John N. Insall and W. Norman Scott, editors. With illustrations
by Christopher Wikoff. New York: Churchill Livingstone; 2001. 2028
pages. $395.00.
This comprehensive and authoritative work consists of ninety-five
chapters presented in two volumes and supplemented by an interactive
CD-ROM. Of the more than 150 authors, many are important contributors
to our current understanding of normal knee function and are innovators
in the treatment of the wide variety of disorders that affect this
joint.
An emphasis on organization and attention to detail is evident
throughout this book. The chapters are clearly written and provide
extensive and timely reviews of the literature. The text is enhanced
by the many high-quality figures and illustrations, which are especially
useful in the chapters on anatomy, imaging, clinical diagnosis,
surgical exposures, and operative techniques. Tables presented throughout
the text effectively focus on the major points of each chapter.
Essentially, every aspect of the operative treatment of knee disorders
can be found in this text.
The first volume reviews basic-science issues, clinical examination,
radiographic evaluation, and the treatment of disorders of the articular
cartilage, meniscus, ligaments, and extensor mechanism. The sections
on basic science and biomechanics cover normal and abnormal knee
anatomy and are supplemented by color figures and videos on the
CD-ROM. Though somewhat difficult to navigate initially, the format
of the CD-ROM is intuitive and, once mastered, is well worth the
effort. It provides an abundance of high-quality clinical and basic-science
photographs, videos, and color figures. The videos that complement
the chapter on surgical exposures are clear and will be useful to
those who do not perform these approaches on a regular basis. There
is an excellent chapter on knee neurophysiology, which is especially
relevant given the current emphasis on accelerated rehabilitation
following knee surgery. The section on articular cartilage injuries
covers the myriad of treatment options, including arthroscopic débridement,
microfracture, the paste-graft technique, mosaicplasty, and autologous
chondrocyte implantation, as advocated by surgeons who have had
extensive experience with these procedures. Similar detail is found
in the chapters on osteochondritis and osteonecrosis.
Arnoczky and Bullough contribute a comprehensive chapter on ligament
and meniscal healing, which is followed by chapters on current techniques
for meniscal repair and the restoration of meniscal function. The
chapters on the evaluation and surgical treatment of cruciate ligament
injuries provide practical, clinically useful information for surgeons
at a variety of levels, ranging from residents and students who
may not be familiar with a specific procedure to experienced knee
surgeons. Multiple techniques for revision anterior cruciate ligament
surgery are presented in a "How I Do It" chapter
that contains many technical pearls.
The second volume includes chapters on pediatric knee disorders,
fractures, and neoplasms about the knee. The chapter on normal and
pathological conditions of the synovium is easy to read and provides as
complete a discussion of this subject as I have seen. Most of this
volume, however, addresses the treatment of patients with arthritis.
Osteotomy and total joint arthroplasty are covered extensively;
virtually every aspect of patient care related to these procedures,
including patient selection, preoperative planning, component selection
and design, transfusion, prophylaxis for deep-vein thrombosis, and
complications, is presented in detail and without bias. I especially
enjoyed the chapter on the prevention of deep-vein thrombosis, in
which a clearly organized framework for comparing the efficacy of
the various treatment options is distilled from a massive body of
clinical and basic-science reports. Six different approaches to
revision total knee arthroplasty, each with a different clinical
scenario, are presented in a "How I Do It" chapter.
This book is destined to become a classic in the field. It provides
exposure to the type of expert insight that, up to now, was available
only to those undertaking postgraduate fellowship training in knee
surgery, and it offers something for everyone who aspires to care
for patients with knee disorders. This high-quality work will continue
to be a valuable reference for orthopaedic surgeons, residents, and
fellows for years to come.