This handbook for primary-care physicians is an excellent source of information on the essential facts about osteoarthrosis. Although this information is familiar to rheumatologists, orthopaedic surgeons will benefit equally from reading this text.
The book offers an impressive overview of the epidemiology of the disease. In particular, the issue of obesity is discussed, as is the fact that osteoarthrosis of the knee appears to be more common in very obese individuals. The references in this section should be reviewed by orthopaedic surgeons who perform total knee arthroplasty on extremely obese patients. The need to lose weight, to regain range of motion, and to follow a conditioning program are also discussed.
The book is divided into four parts. Part 1 consists of general information on the definition, classification, and pathophysiology of osteoarthrosis; the references at the end of each section are excellent. Part 2 covers methods for the evaluation of osteoarthrosis; the section on the pitfalls of diagnosis is very well written. Again, this is important information for practicing orthopaedic surgeons. Part 3 concerns the non-operative treatment of osteoarthrosis. Part 4 chiefly describes operative treatment, and there is a good discussion of the use and value of physical therapy and the advantages and disadvantages of different medications.
I strongly recommend that orthopaedic surgeons add the information presented in this excellent handbook to their knowledge base. Of particular importance are the sections on the use of various medications, the benefits of losing weight, and the value of a home-exercise program designed for the patient.
Leela Rangaswamy, M.D.
Deputy Editor
The Journal of Bone and Joint Surgery
Needham, Massachusetts