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Rehabilitation for the Postsurgical Orthopedic Patient, ed 2

Maxey L, Magnusson J, eds. St Louis, MO 63146, Mosby Elsevier, 2007, hardcover (with DVD), 560 pp, illus, ISBN: 978-0-323-03474-6, $97.

Part 2, "Upper Extremity," covers areas such as acromioplasty, anterior capsular reconstruction, rotator cuff repair, superior labral anteroposterior repair, total shoulder arthroplasty, extensor brevis release and lateral epicondylectomy, ulnar collateral ligament reconstruction with ulnar nerve transposition, primary flexor tendon repair in the digit, and carpal tunnel release. Part 3, "Spine," covers anterior cervical diskectomy and fusion, posterior lumbar microdiskectomy, and lumbar spine fusion.

The final part, covering lower-extremity surgery, is the largest part in the book and contains chapters on total hip arthroplasty, open reduction and internal fixation of the hip, anterior cruciate ligament reconstruction, arthroscopic lateral retinaculum release, meniscectomy and meniscal repair, open reduction and internal fixation of the patella, total knee arthroplasty, lateral ligament repair, open reduction and internal fixation of the ankle, ankle arthroscopy, and Achilles tendon repair.

Each chapter follows the same format: it begins with a description of the indications for that particular surgery, followed by a detailed description of the procedure. A few authors use primarily written descriptions, but most authors supplement the text with photographs or diagrams of the various stages of the procedure. The visual aids were particularly well done in the chapters covering rotator cuff repair, flexor tendon repair in the digit, and the lumbar microdiskectomy. However, all chapters do an effective job familiarizing the reader with the procedure.

A comprehensive description of an entire rehabilitative course specific for each procedure is next. These guidelines for rehabilitation make up the bulk of each chapter. Each phase of rehabilitation is described in detail, including the postoperative timeline defining the stage, the goals, potential complications and precautions, and appropriate therapeutic procedures for each part of the recovery. The text is supplemented with easy-to-use tables summarizing the information, making for an easy and quick reference in a clinic setting. The "Therapy Guidelines" section of each chapter ends with a detailed table containing suggested home exercise components for each phase. Each chapter also contains a "Troubleshooting" section that details the potential pitfalls in the recovery from each procedure. Multiple brief case study–style questions are presented throughout the text and are answered later in the section; these questions effectively drive home critical points through the use of real-world examples. There is a detailed bibliography at the end of each chapter, with frequent citations made in the body of the text. The authors, however, do not address the strength of the evidence supporting specific treatment recommendations.

The book includes 3 appendixes: "Transitioning the Throwing Athlete Back to the Field," "Transitioning the Jumping Athlete Back to the Court," and "New Approaches in Total Hip Replacement." The first 2 appendixes are outstanding resources for the sports medicine clinician. The "Throwing Athlete" appendix has multiple photos from several angles, illustrating the stages of throwing for both baseball and football. The authors include a detailed program outlining how to prepare throwing athletes to return to sport. The "Jumping Athlete" appendix also contains an excellent program design for the sports medicine population. The final appendix includes multiple detailed surgical photos of a minimally invasive total hip replacement, which successfully provides the reader with a complete impression of the procedure.

The text includes a DVD supplement that consists of multiple video clips of the various procedures discussed in the text, as well as downloadable home program instructions that are consistent with the tables presented in the text. The authors give permission for readers to download, edit, and print these programs on clinic letterhead to serve as patient handouts.

In conclusion, this is an outstanding text that is highly recommended for any clinician dealing with this patient population. Physical therapist educators should seriously consider making this text a requirement for the classroom, as this book will certainly give students a clear understanding of these procedures and provide an excellent foundation for clinical decision making.

Todd Forman

T Forman, PT, is the Senior Physical Therapist and a member of the interdisciplinary team at Integrative Therapeutics in Natick, MA.

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