OSTEOARTHRITIS, 2nd edition. Kenneth Brandt, Michael Doherty, L. Stefan Lohmander. £125. Oxford University Press, Oxford. 512 pages. ISBN 0-19-850967-7.

T. Vincent

Wellcome Clinician Scientist Kennedy Institute of Rheumatology London, UK

This is the second edition of Osteoarthritis by Brandt, Doherty and Lohmander which was first published in 1998. It was a surprisingly good read!

At first glance it is difficult to see how a book on osteoarthritis (OA), a disease which is so poorly understood, could fill 512 pages. However, it is concisely written, non-repetitive and covers every conceivable aspect of OA. The book is divided into several sections. Early on it covers basic cartilage biology, pathology of OA and current theories on disease pathogenesis. There are excellent chapters on the genetic aspects of disease and proteolytic degradation of the extracellular matrix. The second section deals with clinical disease, including disease classification (somewhat briefly), current treatment strategies and the role of allied professionals. Finally the book addresses the setting up of clinical trials, validation of clinical scores and the advances and limitations of cartilage imaging. There are ample good-quality colour images and helpful schematic figures. No chapter is more than 10 pages long, and each ends with a summary box and key points.

For me the highlight of this book is the objective way in which it deals with some of the questions most frequently raised by patients in clinical practice such as ‘should one exercise an osteoarthritic joint’ and ‘should one take glucosamine and chondroitin sulphate?’ The book delivers a comprehensive review of such literature in a truly objective fashion.

This is not a book to sling into the handbag, but more of the ganglion-bashing variety. It is an excellent reference book for basic cartilage biology as well as a clinical companion, and as such is accessible to a wide audience including non-clinical scientists interested in the field. At £125 it offers good value for money for any clinical rheumatology or research department.





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