The Crucial Principles in Care of the Knee

A generation ago, John A. Feagin Jr wrote a book titled The Crucial Ligaments of the Knee. In that book, he promulgated the vital importance of the anterior cruciate ligament (ACL) to the stability and function of the knee. Many of his well-respected peers believed that high-level knee function was possible with an absent ACL, though that belief is now considered anathema. Feagin and his contemporaries used scientific principles to study the knee and ACL function and eventually proved that the ACL plays a vital role in knee kinematics and performance. At the same time, a half continent away, J. Richard Steadman became involved with the care of knee injuries in competitive alpine skiers. He also concluded that aggressive reconstruction of ACL ruptures gives skiers the best chance of returning to high-level competition and embarked on a mission to repair articular cartilage lesions using a process termed “microfracture.” Feagin and Steadman participated in the birth of the field of sports medicine, and their efforts helped shape it through its nascent stages. Thus, I was excited to learn that they had collaborated in a book detailing their experience. The Crucial Principles in Care of the Knee is the product of that collaboration. Although listed as editors, Feagin and Steadman author or coauthor the vast majority of the book, and it is fair to say that the contents directly reflect their knowledge and philosophy.