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Dr. MAQUET, the foremost disciple of Professor PAUWELS' and the
orthopae dic heir to the PAUWELS' concepts of osteotomy of the hip
for arthritis, has assembled in this one book the strongest and
most lucid contemporary statement of the principles and practice of
this very important school of hip surgery. Professor PAUWELS'
contributions to the understanding of the biomechanics of the hip
and to the concepts and execution of osteotomy of the hip for
arthritis are outstanding and timeless. With clarity, Dr. MAQUET
articulates this position and refines it further in the light of
his own investiga tion. While other investigators, of course,
differ on individual concepts or princi ples in this book or
disagree with specific positions, assumptions, or conclu sions, it
is clear to all that this book is a benchmark work. Dr. MAQUET, as
Professor PAUWELS always did, illustrates his text lavishly with
beautiful examples of individual cases illuminating the principles
ad vanced. But in addition, he has gone further and presents
long-term follow-up data, quantifying the results of these surgical
precepts as experienced in his own practice. It is a work that has
been long sought and is richly received. Boston, Massachusetts,
1984 WILLIAM H. HARRIS, M.D.
It is matter of some surprise that this treasury of information
concerning the centres of gravity of various parts of the human
body has remained hidden not only from the English speaking world
for obvious reasons, but also to some degree from the Ger mans
themselves. What is less surprising is t 1at this work is a
monument to the renouned German thoroughness as demon strated by
the relentless pursuit of data and the meticulous ac curacy of the
conclusions. However, these scientific investigations carried out
in Leipzig must be viewed in the intellectual climate of the time.
In the lat ter half of the nineteenth century, and later, Germany
underwent an intellectual explosion. It was the age of Rhumkorff,
Max Planck, the Weber brothers and Gottingen University. It was
said that science came to life during discussions on the train be
tween Gottingen and Berlin. So the scene was set and Braune and
Fischer made good use of it and fulfilled their role as mem bers of
the Royal Scientific Society of Saxony. When Pauwels (1935)
analysed the static and dynamic forces exerted on the hip joint
when standing and when walking, he needed data concerning the
centres of gravity of the human body and of its different segments.
I was faced with the same pre requisite when I studied the forces
acting on the knee (1976)."
Pathological conditions affecting the hip and knee joints occupy a
particular place amongst the important orthopaedic entities affect
ing the extremities. On the one hand they are relatively frequent
and on the other they mean for the patient limitation of his
ability to walk, because of their considerable detrimental effects.
A purposeful basic treatment of these joint diseases (and here
osteoarthritis takes pride of place) is only possible if it stems
from a reliable biomechanical analysis of the normal and
pathological stressing of the joint in question. Whilst the
situation in the hip can be considered to be fundamentally
clarified, a comprehensive representation of the knee is still
lacking, particularly when taking into account the latest knowledge
of biomechanics. Recently our concepts of the kinematics of the
knee have been completely changed, but the clinically important
question of articular stressing remains unanswered. Dr. Maquet has
carried out pioneer work in this field for some years in adapting,
by analogy, to the knee joint principles already accepted for the
hip joint. Since the knee is not a ball and socket joint, a
complicated problem arises for which new thoughts are necessary.
The results of the numerous operations carried out by Dr. Maquet
according to the biomechanical considerations demon strate that his
thinking is fundamentally correct. Above all, it is here again
proven (as earlier in the case of the hip) that healing of
osteoarthritis depends decisively on reducing and evenly dis
tributing joint pressure.
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