Joseph P. Iannotti and Gerald R. Williams Jr., editors.
Illustrations by Jennifer Smith. Philadelphia: Lippincott Williams
and Wilkins; 1999. 1141 pages. $295.00.
This book has sixty-one contributors and fourteen subsections
comprising thirty-eight chapters. The subsections address the topics
of rotator cuff disease, glenohumeral instability, frozen shoulder,
glenohumeral joint arthritis, fractures, the acromioclavicular joint,
the sternoclavicular joint, neuromuscular and scapulothoracic disorders, arthroscopy
and imaging, neoplasms, infection, rehabilitation, outcome measurement,
and pain management.
The overall quality of this book matches the excellence expected
from a major publisher. The illustrations, many of which are in
color, are voluminous and of high quality.
The organization of the individual chapters varies to some degree,
but overall the text flows with reasonable consistency. The bibliographies,
although not extensive in some chapters, are adequate and reasonably
(but not totally) up-to-date. The amount of space dedicated to each
topic, with the possible exception of arthroscopy, is apportioned
appropriately, reflecting the statistical importance as well as the
magnitude of each musculoskeletal problem.
The section on rotator cuff disease includes seven chapters covering
basic anatomy and function, management of intact and repairable
cuffs, massive tears, complications, calcifying tendinitis, biceps tendinopathy,
and traumatic muscle ruptures. The reader is easily guided to useful
information related to specific clinical problems. Although rotator
cuff disease is better addressed than it is in most other texts,
the tether to the concept of primary impingement pervades many chapters
in spite of increasing and strong evidence (some of which is cited
in this book) that the Neer theory of skeletal extrinsic impingement
is a minor statistical issue in the etiology of rotator cuff disease.
This unfortunate adherence to the past results in many recommendations in
the book for acromioplasty, which is usually unnecessary and is
sometimes harmful when the stabilizing effect of the coracoacromial
arch is compromised. Interestingly, different authors in the book
and, in one instance, the same author, take contradictory positions
with regard to acromioplasty compared with no acromioplasty or acromioplasty
followed by repair of the coracoacromial ligament.
The chapters on rotator cuff disease and biceps tendinopathy
also contain no specific reference to the histopathology of overuse
tendon failure, and the term tendinitis, rather than the more accurate,
up-to-date term, tendinosis, is scattered throughout some chapters.
Use of such inaccurate terminology perpetuates the erroneous concept
that tendinopathy is a primary inflammatory rather than a degenerative
process, again with major ramifications concerning treatment approaches.
The section on glenohumeral instability also consists of seven
chapters and, as in the chapters on rotator cuff disease, the reader
is easily guided to a specific topic or problem area. The traditional
open surgical approaches are covered thoroughly and accurately,
but the information related to contemporary arthroscopic techniques
and indications is limited and somewhat misleading.
The highlight of this book is the 150-page section on glenohumeral
arthritis, also covered in seven chapters. Although the evolving
and important concepts of arthroscopic approaches are absent, the discussion
on the principles of total arthroplasty is clear, concise, and outstanding.
Rather than adopting the approach taken in other books, in which
a technique for a specific prosthesis is touted, the authors provide
useful information that is applicable to all prosthetic devices,
including the more contemporary anatomical designs. Other strengths of
the book include a concise and helpful chapter on magnetic resonance
imaging and excellent sections on rehabilitation, outcome measurement,
and pain management.
In spite of the cited areas of concern, much of the information
in this text represents an advancement compared with that in similar
texts. As a basic, solid informational resource, this book is highly recommended.