Ripley J. Williams and David P. Johnson, 553 pages, Oxford University Press 2004 ISBN 0-19-852066-2
In the series Controversies in Orthopaedic Surgery, there are already volumes published concerning hip surgery and total knee replacement. After dealing with knee replacement in the last volume, this edition is called Controversies in Knee Surgery and is intended for anyone interested in knee ligament problems and surgery of the meniscus and articular cartilage.
Of the 31 chapters, 16 deal with the anterior cruciate ligament (ACL), while the posterior cruciate ligament is dealt with in no more than 3 chapters. This, of course, reflects the incidence of lesions of these structures and—related to this—the interest of the orthopedic world and the number of studies of the anterior cruciate ligament relative to those of the posterior. The information about ACL surgery is extensive, with a detailed discussion of almost every aspect, but with the exception of computer-assisted surgery.
About one-third of the titles of the chapters end with a query, e.g. “What is the natural history of ACL injury in the athletic individual? “ The authors try to give answers in clear and up-to-date texts, which are unfortunately not always well illustrated. 7 chapters have no illustrations. It is a pity that all figures are in black and white, especially when arthroscopic pictures and histological specimens are shown.
The list of more than 50 contributors, all of whom are experts in their field, is impressive and the fact that most of them come from both Europe and North America produces a well-balanced text. From the index, it is clear where to find the subject you are looking for, but you can also rely on the title of the chapter. The reader can often make his/her own conclusions from the information and is not forced to arrive at only one possible solution to a problem.
This book contains an enormous amount of well-referenced information, often discussing the problem and giving a recommendation rather than producing a dogma. Sometimes there are duplications, e.g. of the anatomy of the posterolateral corner, with the same illustrations being used in two successive chapters. On the other hand, it is good to notice that clinical examination of the posterolateral corner, the “dark side of the moon”, is given enough attention.
The text on meniscal surgery is restricted to allograft transplantation, but well written by the acknowledged experts on this subject. Apart from surgical indication and operation details, much information about transplantation and preservation is given. However, in a book on controversies surrounding knee surgery, a chapter on the use of meniscal repair would have been useful.
There are 3 chapters on articular cartilage injury, dealing with microfracture, autologous chondrocyte transplantation and fresh osteochondral allograft transplantation, which have been written by the advocates of these techniques. Mosaicplasty is mentioned only briefly in one of the chapters—with more words on its limitations than on its advantages. It is at this point that there is too little controversy discussed, although the editor allowed one of the chapters to be followed by a page of “Editor's Questions”.
The last part of the book discusses complex knee injury, and tries to answer the question: “Is it best to surgically address all injured ligaments in the acute injury period, the use of when should osteotomies be used in complex instabilities and shojld simultaneous reconstructions of ACL and PCL be performed? For the knee surgeon, this work can be considered as a reference which pays more attention to the treatment of ligament problems than to the meniscus and articular cartilage injuries.
Rien P. Heijboer
Department of Orthopaedics, Erasmus Medical Centre Rotterdam, The Netherlands