E.C. Rodriguez-Merchan, N.J. Goddard, and C.A. Lee,
editors. Oxford, United Kingdom: Blackwell Science; 2000. 236 pages. $159.00.
This hardbound text is the most comprehensive work to date on
musculoskeletal disease and its management in patients with hemophilia.
With the exception of a brief description of the diagnosis and management
of inherited bleeding disorders, the entire text is devoted to the
management of musculoskeletal problems, and it covers the full gamut
seen in a comprehensive hemophilia center. Most chapters contain
a good description of the literature to date as well as the authors’ experience
and current recommendations. The text is well illustrated,
but not excessively so. The material is well referenced.
The authors recommend a very cautious and conservative approach
to surgery, especially total knee replacement, in patients who are
positive for the human immunodeficiency virus. This approach is
probably more conservative than that used at many centers in the
United States as a result of improved medical management of these
patients.
The four chapters dealing with hemophilic pseudotumors are especially
comprehensive. Nonoperative management is also well covered, with
the possible exception of radiosynovectomy. The chapter on the safety
of this procedure is excellent, but the overall discussion of the
topic is limited given its wide utilization currently in the United
States.
There is a unique and particularly valuable chapter on patient education
for musculoskeletal care and preparation for joint replacement that
presents the authors’ discussion guidelines and protocol
in detail.
The importance of caring for patients with hemophilia at multidisciplinary
hemophilia centers is emphasized.
In summary, this text is highly recommended for orthopaedic surgeons
as well as physiotherapists, hematologists, hemophilia nurses, and
other members of a treatment-center team. Although some sections
are controversial, the material is thoughtfully presented.