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The book, Hip Surgery: An Odyssey, is simply a recollection of personal experiences of Augusto Sarmiento about hip surgery over nearly half a century. he narrative dwells, in various degrees, with ideas and procedures that have, thus far, either survived the test of time or have vanished from the scene. The book states that total hip arthroplasty represents one of the most important and impressive technological developments in the history of orthopedics and one that still attracts the attention of the orthopedist. Augusto Sarmiento has structured this book in a manner that identifies the likely reasons for the failures of so many different approaches to the "hip problem" hoping that enthusiasm of surgeons with new techniques will be tempered by the lessons of history.

Augusto Sarmiento, M.D. is Emeritus Professor and chairman of the departments of Orthopaedics at the Universities of Miami and Southern California. He was a founding member of the Hip Society and the International Hip Society. His productive academic career includes the presidency of the Hip Society and the American Academy of Orthopaedic Surgeons. He has published over a fourteen books, over 400 articles and chapters; lectured in forty different countries and received four of the most coveted orthopaedic awards in the United States: the Elmer Nix Ethics Award of the Clinical Orthopaedic Society, the Kappa Delta Award, the Nicholas Andre Award, and the John Charnley Award. His research activities involved a number of areas, particularly those of fracture healing and care, and traumatic and degenerative conditions of the hip.

The purpose of this book is to report on my 17 years of experience in the development and implementation of a closed functional method of treatment of certain fractures of long bones of the appendicular skeleton. My personal experiences, clinical results, and the basic concepts underlying the treatment philosophy are reported. Illustrations demonstrating the techniques of application of functional casts and braces are presented in detail as well as a step-by-step description of the management regime and a discussion of the behavior of fractures under this system. Indications and contraindications for the use of this method of treatment are clearly outlined. I consider it important to compile this information for I believe that the system has withstood the test of time and is sufficiently sound to be incorporated in the armamentarium of the orthopaedic surgeon. Also, it may have a favorable socioeconomic impact since it offers a viable alternative in the treatment of frac tures.

At the writing of this book, the United States is in the midst of an intense public debate concerning a widely perceived need for reform of the Health Care Delivery System. The reform is primarily aimed at the provision of medical insurance to a large segment of the population currently deprived of that coverage and to the reduction of the escalating costs of medical care. Solutions to the existing problems have been elusive because the causes of the dilemma are multifactorial, complex, and diffucult to identify clearly. There is, however, general consensus that the use and abuse of technology has played a major role in the growing costs of medical care. The importance of fracture care in the overall financing of the health care reform is significant, since injuries to the musculoskeletal system are responsible for a very large percentage of the general expenditures in this area. The cost is not limited to hospitalization and professional services, but also impacts the economy with tempo rary or permanent interruption of individual productivity.

Throughout the world, recent interest in healthcare issues has highlighted flaws in the costs of medical care and its unavailability to the underprivileged. As in the case of the moon, medicine, long-known as the noblest profession, also has its dark side. With increasing frequency, the altruism long-instilled in the psyche of its practitioners is being replaced with overpowering interest in financial profit, to the point where, to many physicians, medicine's raison d'etre is the same as the one of the business community. As a result of that erosion, professionalism and ethical conduct have been compromised, and abuse of diagnostic and therapeutic technologies rampantly practiced. Of overriding importance is the increased relegation of territory and essential responsibilities to the powerful industrial sector. The situation may have reached a critical level, calling for prompt, positive action

La colección Con Él ofrece este mes al lector, 30 meditaciones para cada día del mes, desde el domingo de la 22ª semana del tiempo ordinario al lunes de la 24ª semana del tiempo ordinario, (1 al 30 de septiembre), acompañadas del evangelio del día y un santoral del mes.