JOINTS

JOINTS Synovial Joints. Their Structure and Mechanics. By C. H. Barnett, MA. , M B. F.R. C.S. , D. V. Davies, M.A., M.B. , B.S., and M. A. MacConaill, M.B. , D.Sc., M.R. I.A. (Pp. 304 +xi; illustrated. 50s.) London: Longmans. 1961. During recent years " Bone" has had a very good press, but " Joints " have not-which is remarkable when one considers the vast numbers of people with joint disorders of one sort or another. There have long been rather stuffy sections in anatomy books entitled arthrology, but little that covered the whole field of normal joint structure and behaviour. This is what Synovial Joints, Their Structure and Mechanics by Barnett, Davies, and MacConaill sets out to do, and the question here is whether they have done this in such a way as to attract the clinical reader. I believe they have. Without making their book exactly popular, they have put it together in such a way as to make attractive though not invariably easy reading. Technicalities are kept within bounds, and it is remarkable that they have almost completely suppressed the mathematical aspects of the subject which frighten the life out of most readers. And the book is of comfortable length. There are four sections. The first is on joint components; the second deals with what is called the biology of joints, which ranges widely from certain anatomical features to, rather surprisingly, evolution; the third, joint mechanics; and the fourth, function. The style is by no means uniform. There are stodgy patches here and there, as in the sections dealing with the chemistry of cells, matrix, and synovial fluid. This particular example is unfortunate, because this is the field of joint physiology in which development is most rapid and most promising. By contrast the authors let themselves go on joint mechanics (paying graceful and well-deserved tribute to Thomas Walmsley), and the reader is carried along by the enthusiastic narrative. I like them for this, because they show that, though anatomists, they are still human and not afraid of becoming excited about those aspects of joint structure and function to which they themselves have made significant contributions. Yet it must not be inferred that the reader is given unduly large slabs of Barnett. Davies, and MacConaill. They range very widely over the literature and go back a long way. Thus, this book, though of modest size, has standing as a work of reference and is an excellent starting point for anyone wishing to pursue intensively some single aspect of arthrology. It will cheer the hearts of clinicians to discover how much their contributions are appreciated by these broadminded anatomists. They also make use of comparative anatomy. In experimental work we often try to learn something by modifying one factor and seeing what happens. This is very clumsy and perhaps futile when dealing with structures as sensitive as joints. But an answer, or a near approach to it, may sometimes come from a study of variations occurring throughout the animal kingdom, and particularly so where shape matters, as it does with joint surfaces. The authors score high marks here. Some of their invitations are irresistible: on page 212 "The reader is recommended to look at the ankle joint of a sheep, readily obtainable at the butcher's shop, if he wishes to confirm for hi.self the truth of this statement. " Disagreement over matters of detail and perhaps over some of substance, such as the mechanics of lubrication, and minor criticisms of presentation (the undifferentiated Davies's on p. 28 are confusing) are inevitable in any book as lively as this one; but these are of no consequence in comparison with its solid worth. It will be welcomed particularly by clinicians who are not content with a superficial knowledge of the structure and function of joints. H. J. SEDDON.