Geriatric Orthopaedics: Rehabilitative Management of Common Problems, ed 2.

Geriatric Orthopaedics: Rehabilitative Management of Common Problems, ed 2

Goldstein TS. Gaithersburg, MD 20878, Aspen Publishers Inc, 1999, hardcover, 381 pp, illus, $55.

This text is a comprehensive overview of orthopedic problems common to geriatric populations. The text begins with an excellent chapter entitled "The Aging Human," which discusses different aging theories, including genetic, damage, and gradual imbalance theories. This chapter also covers the influence of aging and hypokinesis on function of the older individual, including balance, strength, and other elements of activities of daily living, and it emphasizes the role of exercise in dealing with aging.

Following this initial chapter and a basic introductory chapter on evaluation and treatment, a series of 14 chapters provides an in-depth presentation of orthopedic problems and their treatment for the major joints of the body tie, hip, knee, ankle and foot, spine, shoulder, elbow, and wrist and hand) Each joint is covered in 2 chapters; the first chapter presents the basic anatomy and kinetics of the joint, and the second chapter presents common orthopedic problems, including fractures, joint injury and inflammation, and other soft tissue problems. Surgical and nonsurgical management is discussed, followed by clinical management options. The hip and knee chapters stand out with their excellent overviews of the respective joint replacement (arthroplasty) approaches. An interesting section of the second hip chapter (chapter 4) discusses the evolution of total hip arthroplasty, how the durability of total hip arthroplasty has increased to 15 years, and the role that effective clinical management and rehabilitation has played in advancing this durability. The presentation of the surgical techniques makes the understanding and utilization of the rehabilitation approaches that the chapter describes much clearer.

All of the treatment chapters are well organized and easy to follow, and they contain good examples and provide excellent graphic elements, which cover subjects such as treatment programs and exercise sequences. An example of an effective graphic is the table entitled "The Etiology and Treatment of Toe Deformities." This table presents, in an easy-to-reference manner, a description, etiology, and treatment of each problem, including a drawing of the respective pathology.

The final chapter, "Balance Interventions for the Orthopaedic Patient," is a new addition to this edition. It is a very timely and well-written chapter and includes several balance assessments and contemporary treatment approaches for balance dysfunction.

The short section the author includes with each treatment chapter entitled "Documentation Tips" is an effective and unique element of the text. Each of these brief sections addresses an aspect of documentation (eg, dos and don'ts of documentation, descriptions of skilled treatments, common buzzwords). Each section is less than a page long, but it is supported with an example that reinforces the need for accurate and complete documentation.

Overall, the text is well organized and it reads easily. It is supported by excellent graphic elements and includes comprehensive references. Clinicians will find this an excellent resource whether new to or experienced in the clinical management of orthopedic problems in geriatric populations. Although the text would be a useful reference source for use in orthopedic courses for physical therapist and occupational therapist students, its use as a course text is limited. This book, like many textbooks, is filled with tremendous quantities of information, but it offers little opportunity for the student reader to integrate and apply the material presented. Although this may limit the use of the book as a means to encourage higher order learning, its value as a clinical reference is outstanding.

Charles J Redmond, PT, ATC
Springfield College
Springfield, Mass

Mr Redmond is Chair of the Department of Exercise Science and Sport Studies and teaches in the Physical Therapy Program. He is a consultant physical therapist for the Visiting Nurses Association of Western New England.3