Emergency care of pediatric orthopedic surgical emergencies is often provided by orthopedic surgeons who primarily treat adults. Pediatric Orthopedic Surgical Emergencies is designed to provide the essential information needed to safely evaluate and treat the most common surgical emergencies in pediatric orthopedic surgery. Each emergency scenario includes the keys to patient evaluation, operative considerations, and expected complications. Each contributor provides technical pearls and tips based on their preferences and clinical experience in this area. Topics covered run the gamut from trauma (including the mangled extremity and compartment syndrome) to individual body regions (the spine, upper and lower extremities) to infection and other conditions. Pediatric Orthopedic Surgical Emergencies is a convenient, illustrated guide to procedures that can be challenging to those physicians who treat pediatric patients infrequently.

It was a great honor for us to preside over the Hip Biomechanics Symposium, held on November 19, 1992, in Fukui City, Japan. We believe it was the first interdisciplinary conference on biomechanical approaches to hip disorders; this volume contains the presentations made at the conference. The information found here will be of value not only for orthopedic surgeons but also for researchers. The advent of biomechanical approaches to hip dis ease has made possible the understanding of fundamental hip pathologies, an understanding which enables us to institute the appropriate non-surgical or surgical treatment. Indeed, efficient surgical planning is not possible without taking these approaches. This comprehensive volume consists of six major sections: loading, gait analyses, THA, osteotomies, motion analyses, and stem designs for stability. Each of these sections brings together many of the leading researchers in this field. We hope this volume will be a spur to future understanding of and on fruitful research on hip disorders. The Editorial Committee wish to express their deep gratitude to the contri butors and the publisher. Shinichi Imura Noriya Akamatsu Hirohiko Azuma Kazuhiko Sawai Seisuke Tanaka v Table of Contents Preface......................................................... V I Hip Joint and Loading 1 Two-Dimensional Finite Element Analysis for Stress Distribution in Normal and Dysplastic Hips Nobuo Konishi.. . .. . . . . . .. . . . . . .. . . . . . . . . . .. . . . . . .. . . . . . . . . . 3 2 Stress Distribution at Hip Joint During Level Walking Kazuhiko Sakamoto, Yoshinobu Hara, Akira Shimazu, and Kenji Hirohashi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 . . . . . . . . . . . . . . 3 Biomechanical Studies of the Hip Utilizing Computer Simulation Takatoshi Ide, Yasuhiro Yamamoto, and Shigeru Tatsugi . . . . . . . . . 21 ."

This book, which derives from an initiative of the Education Committee of The International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS), addresses all aspects of elbow arthroscopy. Anatomy is thoroughly introduced, referencing safe portals and describing techniques to minimize risk of complications. Subsequent chapters focus on the use of arthroscopy in a range of conditions, including osteochondritis dissecans, stiff elbow, epicondylitis, elbow instability, and elbow fractures. Guidance is provided on diagnosis and indications for arthroscopy, and arthroscopic technique is clearly detailed. A key chapter describes complications and how to avoid them. The authors are experts and pioneers in the field from North America, Australia, and Europe who have in common the ability to teach complex procedures in a simple way. This book will be an invaluable aid for the developing surgeon and an excellent reference for the experienced surgeon. "

This booklet is intended as an insightful update on daily shoulder management closely based on the content of closed consensus meetings of the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) Upper Extremity Committee (UEC). Section A provides a comprehensive review of the currently available classifications and outcome scores for shoulder disorders, illustrating their potential pitfalls and limitations. The authors emphasize the need for standardization of shoulder assessment and propose two novel classifications that are expected to facilitate tailoring of management. Section B describes pioneering techniques to re-establish shoulder function after dislocation of the acromio-clavicular joint and covers surgical indications and decision-making criteria. Section C describes the current state of evidence concerning rotator cuff disorders, providing novel theories regarding the underlying biomechanics and reconstruction techniques.

In this volume, world authorities on spinal surgery from the fields of Neurosurgery, Orthopaedic Surgery, and Neuroscience present current data on the basic science and clinical management of the unstable spine. Unique to this book: a frank presentation of controversies in the field.

This second revised and enlarged edition addresses current techniques concerned with the implementation of the AO/ASIF System in small animal orthopaedic surgery. Surgeons who have used the system over the years have now considerable knowledge and experience which they have made available in this text. The same individuals have designed and modified special implants which are now available to the Small Animal Orthopaedic Surgeon. Sections have been added or modified concerned with severe trauma, implant removal and a system for recording fracture type and treatment. The book will serve to inform the experienced surgeon of the current situation, and at the same time it is still a basic text for the newcomer to veterinary small animal orthopaedics in general and the AO/ASIF system in particular.

Arthritis Research: Methods and Protocols, Second Edition expands upon the first edition to present new and current techniques for the research of arthritis and related conditions. A compendium of leaders in the field contribute chapters that cover practical research methods such as the intravital multiphoton microscopy technique, techniques for evaluating exhausted CD8 T cell and for studying nucleic acid sensors and their effects, methods for in vivo tetracycline-controlled transgenic mice and T cell receptor transgenic mice, protocols to detect V(D)J recombination products and microRNA, and the technique to make bleomycin-induced dermal fibrosis. Written in the successful Methods in Molecular Biology series format, chapters include introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible protocols, and notes on troubleshooting and avoiding known pitfalls. Authoritative and easily accessible, Arthritis Research: Methods and Protocols, Second Edition will serve both professionals and novices with state-of-the-art techniques pertaining to this fascinating research field.

Replacement of a failing hip joint or other defective organs in the human body by artificial 'spare parts' has significantly improved our quality of life. These spare parts have to meet a wide spectrum of mechanical, chemical and design requirements. In this book, the properties and selection of materials for such `spare parts' are deduced from case studies at the start of each chapter. Hard tissue replacements (joints, long bones, dental), soft tissue (heart valves) and tissue engineering are included. The chapters also detail the three generic classes of materials: alloys (including shape memory alloys), ceramics & glasses and polymers. Separate chapters are devoted to the toxicity of implants, the metals zirconium(-zirconium oxide), tantalum, niobium and metallic glasses, soluble metals and Rapid Prototyping techniques for the fabrication of custom made prostheses. The book concludes by a chapter on water as water is always 'there' and conditions the interaction between body and implant. Water is the very matrix of life on earth. A peculiarity of the book is its 'perspective view', meaning that the authors looked behind the present biomaterials' decor and included historical backgrounds (real and mythological), future developments, and the relation to nature (plants and geology).

Radiologists, orthopedic and neurological surgeons present the different minimally invasive methods. Peripheral nerve problems and problems concerning differential diagnosis in special situations such as between radicular and peripheral nerve trunk lesions are discussed, pinpointing the significance of different diagnostic tools. Minimally invasive techniques, utilized nowadays to minimize bone demolition, scarring and risk of recurrence are analyzed. Microdiscectomy is compared with the results of intradiscal techniques, and new methods are discussed facing problems such as epidural fibrotisation, microinstability, osteoporotic or neoplastic or posttraumatic vertebral lesions.

Magnesium Biomaterialsprovides a succinct up-to-date overview of Magnesium biomaterial development, critically examines the types of in vitro experiments that may be performed, and investigates the numerous variables that affect Magnesium biodegradation when undertaking these experiments. This work also discusses the direction in which current Magnesium biomaterial development is heading and the necessary steps for future development of this field. Information is drawn from numerous multi-disciplinary sources to provide a coherent and critical overview. Magnesium Biomaterialsis ideal for researchers in thearea of bio-Mg, companies interested in exploring their own alloys, and for researchers working with other biodegradable materials who are seeking a cross-platform understanding of material performance."

A research project entitled Biomechanics of Structure and Function of Living Cells, Tissues, and Organs was launched in Japan in 1992. This data book presents the original, up-to-date information resulting from the research project, supplemented by some of the important basic data published previously. The aim of collecting the information is to offer accurate and useful data on the mechanical properties of living materials to biomechanical scientists, biomedical engineers, medical scientists, and clinicians. The data are presented in graphs and tables (one type of data per page) arranged in an easily accessible manner, along with details of the origin of the material and the experimental method. Together with its two companion volumes, "Biomechanics: " "Functional Adaptation and Remodeling" and "Computational" "Biomechanics," the Data Book on Mechanical Properties of Living Cells, Tissues, and Organs is a timely and valuable contribution to the rapidly growing field of biomechanics.

Bones and joints are always under mechanical loading a key concept in understanding bone metabolism. Among the most common diseases of bones and joints in the elderly are osteoporosis and joint osteoarthritis. Dynamic changes in mechanical loading give rise to problems resulting in stenosis of the spinal column at the cervical, thoracic, and lumbar levels. Mechanical loading also accelerates joint destruction caused by inflammation from such conditions as chronic rheumatoid arthritis. An understanding of mechanical loading is essential therefore to clinicians, basic researchers, and engineers working with bones and joints. Providing up-to-date research and clinical findings, the contents of this volume are from the papers, symposia, and special lectures presented at the 12th Annual Meeting of the Orthopaedic Research Meeting of the Japanese Orthopaedic Association in Niigata, in October 1997.

There is a large and rapidly growing body of literature on the importance of mag nesium in biochemical and physiological processes. There is also much evidence that magnesium deficiency, alone and in combination with agents that interfere with its utilization, is associated with functional and structural abnormalities of mem branes, cells, organs, and systems. The manifestations of the changes caused by magnesium deficiency depend upon its extent and duration and on variable factors. Among the conditions that increase the risk of magnesium deficiency are (1) meta bolic factors that affect the absorption, distribution, and excretion of this mineral; (2) disease and therapy; (3) physiologic states that increase requirements for nutrients; and (4) nutritional imbalances. Excesses of nutrients that interfere with the absorption or increase the excretion of magnesium-such as fat, phosphate, sugar, and vitamin D-can contribute to long-lasting relative magnesium deficiency. All have been implicated in several of the diseases considered in this book. Whether their influence on the need for magnesium is a common denominator remains to be investigated further."

This monograph analyses all aspects related to the etiopathogenesis, pathomorphology, diagnosis and treatment of lumbar disc herniation. It includes 24 chapters, over 500 illustrations, partly in colour, and 2800 bibliographic entries, going from the historical to the most recent ones. Five chapters are dedicated to biological and pathomorphologic aspects both of lumbar disc herniation and the conditions most often associated with herniation. The etiopathogenesis is analysed in the light of the most significant and recent studies. Five chapters deal with the clinical presentation and diagnostic tests in an extremely wide and detailed way. Large space is reserved to conservative management. The chapters on invasive treatments and on the results and complications of surgery define the advantages and limitations of the old and new percutaneous or surgical treatments. Two chapters are dedicated to surgical management of patients with spinal conditions associated with herniation, and two other deal with the surgical failure. This monograph is aimed at satisfying the requirements of both experts and young doctors. Some chapters are of particular interest to the spine specialist, whilst others are useful to the novice to acquire a general knowledge of the subject.

Gene therapy for inflammatory diseases is a new , burgeoning field of medicine. Edited by the undisputed pioneers of this area of research, this volume is the first devoted to its topic. It contains thirteen chapters, each written by leaders in their respective fields, that summarize the state of the art in developing novel, gene based treatments for inflammatory diseases. As well as providing an introduction to the basic concepts of gene therapy and the use of naked DNA approaches, the book describes the advances that have been made in applying them to arthritis, lupus, multiple sclerosis, diabetes, Sjogren`s syndrome and transplantation.One chapter is devoted to discussing the first human clinical trials that apply gene therapy to the treatment of an inflammatory disease. As well as providing novel therapeutic approaches, gene therapy facilitates the development of new and improved animal models of disease; a chapter describing these advances is also included. As an up-to-date, timely book written by th

In bone surgery it is essential to compress fractures interfragmentarily in order to make them resistant to the tensile force of muscles and the force resulting from acceleration and deceleration. This can be best achieved by the use of cable tension bands as a traction mechanism. The cable tension band is - in terms of stability of fractures - far superior to the conventional rigid cerclage wire which has been widely used in osteosynthesis for over 100 years. The author explains the biomechanics of the tension band in detail. Theoretical findings are confirmed by clinical test results. All osteosynthetic techniques which can be carried out with cables are described giving details of operation instructions. Errors and risks are always pointed out. A reference book and operative manual at a time.

Dr. Heinonen reviews and critically evaluates the scientific literature on the biological role of inorganic pyrophosphate (PPi ) published from 1940 to the end of 1999. He describes and classifies all known biochemical reactions that produce Ppi; describes and evaluates all published methods used in biological Ppi; and compiles and critically evaluates information on the concentration of PPi (with the conclusion that, contrary to common belief, PPi exists throughout the living world in rather high concentrations). Many reactions in which PPi is used as a biochemical energy source instead of ATP have been described in recent decades, especially in bacteria, protists, and plants. These reactions are evaluated from the bioenergetic and regulatory points of view. Also considered is the possible role of PPi as a source of biochemical energy in the primitive phases of life, before ATP. Data is presented on the regulatory role of PPi in living systems, such as activities of enzymes, fidelity of syntheses of macromolecules, and proliferation of cells. PPi may also regulate the formation and dissolution of bone as well as pathologic calcification of soft tissues and the formation of urinary stones. The formation of calcium pyrophosphate dihydrate crystals in the extracellular fluids of joints cause the disease called pseudogout. Biological Role of Inorganic Pyrophosphate book is a unique and invaluable source of references (about 1120) and summarized data for professionals who study or plan to study the role of PPi in living systems. Many different branches of science (biochemistry, microbiology, bioenergetics, plant physiology, parasitology, evolution, orthopedics, rheumatology) have involvement with PPi. This book sums up available knowledge in one place and will help scientists cross disciplinary boundaries.

The purpose of this volume in the Progress in Inflammation Research series is to provide the biomedical and clinical researcher with a state-of-the-art insight in the role of cytokines in joint inflammation and joint destruction. This is of relevance for better understanding of key processes in diseases such as rheumatoid arthritis (RA) and osteoarthritis (OA). Apart from the impact of old and novel cytokines on joint tissues, the various chapters address the issue of targeted therapy with biological response modifiers and future interventions with carefully designed inhibitors. Spe cial attention is given to elements of synovial cell activation, cell-cell interaction, cytokine interplay as well as mechanisms of cartilage destruction and bone erosion. In addition to an outline of the role of established cytokines, such as TNF, IL-l and IL-6, new information is given on the novel cytokines IL-15, IL-17 and IL-18 and their positioning in the complex cytokine interplay. Cytokine regulation of destructive enzymes, RANKL, the endogenous inhibitor OPG and their crucial roles as central players in joint erosion are highlighted. Together, the chapters provide a complete and balanced view on pivotal cytokines and joint pathology.

This book provides a complete overview of all modalities used for hand and wrist imaging, along with a complete over- view of the various disease entities that can be diagnosed. As a state-of-the-art overview of hand and wrist imaging it is a reference work for radiologists, hand surgeons, ortho- pedists, traumatologists, rheumatologists and internists and their residents in training. The chapters are written by ex- perts in musculoskeletal radiology from various European countries and the USA.

Severe spondylolisthesis/spondyloptosis is still a controversial issue in spine surgery. This book takes an interdisciplinary approach and discusses the state of the art and defines therapeutic strategies. The contributing authors are well-known specialists in the field.

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...

Advances in Materials Science and Implant Orthopedic Surgery brings together experts from major university hospitals, materials scientists specializing in bio-materials, and development engineers working for implant manufacturers to address such issues as: mechanisms of fixation; foreign-body immune response; generation and consequences of ionic and wear debris; materials selection, design and manufacturing schemes; and surgical techniques to maximize the safety and efficacy of the devices.

Up to date and evidence-based answers to a wide range of spinal surgical questions that could be asked in the FRCS (Tr & Orth) Viva exam. Using a clear, case-based structure key points emphasise the core information that will improve the performance of every surgical in training. Sections cover all the key areas of Trauma, Degenerative spinal pathology, Spinal cord injury, Spinal deformity, Primary bone tumours, Metastatic disease, Paediatric spinal surgery, Basic sciences, and other topics. Suitable for use by trainees at all levels in orthopaedic surgery and neurosurgery, both in the UK and internationally, and those with an interest in spinal surgery.

Growth Hormone is a fitting addition to the Endocrine Updates Series. The aim of these publications is to provide the clinician with cutting-edge, yet succinct, access to the latest advances in endocrinology. Current interest in this rapidly evolving area of endocrinology makes this a timely and important update. Growth Hormone joins Dr. Fagin's Thyroid Cancer in continuing the standard of excellence as the fourth volume in this series of topical updates. Shlomo Melmed, MD, Series Editor, Endocrine Updates Ten years ago, many endocrinologists were still skeptical that growth hormone (GH) played an active role in adult metabolism. This is, perhaps, surprising given that GH deficiency (GHD) in adulthood had been `recognized' as long ago as the 1960s. During the last ten years studies have shown that GHD in adulthood is a far-reaching syndrome associated with abnormal body composition, reduced bone mineral density with an increased fracture rate, increased cardiovascular morbidity and impaired cardiac function, as well as reduced exercise performance and decreased psychological well-being. Importantly, it is also clear, from placebo-controlled trials, that GH replacement therapy can normalize body composition, increase bone mineral content and improve the cardiovascular risk factor profile. GH replacement therapy also improves cardiac performance and exercise capacity, increases muscle strength and improves well-being and quality of life. The aim of Growth Hormone is to provide a critical update of current knowledge about adult GHD and the future role of GH/IGF-1 in adult medicine. For this purpose, contributions from a number of research groups have been invited. It is my hope that the book may not only serve as an introduction to the field, but also stimulate further research within this exciting area.

1 Indikationsstellung fur gelenkerhaltende und gelenkersetzende Behandlungsverfahren.- Gelenkerhaltende Eingriffe.- Gelenkersetzende Eingriffe.- 2 Technische Besonderheiten fur die Implantation bikondylarer Prothesen.- 3 Management der Fehlstellung totalkondylarer Prothesen.- Allgemeine Bemerkungen.- Praoperative Planung.- Anatomische und klassische Resektion.- 4 Behandlung der Beugekontraktur.- Behandlung der milden Form der Beugekontraktur (Grad I bis 10 Grad Flexion).- Behandlung der mittelschweren Form der Beugekontraktur (Grad II zwischen 10 und 30 Grad).- Behandlung der schweren Form der Beugekontraktur (Grad III mehr als 30 Grad).- 5 Behandlung der Extensionskontrakturen.- Chirurgisches Vorgehen.- 6 Management der Varusfehlstellung.- Management der leichten Varusgonarthrose.- Management der massigen Varusgonarthrose.- Management der schweren Varusfehlstellung.- 7 Management der Valgusfehlstellung.- Behandlung der extremen Valgusfehlstellung mittels Korrekturosteotomie.- 8 Management der aseptischen Prothesenrevision.- Praoperative Planung.- Zugangswege bei Revision.- Entfernung der alten Implantate.- Technik der aseptischen Kniegelenksrevision.- Anhand des Kniesystems Wallaby III soil die Technik der Revisionsoperation erklart werden.- 1. Standardisierte Operationstechnik unabhangig vom Knochendefekt.- 2. Die Wiederherstellung der ligamentaren Stabilitat.- 3. Wiederherstellung der knoechernen Integritat.- 4. Sichere Fixation der femoralen und tibialen Komponente.- Klinisches Beispiel.- 9 Management der septischen Prothesenrevision.- Klassifikation und Ursachen.- Wundheilungsstoerung/oberflachlicher Infekt.- Der Fruhinfekt.- Der Spatinfekt.- Der zweizeitige Wechsel.- Der einzeitige Wechsel.- Wahl des Implantates.