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Doody's Review ServiceReviewer: B. J. Manaster, MD, PhD (University of Utah School of Medicine)
Description: This book is designed by its author, an orthopedic surgeon, to introduce both radiologists and orthopedic residents to the imaging of orthopedic hardware. The book has relatively little text, as it is presented mainly as an atlas.
Purpose: The purpose is to present the basic information on orthopedic hardware that is necessary for an understanding of language, mechanics, and cooperation between orthopedic surgeons and radiologists. This is a worthy objective. The book, however, does not adequately meet these objectives.
Audience: The book is written for both radiologists and orthopedic surgeons. The authors are a wide collection of surgeons, with a few radiologists chosen to supplement the imaging chapters.
Features: This book starts with an imaging chapter, which falls short of my expectations. For example, Table 1-1 is outdated; newer compilations of radiographic signs of hardware failure are available. The discussion of THA imaging does not include groin lateral films, which are essential for evaluation of acetabular component anteversion. Although there are regional differences of preferences in imaging hardware, the basics are sometimes not covered. The discussion of arthrography does not offer the use of digital subtraction as an option. The discussion of aspiration of total joints mentions that saline may be injected, but does not state that the saline must be non-bacteriostatic. CT is only barely mentioned, and the advantages of multislice scanning with reconstruction as a means of minimizing hardware artefact is not mentioned. These authors missed an opportunity to show how to produce outstanding images with CT that can answer questions about osseous defects or arthrodeses. Other chapters are divided by the sites of arthroplasties or individual types of hardware (i.e., THA, TKA, spinal instrumentation). There are also special interest chapters, such as one devoted to evaluating polyethylene wear in total hip arthroplasties. The content and treatment is somewhat uneven. However, it is even more disturbing that the authors missed the opportunity to educate their audience about what to specifically watch for as complications of hardware placement. Examples are given in an atlas format, but there is no sense of how frequent specific failures might be. The authors spend a large amount of the book's content on THAs , but never mention that limb length, anteversion, and horizontal center of rotation are important parts of the evaluation of the postoperative radiograph. There is no discussion of poly fracture or dislocation. Little is said of particle disease. These are serious omissions.
Assessment: This book has lofty and important goals, but does not meet them. The illustrations and naming of the hardware yields a superficial confidence for those radiologists who may be entirely unfamiliar with the jargon required for discussions of orthopedic hardware. However, the authors miss the opportunity to address many of the failures that must be watched for, and give the reader no comprehensive basis for evaluation. There are review articles in the radiologic literature which are much more comprehensive for each of the arthroplasties, but unfortunately these are scattered and not as easy to use as a book might have been.