Fundamentals of Orthopaedic Biomechanics.

This textbook is an attempt to "teach the orthopaedist, resident, physical therapist, and other health professionals the way in which the musculoskeletal system, and the implants that are used to replace or support it, are affected by forces." Since biomechanics is the study of the effect of forces on biological systems, this book presents engineering principles that can provide readers with skills necessary for determining treatment choices that are based on these constructs. The authors attempt to present only first principles and provide numerous examples to aid in the clinical application of these principles.

The book is divided into seven chapters. Chapters 1 through 3 deal with fundamental mechanics related to the application of forces throughout the musculoskeletal system. Chapters 4 through 6 introduce mechanical behavior of various tissues that are present in the musculoskeletal system, and chapter 7 discusses the performance of implant systems. In each chapter, the authors introduce biomechanical concepts in a specific clinical context. In this way, the reader is not overwhelmed by definitions and mechanics in an abstract setting. The inclusion of 125 figures allows the reader many opportunities to visualize difficult concepts. In later chapters, as mechanical principles of materials are addressed, artistically shaded three-dimensional pictures provide excellent visual aid.

The use of clinical examples is a great asset of this text. Forces and moments, for example, introduced in chapter 1, are discussed in terms of the forces necessary to maintain static equilibrium when the shoulder is abducted at 90 degrees. Lines of force are illustrated, and calculations of the forces and moments are demonstrated. This discussion is then extended to introduce dynamic equilibrium problems.

The extensive coverage on mechanical behavior of bone and artificial materials is well presented. There is ample discussion of measurement techniques that are commonly used to test the stress and strain capabilities of materials that undergo physiological loading. Concepts such as modulus of elasticity and rigidity, hysteresis, and Poisson's effect are introduced and used immediately to demonstrate their clinical importance. The authors appear to be well versed in the most recent literature describing new ideas about implant technology and science.

In summary, I found this book to be well written, generously illustrated, and very clinically applicable. The book should appeal to a variety of readers. First and foremost, it would make a valuable textbook for students interested in expanding their knowledge of orthopedic biomechanics. Also, the book should be of value to the generalist physical therapist and occupational therapist working with orthopedic patients where an understanding of the biomechanics of the muscu-loskeletal system and implants can, and often does, play an important role in treatment strategies.

David A Brown, PhD, PT Palo Alto VAMC Palo Alto, Calif