Ortho Textbook
A fellowship-level reference library organised by subspecialty, with highlighted exam-tested points, open-licence figures, and 10-15 linked further-reading references per chapter.
📋 View BOAST trauma guidelines →Spine · 3
Adolescent Idiopathic Scoliosis
Adolescent idiopathic scoliosis (AIS) is a three-dimensional structural deformity of the spine occurring between age 10 and skeletal maturity, defined by a coronal Cobb angle of at least 10° with vertebral rotation.
Read chapterCervical Myelopathy
Cervical myelopathy, encompassing degenerative cervical myelopathy (DCM), is the leading cause of non-traumatic spinal cord dysfunction in adults over 55 years of age. Prompt recognition through upper motor neuron signs and emergent or urgent surgical decompression arrests progressive, irreversible neurological decline.
Read chapterLumbar Disc Herniation
Lumbar disc herniation involves displacement of disc material beyond the intervertebral disc boundaries, characteristically provoking unilateral nerve root impingement and lumbosacral radiculopathy. Primary initial management is conservative, with microdiscectomy indicated for intractable pain refractory to structured therapy, progressive neurological deficit, or emergent cauda equina syndrome.
Read chapterKnee · 6
Anterior Cruciate Ligament Injuries
Anterior cruciate ligament (ACL) tears represent common sports-related injuries caused primarily by non-contact pivoting and deceleration mechanisms, leading to pathognomonic anterior and anterolateral rotatory knee instability. Management hinges on patient age, athletic aspirations, and secondary meniscal or chondral pathology, with anatomical intra-articular reconstruction offering predictable restoration of joint kinematics.
Read chapterKnee Osteoarthritis
Knee osteoarthritis is a progressive, whole-organ degenerative joint disease characterised by hyaline cartilage degradation, subchondral sclerosis, osteophyte formation, and synovitis, predominantly presenting as activity-related mechanical pain and functional limitation. Management follows a stepped paradigm from multimodal non-operative care to joint-preserving realignment osteotomies, unicompartmental arthroplasty, or total knee replacement depending on disease compartmentalisation, patient age, and functional goals.
Read chapterMeniscal Tears
Meniscal tears represent the most frequent intra-articular knee pathology, arising as traumatic injuries in young athletes or degenerative cleavages in older adults. Modern management centres on joint preservation through anatomical repair or conservative therapy, reserving partial meniscectomy for irreducible, symptomatic tears within the avascular zone.
Read chapterPatellofemoral Pain Syndrome
Patellofemoral Pain Syndrome (PFPS) is a common cause of anterior knee pain in adolescents and young adults, stemming from biomechanical maltracking and joint overloading. Diagnosis is predominantly clinical, with management rooted in combined quadriceps and posterolateral hip strengthening, while surgical intervention is strictly reserved for refractory structural abnormalities.
Read chapterTotal Knee Arthroplasty
Total knee arthroplasty (TKA) is a definitive surgical procedure for end-stage degenerative, inflammatory, or post-traumatic arthritis of the knee refractory to non-operative treatment, designed to provide durable pain relief, correct deformity, and restore stable mechanical function.
Read chapterUnicompartmental Knee Replacement
Unicompartmental knee replacement (UKR) resurfaces isolated single-compartment disease while preserving native cruciate ligaments, physiological kinematics, and joint proprioception. Successful outcomes depend strictly upon accurate patient selection, absence of contralateral compartment disease, an intact anterior cruciate ligament, and precise surgical technique to avoid overcorrection.
Read chapterHip · 6
Avascular Necrosis of the Femoral Head
Avascular necrosis (osteonecrosis) of the femoral head results from cellular bone death due to impaired microvascular perfusion, frequently culminating in subchondral fracture, articular collapse, and secondary osteoarthritis in young adults.
Read chapterDevelopmental Dysplasia of the Hip
Developmental dysplasia of the hip (DDH) encompasses a wide spectrum of neonatal and paediatric hip pathology ranging from acetabular dysplasia to irreducible frank dislocation. Early identification via targeted screening and sonographic assessment allows timely non-operative harness reduction, preventing long-term secondary osteoarthritis and complex reconstruction.
Read chapterFemoroacetabular Impingement
Femoroacetabular impingement (FAI) syndrome is a motion-dependent clinical triad of pathomorphology (cam, pincer, or mixed), mechanical hip pain, and positive impingement signs, leading to chondrolabral injury and early secondary osteoarthritis. Management progresses from physiotherapy and core stabilising protocols to hip arthroscopy or surgical hip dislocation aiming for osseous re-contouring and labral preservation.
Read chapterHip Osteoarthritis
Hip osteoarthritis is a progressive degenerative arthropathy characterised by articular cartilage breakdown, subchondral sclerosis, osteophyte formation, and subchondral cysts. Definitive surgical management with total hip arthroplasty provides reliable pain relief and functional restoration when multimodal conservative measures fail.
Read chapterHip Resurfacing Arthroplasty
Hip resurfacing arthroplasty (HRA) is a bone-preserving alternative to total hip arthroplasty indicated primarily in young, active male patients with end-stage hip osteoarthritis and robust proximal femoral bone quality. Its clinical utility is tempered by stringent patient selection criteria and distinct failure modes including early femoral neck fractures, component malorientation, and adverse reaction to metal debris (ARMD).
Read chapterTotal Hip Arthroplasty
Total hip arthroplasty (THA) is the gold-standard surgical intervention for end-stage hip pathology, reliably restoring mobility and relieving pain through prosthetic articulation of the acetabulum and proximal femur. This chapter synthesises surgical approaches, biomechanics, implant fixation, bearing couples, spinopelvic kinematics, and the management of primary and perioperative complications for exit orthopaedic examinations.
Read chapterFoot and Ankle · 6
Achilles Tendinopathy and Rupture
Achilles tendon disorders encompass insertional and midportion tendinopathy, acute full-thickness tears, and chronic neglected ruptures. Current evidence supports functional rehabilitation in gravity equinus for acute tears alongside percutaneous or open reconstruction for active patients, whilst chronic ruptures require reconstructive gap bridging or tendon transfers.
Read chapterAnkle Arthritis and Arthrodesis
Ankle arthritis is predominantly post-traumatic and causes profound disability; arthrodesis remains the benchmark surgical intervention for end-stage pathology, reliably providing stable pain relief when fused in neutral dorsiflexion, slight valgus, and external rotation symmetrical to the contralateral limb.
Read chapterAnkle Fractures
Ankle fractures encompass osseous and ligamentous injuries to the ankle mortise, evaluated by the Danis-Weber and Lauge-Hansen classifications. Treatment focuses on anatomical restoration of the articular surface, fibular length, and syndesmotic stability using non-operative casting or open reduction and internal fixation.
Read chapterCharcot Neuroarthropathy
Charcot neuroarthropathy is a progressive, destructive condition characterised by osseous fragmentation, joint dislocation, and profound architectural deformity in the setting of peripheral neuropathy and autonomic dysregulation. Early recognition and non-weight-bearing total contact casting during active phases are vital to avoid rocker-bottom deformity, intractable ulceration, and catastrophic limb loss.
Read chapterHallux Valgus
Hallux valgus is a complex, triplanar deformity characterised by lateral deviation and pronation of the hallux coupled with medial deviation (varus) of the first metatarsal. Management hinges on systematic clinical and weight-bearing radiographic assessment to tailor soft-tissue balancing, corrective metatarsal osteotomies, or targeted arthrodeses.
Read chapterPlantar Fasciitis
Plantar fasciitis is a degenerative fasciosis of the plantar aponeurosis origin at the medial calcaneal tuberosity, typically presenting as post-static dyskinesia ('first-step' heel pain). Over 90% of cases resolve with non-operative interventions, with surgical release or gastrocnemius recession reserved for recalcitrant disease failing at least 6–12 months of structured therapy.
Read chapter