Trends in cancer incidence: Causes and practical implications

Abstract

This thoughtfully edited volume attempts a quantitative explanation of bone and joint function and dysfunction through presentation of recent developments that integrate many biomechanical principles. Bone mechanics under dynamic loading, joint lubrication, and the mechanics of arthritic joints are dealt with early in the book. This provides a clear and tangible starting point for those new to biomechanics. The subsequent treatment of stress analysis around holes in bone and in prosthetic appliances is then quite complex and completely theoretical. The first half of the book then ends with a consideration of those biomechanical aspects of artificial joints so directly applicable to clinical design. Human weight-bearing joints display amazingly low coefficients of friction in the physiologic state; indeed, few machines have been built with such efficient bearings. John Charnley, considered by many the father of joint replacement surgery, first proposed the mechanism of boundary lubrication in trying to find a suitable bearing material for artificial joints. The chapter on joint lubrication mechanisms by Collins and Kingsburg takes the reader through the development of the subject while explaining the principles of hydrodynamic, boundary, and weeping lubrication. The material presented is often quite technical, yet it is in the hope of keeping vital that inventive spirit of the recently deceased Dr. Charnley that the clinician is encouraged to work through a book of this difficulty. The mechanical functions and disorders of the spine are the subject of the second half of the book. Biomechanical techniques for assessment and treatment of spinal injuries and deformities are ultimately presented after another rigorous theoretical development of the applicable kinetic and materials science. Mathematical modeling of the spine is a complex subject that has been studied using a variety of methods. Concepts from the continuum analysis of stress fields in the intravertebral disc to rules for the design of a comfortable chair are explained in detail. The biomechanical basis of specific procedures in spinal surgery is described first, with attention to the actual surgical hardware, but then full treatment is given to the engineering concepts involved in their use. The clear presentation of the theoretical mechanics of the spine, while not inclusive, is one of the book's major strengths. Osteoarthro-Mechanics is a collection of eleven chapters written mostly by Ph.D.'s in bioengineering. It requires a knowledge of mechanical engineering and mathematics that may not be fresh in the minds of such clinicians as orthopedists, physiatrists, and rheumatologists. The elegantly written style of the text in the more mathematical chapters, noteworthy in J.L. Nowinski's chapter on stress fields around perforations in bone, makes even difficult points easy to grasp. Illustrations are numerous and generally helpful, and the bibliographies are excellent. Though it is probably written as a source book for a biomechanics course, anyone interested in orthopedic design would do well to be acquainted with this volume.