By: 24 March 2011

This book is divided into three sections so that the reader begins with fundamentals of Orthopaedic Science incorporating cell and molecular biology, genetics and skeletal biomechanics. This escalates in the second section encompassing physiology and alterations in normal processes in disease and injury. The third and final section deals with basic advances which can be directly applied to and be appreciated in the newer treatments for degenerative, inflammatory, auto-immune and metabolic conditions with updates on biological responses around implants and prosthesis.

Agreed that the first section is bereft of the usual joy experienced unlike when eschewing clinical sections. Nonetheless the authors have attempted to liven up the drab areas of medicine most important yet the least joyful to leaf through. Genetic basis of common conditions and their orthopaedic manifestations are succinctly described and for those hard-pressed for patience have been tabulated in a neat format for easy reference.

The newer concepts in joint biomechanics and biomaterials have been well elucidated apart from basic concepts which have remained the same. Plenty of diagrams and logically inserted graphs make the understanding easy and revision of long forgotten basics a joy to revisit. The updates on ceramics and polymers are informative and though not exhaustive give us a bird’s eye view of the biomaterials currently available. A good attempt has been made to explain statistics in Orthopaedics of more importance now than ever before for critical analysis of literature and confusing success stories of newer implants and prosthesis.

Clearly a detailed treatise on statistics is beyond the scope and requirement of this book, thus, the present offerings suffice. Growth and development of the skeleton is covered in depth with common affections of the skeleton and their effects on growth plate physiology. The form and function of the meniscus is a delightful chapter to read and incorporates the most recent knowledge unearthed in joint articular anatomy and physiology. Meniscus replacement and/or transplantation is at the orthopaedic doorstep and this topic is a must-read. Form and function of ligament and tendon is quite graphic, literally, and makes understanding of ligament and tendon injuries rather easy and interesting. No easy task this.

Coverage of Skeletal muscle physiology seems basic and informative yet seems lacking in depth. Recent concepts of muscle physiology need to be incorporated. Also, the change in structure and function in disease processes would have been most appropriate. Many immunohistochemical changes and the low-down on different classification systems of Fibre Type seem out of place. I found Kinesiology to be by far the most interesting topic in the book and the detailed description of wrist and spinal biomechanics is exceptional. Carefully inserted diagrams and graphs make relevant and interesting additions to the text. Suffice to mention that most necessary and comprehensive biomechanics principles have been delivered in a span of thirty interesting pages.

Infections in Orthopaedics seems to touch upon many of the dilemmas facing clinicians in daily clinical and occasionally confusing situation. The dummies guide to mechanisms of common antibiotics and mechanisms of antibiotic resistance is well elucidated in form of charts for easy recall and reference. Boon for the pharmacologically challenged amongst us! Viral disease transmission and the surgical setting is touched upon but would have benefited from detailing and depth.

The section on Orthopaedic pharmacology though attempting to touch upon a wide spectrum of applications famously fails to address in depth issues of glucosamine-chondroitin preparations, newer arthritis medications and Hyluronic Acid injections. A lot of confusing pharmaceutical and non-medical literature does the hospital rounds and it is difficult for even the most objective practitioner to ignore patient queries and apprehensions. Hopefully the authors would do well to impart more depth and science with evidences in the forthcoming editions.

Bone grafts and their substitutes are covered in adequate detail and readers will find the topic useful. Cartilage repair techniques make interesting reading and the section on evaluation of treatment outcomes is relevant after such surgically unpredictable procedures. The cartilage scoring systems tabulated can be actually photocopied and used directly in the OR.

Biologic response to orthopaedic implants is woefully inadequate in depth and needs to be covered in a more robust and clinically applicable format in future editions. I found the section on immunomodulation for Osteoarthritis and rheumatoid arthritis well covered and interesting perhaps because this chapter borders on clinical applications rather than stick to dry histopathology. Some sections in the book have been unnecessarily duplicated or similar topics grouped under different headings and sections. Yet due to the very nature of its coverage and the fact that most of basic science is well elucidated makes this book a good companion for the surgeon and student alike.

The DVD helped me to save space and weight. A hardbound cover would be ideal to keep this book in top shape as I found my book getting dog-eared as I went through it. A most apt book for your library.