Charles T. Price, editor. Rosemont, Illinois: American
Academy of Orthopaedic Surgeons; 2000. $120.00 (members)
or $150.00 (nonmembers), 702 pp.
The Annual Meeting of the American Academy of Orthopaedic Surgeons
that was held in February 1999 offered 211 Instructional Courses
and Lecture Demonstration Courses, with 711 individual lectures.
From these, Price selected sixty-six topics for this volume.
The text is impressive with regard to its scope, the intellectual
and experiential heft of the authors, and the meticulous and attractive
presentation of the material. The first and longest of the twelve
sections focuses on adult hip reconstruction and contains seventeen
chapters, all of which are devoted to difficult salvage problems.
Many of the authors of these chapters have been major contributors
to the science and art of total hip arthroplasty. Subsequent sections
are devoted to the knee; arthroscopy of the wrist, elbow, and ankle;
trauma; and disorders of the upper extremity. There is also a cogent
section on degenerative disease of the cervical and lumbar spine.
Orthopaedic oncology is discussed in terms of both soft-tissue
and metastatic tumors. The complication of infection is considered
from the standpoints of the emergence of multiresistant pathogens
and contemporary issues regarding the human immunodeficiency virus
and the surgeon’s risk of occupational transmission. Degenerative
arthritis is presented in a multifaceted fashion over its entire
spectrum, from prevalence and pathogenesis to the use of oral glucosamine
and chondroitin sulfate and the intra-articular injection
of hyaluronic acid. The discussion of preoperative planning
for correction of deformity and limb-lengthening with use of external
fixators is succinct and clear.
The final sections are devoted to pain management with use of
both orthodox methods (such as administration of opioids via various
pathways) and alternative modalities (such as hypnosis, electromagnetic
fields, and acupuncture), an illuminating and compelling discussion
of orthopaedics in developing countries, the ethical aspects of orthopaedics
(including the teaching of ethics in a residency program), and the
development of orthopaedic critical pathways. The text concludes
with a cumulative index of the Instructional Course Lecture volumes
from 1997 to 2000, which is so detailed that it encompasses over
fifty pages.
As a resident decades ago, I learned to value my attendance at
the Instructional Course Lectures and my subsequent reading of the
lectures that were selected for publication. Instructional Course
Lecture presenters and authors are not limited merely to their own
experience or to that of a single institution; rather, they typically
synthesize the best and freshest information and knowledge on a
narrow subject from diverse sources. This is a continuing characteristic,
as evidenced by the plethora of references cited by these authors;
many chapters contain over 100 citations. I have come to believe
that the presence of three or four other experts on an Instructional
Course Lecture panel served as a check on the potential presentation
of hyperbolic blarney. That rein is certainly noticeable in the
current collection and is due in large part to the editorial direction
of Dr. Price and the durability of the printed word.
The extensive use of tables, illustrations, and figures serves
to amplify and emphasize the salient points covered in the text.
The 2.2-inch-wide, three-column format is easy to read. The visual
impact is further enhanced by the inclusion of a CD (compatible
with recent configurations of Windows and Macintosh systems), which
provides video supplements for eight of the chapters.
In summary, this volume of lectures is pertinent, current, and
practical. It will appeal to orthopaedists across many categories
of age, specialty, and academic involvement. The Instructional Course Committee,
which set the stage for this volume, and the authors, editor, and
staff, who delivered it to the fellowship from the spoken to the
written word in less than eighteen months, are to be commended for their
effort.
William J. Kane, MD, PhDMinneapolis Orthopaedic and Arthritis Institute
Minneapolis, Minnesota