The Arthrodesis in the Restoration of Working Ability. Edited by George Chapchal. Acton Massachusetts Publishing Sciences Group Inc 1975. 233 pagesкод для вставкиСкачать
652 the knee, hemophilia, and juvenile rheumatoid arthritis. The remainder of the book is devoted to topics of orthopedic interest that are not directly related to arthritis. Before making a few specific comments, 1 will describe the book in general. It is one of a series of volumes that have been published at intervals since 1964. Each volume is devoted to a few selected topics. The editor chooses his experts who, in turn, approach the topics from various points of view. A contributor may dwell on new developments as adopted in his own current practice. He may present a status report of practice techniques, most of them tried and true, or summarize a disease or condition in which, apart from the orthopedic problems, systemic manifestations and pathology properly belong to a specialty other than orthopedics. The three chapters that would interest a rheumatologist fit the above tripartite scheme nicely. First, total arthroplasty of the knee, the current frontier of orthopedic surgery, is dealt with in a series of four subchapters on different models of devices being used; a discussion of several additional models follows. The emphasis is on the devices being developed. A chapter on hemophiliac patients, who often offer the orthopedic surgeon challenges in rehabilitation, describes those newer developments in the replacement of clotting factors that provide greater opportunities for orthopedic surgery. The surgery is standard, but mostly previously impractical because of now avoidable bleeding problems. The chapter on juvenile rheumatoid arthritis is a short summary of the disease as the pediatrician sees it, of the conservative therapy given by the orthopedist in children, and of the long-term sequelae amenable to orthopedic treatment in the adult. Of the three chapters, the one on total knee arthroplasty seems to be the most valuable for obvious reasons: Knee problems are so frequent in arthritis patients, and arthroplasty is in such a dynamic state of development, that nearly everyone should be interested in a report of the current state of the art. Although all the experts provide extensive technical discussions of the engineering of the devices, manner of application, and advantaBes over other devices, the rather summary descriptions of in-service performance reflect the relatively short (5-year) developmental history. Relatively few cases are described by the authors, and all of them are from large medical centers where the procedures have been developed. In each article about 100-200 cases are mentioned; for comparison, the same centers could easily have reported 1000 cases of total arthroplasty of the hip. Obviously total knee arthropArthritis and Rheumatism, Vol. 19, No. 3 (May-June 1976) lasty is not a routine operation and, if the experts are reluctant to widen its application, the technique must not be ready for even occasional use. Perhaps the reasons for this reluctance are that the indications are not yet clearly delineated, that the complications are too frequent, and that the proximity of the prosthesis to the skin and sensitivity of the knee to minor malalignment present too great a danger. These subjects are not discussed, but they may not be relevant to the purposes of the book. Whether the book can be recommended to an audience wider than practicing orthopedic surgeons is questionable. Certainly it is a good account of current practice, with the reservations mentioned. And certainly it gives summaries of developments by experts who are relieved of the constraints of documentation demanded in articles in medical journals. Finally it has the great virtues of easy readability, up-to-date references, and brevity. JONATHAN COHEN, M.D. Kennedy Memorial Hospital for Children 30 Warren Street Brighton, Massachusetts 02135 The Arthrodesis in the Restoration of Working Ability. Edited by George Chapchal. Acton, Massachusetts, Publishing Sciences Group, Inc, 1975. 233 Pages. This compact volume contains over a hundred short contributions by a variety of continental authors, all focused on the subject of arthrodesis of major and minor joints. In general the subjects are well defined from the standpoints of indications, biomechanical effects, and techniques, including some recent additions using A.S.I.F. instrumentation. All joints of the upper and lower extremities are covered, with special attention to the hip and knee, and there is a particularly thorough exposition of problems of arthrodesis of the spine. Because the conference on which this book is based was as least in part directed toward rehabilitation of the injured working man, considerable attention is paid to restoration of employability and functional use of the extremities for the purposes of insurance evaluation. Parts of the book are highly technical with many details provided for operative procedures. There are some end result studies included, and although some of the chapters include a number of references, many do not. Arthrodesis of the extremities is not a common orthopedic pr,ocedure in the United States today; many 653 of the procedures described are rarely if ever performed in this country, except in very specialized centers. The details of the operative procedures are of some interest, and as such, certain chapters would be of some value as a manual for the reconstructive orthopedist or for someone who deals with late effects of trauma. There are too few end result evaluations to judge the quality of some of the operative procedures described. The information related to workmen’s compensation is of value to industrial surgeons. Although the book does not have widespread appeal, it may prove a valuable addition to orthopedic libraries, particularly those in centers that deal with a large volume of reconstructive industrial orthopedics. The book is generally well illustrated and the translation from the original language is for the most part quite good. HENRYJ . MANKIN,M.D. Chiex Orthopaedic Service Massachusetts General Hospital Boston, Massachusetts 021 14 Rheumatology. An Annual Review. Vol. 6. Immunological Aspects of Rheumatoid Arthritis. J. Rotstein (coordinating editor); J . Clot and J . Sany (volume editors). Basel, S Karger A G , 1975.368 Pages, 86 illustrations. Price: $61 S O . This volume represents the reports of the International Symposium on Immunological Aspects of Rheumatoid Arthritis, which was held in Montpellier, France, in March 1974. The meeting was sponsored by the Socittt franqaise de Rhumatologie and the Institut national de la Santk et de la Recherche mtdicale. The book, published as an Annual Review of Rheumatology, not only reflects the thinking of senior investigators in a variety of areas, but also serves as a vehicle for the Arthritis and Rheumatism, Vol. 19, No. 3 (May-June 1976) factual updating and collating of opinions in the area of immunologic aspects of rheumatoid arthritis. Although all of the presentations are not of equal quality, by and large the volume is outstanding. The presentations are succinct and the discussions give a good perspective of the field. A variety of topics on rheumatoid disease are discussed, including immune complexes, complement, T and B cells, experimental models, and infectious agents. That a book of only 368 pages embraces such a broad scope of topics clearly suggests that much material is touched only superficially. Nevertheless the summary of each paper and the authoritativeness with which each topic is approached add much and make the book a worthwhile addition to the library of any rheumatologist or clinical immunologist. J . CLAUDE BENNETT,M.D. The University of Alabama in Birmingham University Station Birmingham, Alabama 35294 BOOKS RECEIVED Disorders of Connective Tissue. Daniel Bergsma, Editor. Stratton Intercontinental Medical Book Corporation, 381 Park Avenue, New York, N . Y . 379 pages. Price: $16.95. Rheumatologie fur die Praxis. H . J . Albrecht. S. Karger AG, Arnold Bocklin Strasse 25, CH-4011 Basel, Switzerland. 284 pages. Price: approximately $1 9.00. Surgical Management of Degenerative Arthritis of the Lower Limb. Richard L. Cruess and Nelson S. Mitchell. Lea & Febiger, 600 Washington Square, Philadelphia, Pa. 236 pages. Price: $22.00.