Over the past four years, our authors have exhaustively reviewed a multitude of new techniques, new equipment, and new information in the world literature to produce a comprehensive update of our textbook. This edition reflects the growing numbers of less-invasive surgical techniques and devices that are being described, with promising results reported, and many arthroscopic and endoscopic techniques that continue to expand their indications. Over the last several years, ambulatory surgery centers have become an important part of orthopaedic surgery—from ligament repair to total joint arthroplasty—and outpatient orthopaedic surgery is now more frequently performed than standard hospital-based surgery in many centers. With knowledge and technology expanding and evolving at an ever-increasing speed, we have attempted to include the latest orthopaedic procedures while retaining as a foundation many of the classic techniques. As always, the Campbell Foundation staff—Kay Daugherty and Linda Jones, editors; Shawn Maxey, graphics; and Tonya Priggel, librarian—were essential in the production of this edition. Thanks to Kay and Linda for taking sometimes illegible notes on a napkin and translating them into eloquent English, to Shawn for keeping track of the hundreds of illustrations, and to Tonya for always locating the latest information on any topic. As many of our orthopaedic colleagues who have visited our institution can affirm, the piles of references, rough drafts, and jammed-full file folders that occupy the office floor are a testament to this monstrous undertaking. Our thanks, too, to Taylor Ball, Content Development Editor; Dolores Meloni, Executive Content Strategist; and John Casey, Senior Project Manager, at Elsevier publishing, who provided much guidance, encouragement, and assistance and who, while they may have doubted that we would get material in on time, never expressed anxiety. We also are most appreciative of the worldwide community of orthopaedic surgeons for their expertise and innovation without which our book would not be possible.

In this sixth edition of Anatomy and Human Movement, we have made a number of small but significant changes, mainly to the text, which are designed to further improve the usefulness of this already successful book. In this edition, there have been further improvements to the illustrations and we have added some new illustrations. Where possible, structures such as ligaments or cartilage have been coloured the same throughout the book, in an attempt to further enhance the clarity of illustrations. The book has progressed a long way since the first edition in 1989 when only black and white was used throughout the text. As regards the content, we have continued to engage with the community of users of the book, namely, students, teachers, practitioners, and have responded to yet more suggestions. As a result of this very positive feedback, there has been some minor reordering within the text and expansion of some sections, namely those on joint replacement. The use of Summary Boxes at the end of various sections has been retained: they are intended to be used as a quick aid to revision when the majority of the subject area has been learned, but feedback suggests that some will use them to get a general overview before starting to tackle the detailed text. Helping individuals to understand, remember and apply anatomy has always been the prime purpose of this book. In response to the advances in the range of electronic aids to learning, the sixth edition also gives automatic access (unlocked by the unique PIN found on the inside front cover) to the e-book via Pageburst, allowing users to quickly search the entire book, make notes, add highlights and study more efficiently. In addition to this, the authors have helped create a separate five-hour modular e-learning course in functional human anatomy. At present, this is only available for purchase by universities and other institutions. This is presented in short lesson chunks following the body’s regional structure – ideal for the student to study at their own pace and time and the lecturer to assign accordingly. Learning is delivered via outcome measures, animation, video, quizzes, activity analyses and exams.

For the past few years, we have really stressed core strength at Duke. It improves an athlete’s base, and that’s vital, because so much emanates from there. Strength, power, and endurance all flow from the core. And taking care of the core is also important for increasing performance. If an athlete is strong in the middle, his/her extremities will be helped. For years, people didn’t emphasize that, and as a result there were more extremity injuries than there should have been. Nothing can eliminate those injuries entirely, but good core strength helps cut them down. We believe in training the core and work with our players on it year-round. We do a lot of band work that helps build the core. The training methods for that area of the body have changed throughout my career at Duke. Of course, I have been coaching 41 years, so a lot of things have changed, especially since I played. Back then, we didn’t even lift weights. We’ve put a huge emphasis on the hips. They are vital for players to get into their defensive stance (Figure F-1), for the running we do and the explosive strength our players need. Hip strength and core strength determine whether a player has a better landing base after jumping, and we are up and down on the court a lot. If players have weak cores, they aren’t landing on strong bases. It all makes more sense. That part of the body, which has been neglected, gives the body so much. A lot of people see 6-pack abs or strong biceps or leg muscles, but that’s not what we’re talking about. We’re talking about strength you can’t see, but you see it in performance. I think one of the reasons that people haven’t done a lot with the core is that you can’t see the parts of the body that make up the core. But so much emanates from that. So, it works for us in terms of injury prevention and performance.

The visual culture of anatomy and medicine has been the subject of several scholarly publications since the 1980s. Ludmilla Jordanova’s groundbreaking work, Sexual Visions: Images of Gender in Science and Medicine between the Eighteenth and Twentieth Centuries (1989),2 incorporated the methodologies of feminism, gender studies, and art history (visual analysis) into the histories of science and medicine to assess critically and specifically how the female body is treated, understood, and visualized differently in medical imagery and what that means for us. Jordanova’s work spawned a resurgence of scholarly interest and attention to the body in general and to anatomy in particular, not only in the history of science and related disciplines, but also in art history. For example, Anthea Callen’s The Spectacular Body: Science, Method and Meaning in the Work of Degas (1995) applies many of Jordanova’s points to late nineteenth-century art, scientifically focusing on physiognomy as a branch of continued human understanding and its not unproblematic application to issues of race, class, and gender in both science and art of the period.3 The similarly titled exhibition and catalogue, Spectacular Bodies: The Art and Science of the Human Body from Leonardo to Now (2000), curated–authored by Martin Kemp and Marina Wallace, broadens Callen’s artistic and scientific considerations of the body across a much more comprehensive timeline.4 Divided into several parts, its first is perhaps of greatest congruence to the present volume. It is a brief, but sweeping, discussion of visual representations of anatomists, anatomized bodies, models drawn from life, dissected models and écorchés, and idealized physiques.

Many groups of students and research workers need to acquire a working knowledge of mammalian anatomy and histology. Such knowledge can be acquired from books though this a very poor second best to acquiring the information from the animal itself. Dissection and the preparation and examination of histological sections remain the best methods. Knowledge of anatomy is necessary for all those who use histological techniques: the taking of specimens for histological work presumes some knowledge of anatomy. But not all those who work with small mammals receive training in mammalian anatomy and histology. In the past this was less of a problem: zoology was grounded in comparative anatomy and morphology; dissection formed a part of every school, college and undergraduate course in biology and zoology. This is less the case today. In addition, not all those who work with small mammals, for example, in toxicology laboratories, have a zoological background. In this book we have tried to provide an introduction to the anatomy and histology of one small mammal, the rat. The rat, and its relative the mouse, are the most widely used experimental animals and many research workers and trainees need to be familiar with these species. We have assumed that the reader wishes to learn by practical experience: our approach is based on dissection and on the preparation of histological sections. Our earlier book, ‘Histological Techniques: An introduction for beginners in toxicology’ deals with techniques in some detail. In our descriptions of dissections we have stressed both anatomical points and the techniques applied in postmortem examination of experimental animals.