An Illustrated Guide to the Knee.

An Illustrated Guide to the Knee

Tria AJ, Klein KS New York, NY 10011, Churchill Livingstone Inc, 1992, hardback, 168 pp, Illus, $59.95.

The authors' purpose for creating this text is to present, in one concise text, all of the basic facts related to the knee joint. Their intended audience is orthopedic residents and attending physicians. One of the problems with attempting to summarize the tomes of work already published on the knee is deciding what to leave out and how to describe simply that which is complex. I believe the authors were only partially successful in their effort to do this, making this book less than adequate for the orthopedic resident.

The text is divided into 13 chapters, which cover such topics as anatomy; embryology; biomechanics; and physical examinations, including roentgenographic techniques, surgical approaches, fractures, arthritides, congenital and developmental anomalies, tumors, and infections. The narration is well written and concise and is complemented with numerous line drawings, illustrations, and occasional pictures of radiographic images. One of the nicest features of this text is that most of the figures appear on the same page as, or the page facing, the text to which it refers--a task difficult to achieve when there are so many accompanying illustrations. The illustrations that depict the clinical stress tests are particularly well done, giving the reader a good sense of the direction of the applied forces and structures being tested. Including separate chapters on knee ligaments, the menisci, and the patella allowed the authors to expound on some of the special problems associated with those structures. In the nicely organized chapter on ligaments, common ligamentous tears are addressed succinctly in a clinical presentation, diagnosis, pathology, and treatment format. Each chapter concludes with a list of suggested readings, which have sources and major references highlighted. The index assists the reader in locating specific topics, as well as the figures or tables that go along with the information. Overall, this book is beautifully bound and logically sequenced, with the most important material dominating the pages.

The authors have missed the mark, however, in trying to keep their text brief. Unfortunately, it is brief to the point of being almost non functional. The chapter on roentgenographic techniques, for example, seems to be dominated by use of x-ray films for viewing the patella, with very little attention given to the indications and interpretation of computed axial tomography scan, magnetic resonance imaging, or other techniques. Another example is the chapter on surgical approach, in which the coverage on arthroscopy is limited to just a few lines.

I also found several errors or misconceptions throughout the text. On page 35, for example, the authors state that "as the knee enters full extension, the popliteus and the iliotibial band encourages external rotation." I could not verify this statement as it was not referenced, but I have always understood the popliteus to be a knee (tibial) medial (internal) rotator. On page 91, the authors suggested that the medial meniscus had no ligamentous attachments, which is not true. In the biomechanics chapter, the authors addressed the concepts of viscosity and fluid mechanics in terms that are too simplistic to be of any value. Their coverage of joint lubrication in relation to menisci was similarly simplistic in approach. Also, at times, the authors used terms that they did not define (ie, ,hoop stress"), rendering some concepts less useful.

As I conclude this review, I must ask myself if the shortcomings of this text could result in a poor clinical judgment. I would have to say, no; however, I still cannot recommend this book. Orthopedic residents and physical therapy practitioners need much more information than this book provides. The attending physician might benefit from the chapters on physical examination, ligaments, menisci, and the patella, but, for the price, more complete books on the knee are available.

Gordon J Alderink, PT Grand Valley State University Allendale, Mich 000125687532 08443AUG0092HTGQ0620

This book proves to be very handy. It was written in a collaborative effort by Pathfinder Resources and the Coalition for Children with Special Needs, based in St Paul, Minnesota. Pathfinder Resources works to promote the health and wellbeing of children and adults who have chronic health conditions. They seek to improve existing services and to make consumers, families, and professionals aware of available options. This book is a fine example of accomplishing those goals, and it is done in just the right number of pages.

This book is concisely written and is organized in a helpful manner. Using common language and gentle statements about sometimes quite emotional topics, the book covers the following topics: (1) how to get the best health care for your child, (2) ideas for working with your own feelings, (3) paying for your child's health care, (4) where to go for further help, and (5) special resources for your child. Each topic is initially explored by stating and defining benefits as they are customarily provided. The information is then expanded upon to help the reader understand his or her own unique situation and to provide ways to clarify the more nebulous aspects of it. More helpful information in small, digestible increments is then provided to assist in the handling of respective problems. Suggestions that are listed include how to become more assertive and informed.

The book ends with avenues that go beyond the usual offerings, giving hope that persistence and networking will lead to support that is well deserved.

This book would prove to be useful to any family or individual who is in a situation requiring extended health care services. Physical therapists would be wise to invest in this book so they could pass valuable information along to such families and individuals.

Janet Sternat, PT River Falls, Wis