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BASIC ORTHOPAEDIC BIOMECHANICS. ED. 2. Edited by Van C. Mow and Wilson C. Hayes. Philadelphia, Lippincott-Raven, 1997. $89.00, 514 pp.

Scarcely seven years have passed since the publication of the first edition of this text. This new edition is a celebration of the rapid strides that have been made in our understanding of musculoskeletal biomechanics and in the design and evaluation of joint-arthroplasty components. The text has been carefully crafted into twelve very readable chapters, each with its own table of contents. The editors have enlisted the expertise and collective knowledge of scientists and engineers who are on the cutting edge of this advancing discipline. Despite the seemingly erudite introduction, this is a text primarily for students of the craft, and it will also be useful to scientists and surgical practitioners. Such versatility is testimony to the obvious efforts of the authors.

The first chapter deals with the fundamental concepts of biomechanics and with their numerous applications to soft-tissue and joint-loading conditions. The second chapter provides background information for an understanding of the kinematics and kinetics associated with locomotion as well as their clinical applications. The thread continues through a chapter dealing with the biomechanics of cortical and trabecular bone and their clinical implications, particularly with regard to skeletal fractures. The groundwork is thus laid.

Insight into the physiology of normal joint function as well as the pathophysiology of degenerative joint disease depends on an understanding of the mechanisms of load transmission across and through cartilaginous structures. The composition, mechanical properties, and material behavior of these structures are presented in a chapter that clearly represents a chronological advance in our understanding. The reader will gain compelling insight into the structure and behavior of cartilaginous tissues, which provide the surface for diarthrodial articulations and also are interposed between them.

Of collateral interest is a new chapter describing techniques for the quantitative prediction of the surface geometry of diarthrodial joints. The information in this chapter adds to our knowledge regarding the location of contact surfaces during joint function and will be helpful in the design of new implants.

Also new to this edition is a chapter on the physical regulation of cartilage metabolism. This chapter reviews the findings of numerous studies of the response of chondrocytes to different mechanical and electrical stimuli and discusses the influence of these stimuli at the molecular level, providing the reader with valuable insight into this exciting area of investigation.

Chapters on the structure and performance of the ligaments and tendons, the lubrication of joints, and the fixation of fractures provide a contemporary understanding of musculoskeletal behavior under normal and pathological conditions. An excellent appendix of understandable biomechanical definitions is included at the end of the chapter on fracture fixation. One of the most contemporary (and perhaps contentious) issues of our day pertains to our understanding of the complexities of the spinal column. The chapter dealing with this subject provides a mechanical, morphological, and clinical basis for a better understanding of spinal disorders.

The text ends with two extremely well written and informative chapters on the extensive role of finite element analysis coupled with in vitro experimentation in current investigations into the design and fixation of hip and knee implants. There is an excellent discussion of ultra-high molecular weight polyethylene wear as seen in retrieved knee components and of the lessons that have been learned by focusing on material processing and the in vivo alignment of these components. Lastly, the authors discuss the ability of contemporary knee simulators to predict in vivo wear performance accurately through material and kinematic alterations. These alterations bring simulated wear patterns closer to agreement with those observed in implants that have been retrieved. Such methods will be useful in optimizing the design of future implants.

This text should find a welcome place in orthopaedic and engineering libraries.

A. Seth Greenwald, D.Phil.(Oxon)

Orthopaedic Research Laboratories

Mount Sinai Medical Center

Cleveland, Ohio

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This Article Extract Full Text (PDF) Free Letters to the Editor: Submit a response Alert me when this article is cited Alert me when Letters to the Editor are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Rights and Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Greenwald, A. S. Search for Related Content PubMed Articles by Greenwald, A. S. Social Bookmarking                   What's this?

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