March, 1969 P H Y S I O T H E R A P Y Page 5 Fig. 4. R in g ’s Screw -in H ip P rosth esis. C om plications: 1. D islo c a tio n : If t h e a c e t a b u l a r c u p h a s n o t be en i m p l a n t e d at t h e c o r r e c t an g le , a n d if flexion o f t h e h i p is e n ­ c o u r a g e d t o o e a r l y in t h e p o s t - o p e r a t i v e p e r i o d , t he m et al h e a d is liabl e t o d i s lo ca te . C a r e f u l h a n d l i n g o f t he p a t i e n t be f o re h e r e c o v e r s f r o m t he a n a e s t h e t i c is m a n d a t o r y . 2. S e p s is: T h i s is u n u s u a l a n d s h o u l d be p r e v e n t e d by ever y m e a n s p os si bl e. In fa ct, M r . C h a r n l e y o f M a n ­ ch e s t e r h a s de v is ed a spe cia l g las s-c ag e o p e r a t i n g t h e a t r e w i t h a slight p os it iv e p r e s s u r e to e v a c u a t e all ai r b r e a t h e d by t h e s u r g e o n , sist er a n d as s i s t a n ts . 3. S c ia tic a : F r a g m e n t s o f ac r y l i c c e m e n t if left lying in t he p o s t e r i o r re g i o n o f t h e o p e r a t i o n site m a y ir ri t a t e t he sciatic ner ve. T h e w o u n d s h o u l d be t h o r o u g h l y in sp e ct ed a n d irri ga te d p r i o r to c l o s u re . 4. P e n e tr a tio n o j th e F e m o ra l C o r te x : i f t h e f e m o r a l pr o s t h e s i s is n o t d r i v e n i n t o t h e f e m u r c o r r e c t ly , th e s t e m o f thi s p r o s t h e s i s m a y p e n e t r a t e t h e f e m o r a l c o r t e x . It is i m p o r t a n t t h a t t h e s u r g e o n s h o u l d m a k e s u r e t h a t t h is c o m p l i c a t i o n d o e s n o t a r i se b e f o r e he cl o s e s t h e w o u n d . 5. L o o s e n in g o f th e C u p o r F e m o r a l P ro sth e s is : T h i s m a y b e c o m e l o o s e in t h e acrl yi c c e m e n t a f t e r sev era l m o n t h s . T h e p a t i e n t will t h e n c o m p l a i n o f p a i n o n m o v e m e n t s es p ec i al l y w h e n g e t t i n g up f r o m a c h a i r o r w h e n c o m ­ m e n c i n g to wa lk . T h i s m a y r e q u i r e e x p l o r a t i o n a n d re v i si o n o f t h e o p e r a t i o n . In d ications: 1. In u n i l a t e r a l hip c o n d i t i o n s w h e n t he p a t i e n t is o v e r 65 y e a r s o f ag e o r w h e n th e p a t i e n t has r et ire d f r o m w o r k b e c a u s e o f a g e o r d isa bility. 2. T h i s o p e r a t i o n re p l a c e s th e ne ed for ex c i s i o n o f t h e h e a d a n d n e c k o f t h e f e m u r in c o n d i t i o n s w h e r e t hi s p r o ­ c e d u r e w as i n d i c a t e d in th e pa st . 3. It c a n be u se d fo r failed a r t h r o d e s i s cases. 4. It c a n be u se d f o r p a t i e n t s w h o h a v e h a d p r e v i o u s o s t e o t o m i e s o r failed u n i o n o f f r a c t u r e s o f t h e n e c k o f t h e f e m u r a n d p a r t i c u l a r l y in a v a s c u l a r n ec r o si s o f the h e a d o f t h e f e m u r. 5. It c a n b e u se d in a n k y l o s i n g s p o n d y l i t i s t o give th e p a t i e n t a sligh tly m o b i l e h i p j o i n t . 6. It c a n al s o be used in p a t i e n t s s u ff er in g f r o m f a i l u r e o f A u s t i n - M o o r e o r S m i t h P e t e r s e n C u p p r o st h e s i s. 7. It c a n a ls o be used in p a t i e n t s w h o h a v e h a d a c o n g e n i t a l d i s l o c a t i o n o f t h e hi p f o r m a n y y e a r s a n d a r e n o w s u ff er in g f r o m a p a i n f u l o s t e o - a r t h r i t i s . 8. P r o t r u s i o A c e t a b u l i is a n o t h e r i n d i c a t i o n . 9. R h e u m a t o i d A r t h r i t i s is a ls o a ver y i m p o r t a n t i n d i c a t i o n fo r this t y p e o f p r o s t h e t i c r e p l a c e m e n t o f t h e hi p j o i n t . C O N C L U S I O N S At t h e pr es en t st a g e o f d e v e l o p m e n t o f this o p e r a t i o n , we m u s t still r e g a r d this as a sa l v a g e p r o c e d u r e a n d n o t as a p r i m a r y m e t h o d o f t r e a t m e n t . W e m u s t a d o p t a p o li cy o f c a u t i o n a n d c a l c u l a t i o n r a t h e r t h a n o n e o f i n t e n s e c o m m i t ­ m e n t t o this o p e r a t i v e p r o c e d u r e . T h e r e m u s t be m e t i c u l o u s se l e c t i o n o f p a t i e n t s a n d t h er e m u s t b e a full u n d e r s t a n d i n g o f t h e d et ai ls o f t e c h n i q u e wit h a full k n o w l e d g e o f th e pitfa lls a n d c o m p l i c a t i o n s likely t o arise. I f th e s e p r e c a u t i o n s ar e f a it h fu ll y o b s e r v e d a n d if e n t h u s i a s m f o r this p r o c e d u r e is se ns ib ly r e s t r a i n e d , we m a y be at th e d a w n o f a n e w er a in hi p su rg er y. BO EK BESPREK IN G Inleiding in de K in isiologie van de M e n s— D r . R. H . R o z e n d a l . Uitg eve ri j S t a m - K e n i p e r m a n N . V . , C u l e m b o r g , H o l l a n d . Pry s : R I O .40. D i e la as te tyd het d a a r in H o l l a n d n o g a l he e l w a t b o e k e o p di e m a r k g e k o m wat v a n b e l a n g m a g wees vir fisio- t e r a p e u t e . D i t is o o k d ie geval m e t b o g e n o e m d e bo ek . S o o s die v o o r w o o r d se, k a n h i e r d i e b o e k g e b r u i k w o rd by di e o p l e i d i n g v a n d o k t e r s , fi s i o t e r a p e u t e , a r b e i d s t e r a p e u t e , ens. O m d a t k i n e s io l o g i e ' n m o e i l i k - a f - t e - p e r k g e b ie d v an w e t e n s k a p is, het d ie sk r y w e r h o m b e p a a l t o t ’n in lei d in g in k i n e s io l o g i e e n g ee h y a a n die e i n d e v a n die b o e k vir elke h o o f s t u k "n lys v a n b o e k e vir s t u d e n t e w a t geTnteresseerd is o m v a n b e p a a l d e o n d e r w e r p e m e e r te weet. D i e b o e k is in t w e e d e l e ver d ee l. I n die e e r s t e deel w o r d eer s ’n u i t e e n s e t ti n g gegee v a n wat m e t k i n e s io l o g i e bedo el w o r d , w a a r n i h o o f s t u k k e vo lg o o r s i t o l o g i e e n h i st o l o gi e d ie skel et, v e g e t a t i e w e stelsels, s i n d e s m o l o g i e , m y o l o g i e en d ie se nu we est els el. O p m ee st al b e g r y p e l i k e wys e e n a a n die h a n d v a n ba i e t e k e n i n g e w o r d u it ee n g es it w at el ke vak beh el s e n wat sy plek in di e geheel is. N a m y m e n i n g k o n die sk r y w e r o p s o m m i g e p u n t e ie t w a t d u i d e l i k e r ge we es het. I n die t w e e d e deel w o r d d ie f u n k s i o n e l e a n a t o m i e v a n die a r m , b e e n e n r o m p b e h a n d e l , te rw y l di e b o e k af sluit m e t n h o o f s t u k o o r h o u d i n g , b a l a n s , ens . e n ’n h o o f s t u k o o r die k i n e s io l o g i e v a n l o o p . O o k h i e r w o r d d ie t ek s v e r d u i d e l i k d e u r ' n g r o o t a a n t a l t e k e n i n g e . D i e s e n u w e e v o o r s i e n i n g e n w o r t e l w a a r d e v a n die sp i e re is in twee ta b e l l e vasgele. M i s k i e n so u d it g o ed wees as h ie r d i e w o r t e l w a a r d e o o k by die b e s p r e k i n g v a n el k e spie r a f s o n d e r l i k geg ee w o r d . A a n die e i n d e v a n el k e h o o f s t u k is d a a r ’n hele p a a r v r a e o o r d ie s t o f w at b e h a n d e l is, s o d a t die s t u d e n t k a n t o e t s wat hy gel eer het. U i t die o o g p u n t v a n s t u d i e lyk d it vir m y ba ie b e l a n g r i k . O o r die a l g e m e e n het d i e sk r y w e r d a a r i n g es la ag o m in ’n h a n t e e r b a r e b o e k ’n o o r s i g te g ee y a n d ie k o n e - s io lo g ie v a n die m e n s , e n k a n die s t u d e n t e i n fi si o te ra p ie e n a n d e r p a r a m e d i e s e b e r o e p e v o o r d e e l t r e k uit die b es tu - d e r i n g v a n hi e r d i e b o e k . W ei is di t n o o d s a a k l i k d a t v a n ’n a n a t o m i e a t l a s g e b r u i k g e m a a k w o r d . D r u k e n u i t v o e r in g v a n die b o e k is u i t s t e k e n d . B. G O E D H A R T S O U T H A F R IC A N S O C IE T Y O F P H Y S I O T H E R A P Y C H R I S T M A S G R E E T I N G S w er e re cei ved f r o m t h e f o l lo w in g c o u n t r i e s : A u s t r a l i a , A u s t r i a , B e lg i u m , C a n a d a , D e n m a r k , G r e a t B r i t a i n , I c e l a n d , J a p a n , N e t h e r l a n d s , N e w Z e a l a n d , N i g e r i a , N o r w a y , S w i t z e r l a n d , W e s t e r n G e r m a n y , U r a g u a y , S w ed en . G R E E T I N G S w e r e a ls o re ceived f r o m t h e fo ll o w in g : All t h e B r a n c h e s o f t h e S . A . S . P . , M r s . E. C a r r o l l , Mis s M. C a t t , M r . a n d M r s . C. D e a c o n , M r s . A. H o d g e s , Mi ss S. O o s t h u i z e n , P r e t o r i a P h y s i o t h e r a p y C o ll eg e, M r . a n d M rs . A. R o t h b e r g , M i s s B. Setzer, M i s s M . S t e r n w e i l e r, S.A. M e d i c a l a n d D e n t a l C o u n c i l , S .A . M e d i c a l C o n g r e s s , S .A. N a t i o n a l C o u n c i l f o r t h e W e l f a r e o f t h e A g e d . R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. )