The formation of this large, two-volume text was coordinated by four
knowledgeable and insightful editors who, in a very well-organized manner,
have displayed the work of more than sixty contributors. The editors'
intention was for the book to be an all-inclusive text, and they have largely
succeeded. In addition to supplying a tremendous amount of information, the
book contains extensive scientific referencing, which makes it a useful
resource for further in-depth study of any topic of interest with regard to
the shoulder. The production quality is excellent, with extensive use of line
drawings to accurately display structural details and concepts.
The initial three chapters on anatomy and related topics are almost a
subtext in and of themselves. They are so well done and so informative that
they alone are worth the purchase of the book or the retrieval of the book
from a library for specific study of these chapters. A related chapter on
biomechanics complements these chapters nicely. A concentrated review of these
chapters will make one a better shoulder surgeon—guaranteed.
In the book The Shoulder and Neck, published in 1972, James Ennis
Bateman endeavored to organize the current-day thinking about patterns of
clinical presentation of patients with shoulder difficulties. The result
proved to be a useful way for clinicians to shape their thoughts about their
patients. In the chapter on clinical assessment, the Rockwood text offers some
new insight and details into this patterning of clinical presentation that
clinicians will find refreshing and useful in practice. Imaging has always
been an interest of the senior editor, and the chapter on radiographic
evaluation displays in full detail the historical development and variations
of plain radiologic techniques. This information, of course, should not be
forgotten. There is not much information on cross-sectional imaging,
particularly on magnetic resonance imaging, and it would be hoped that any
subsequent editions of this book would include a substantive section about
these new advances in our ability to understand anatomy and structural
changes.
The authors have included a chapter on anesthetic techniques, with focus on
the interscalene brachial plexus block supplemented with a cervical plexus
block. This technique has dramatically improved the experience of patients
undergoing shoulder surgery, and it is increasingly being adopted throughout
the orthopaedic surgical world. Postoperative pain is well controlled by use
of the block. This is one of the major advances in shoulder surgery, and I am
glad it was not overlooked in this all-inclusive text.
Shockingly, arthroscopy receives only seventy pages of this 1417-page text,
but fear not—this succinct chapter is an outstanding overview of the use
of shoulder arthroscopy. Additionally, arthroscopy is mentioned in the many
chapters on specific subjects, perhaps not in as much detail as one would
wish, but it is still there. I think all of us will appreciate, enjoy, and be
informed by the short chapter that is included.
The three chapters on fractures impart classic knowledge, such as how to
evaluate and classify, and they supply information about well-accepted,
commonly used treatment methods and outcomes. There is little information
given about recently introduced advanced technologies, including the use of
blade plates, locking plates, or the more complex intramedullary devices for
proximal humeral fractures. The reader will be impressed, however, by the
detailed analysis provided in Chapter 10, relating to the improved
understanding of complex scapular fractures. The chapters on fractures of the
clavicle, disorders of the acromioclavicular joint, and the sternoclavicular
joint carefully define the problems, display the negatives that have resulted
from many types of treatment options, express a clearly worded philosophy, and
remind us that we are all a bit unsettled about how to consistently accomplish
excellent and effective treatment for these areas when they are injured.
As one would anticipate, there are major chapters on instability,
rotator-cuff-related problems, and shoulder arthritis. Appropriately, the
material on instability emphasizes how complex a subject this is and how great
are the advances that have been made in understanding shoulder instability
over the last decade-plus. The overview on rotator cuff problems is thought
provoking. Most surgeons who treat rotator cuff problems are very happy in
treating the midrange of the spectrum of these problems, as treating the
smaller and the extra-large problems can be difficult. The authors have
organized the information on this subject in such a way as to help us in our
decision-making about these more extreme variations in the pathologic process.
If the goal of the reader is to understand the current state of affairs in
shoulder arthroplasty, the chapter on glenohumeral arthritis is the one to
read. Although it is a bit disjointed in its attempt to incorporate new topics
with topics from past editions and in its inclusion of segments on shoulder
arthrodesis, it certainly is all-inclusive of the basics as well as the
nuances of treatment, as developed through scientific studies. Complications
of arthroplasty are summarized, and revision surgery is mentioned. I suspect
that these segments of the chapter will be greatly expanded in future editions
of the book as we slowly gain a better appreciation of the details surrounding
these aspects of shoulder arthroplasty.
By virtue of being a large and comprehensive textbook, The
Shoulder offers a number of chapters that readers will appreciate,
containing information that is not easily accessed elsewhere. These chapters
cover problems with specific nerves; the science underlying calcific
tendinitis; the comprehensive but slightly tongue-in-cheek review of biceps
problems; a thorough analysis of the stiff shoulder; a display of information
on rather rare muscle ruptures; a wonderful overview of shoulder tumors, aimed
at the non-oncologist (with clear reference as to how the reconstructive
techniques used after tumor resection can be applicable to severe trauma or
failed arthroplasty); the basic science behind sepsis; detailed information on
techniques for amputations and the use of orthotics and prosthetics; an
approach to shoulder problems from a sports perspective and also from the
perspective of those who treat children; occupational-related issues; and,
importantly, a thorough review of treatment evaluation methods.
I anticipate that most surgeons who have a sincere interest in treating
shoulder problems will want to have this book on the shelf. In addition,
orthopaedic departments will wish to have this book in their libraries for use
by staff members who treat shoulder problems less frequently and for the
education of residents and fellows. Broad-based practitioners will find this
text useful because of its thoughtful review of contemporary thought as well
as its information on rarer conditions, which is hard to find in a collective
way elsewhere. Congratulations to the editors and authors for a job well
done.