted around the world; and bone densitometry has received widespread recognition by healthcare agencies as being central to the preven tive health strategy necessary to care for an aging population. With all these advances, scientists continue to explore new methods to understand and treat this disease. The field of orthopaedic surgery has a great opportunity to bring this new information to its dinics and operating rooms. It is critically impor tant that the practicing surgeon be armed with this knowledge. Fractures are dearly the most common orthopaedic problem associated with osteoporosis. The goals of treatment are rapid restoration of mobilityand func tion and return of patients to a level of activity that supports their general health. The ability to control the metabolic condition or to treat the under lying cause of the osteoporosis with pharmacological intervention willimprove surgical results. Moreover, the special techniques required to succeed in the operative treatment of bone, which is already weakened by osteoporosis, must be carefully developed, tested, and understood. This book provides the first attempt to bring this body of information to the orthopaedic surgeon in a dearly organized and comprehensive way. Historically, few orthopaedic surgery or trauma training programs have offered much in the way of education in the science of bone metabolism."