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Cervical Instability in the Young Adult
Os odontoideum, trauma and genetic conditions such as Down's syndrome, Morquio's disease and pseudoachondroplasia are common causes of cervical instability in the young adult. Each underlying cause presents unique challenges to the treating physician, but a systematic approach to the problem can help guide physicians and patients in developing an individualized and appropriate treatment plan. The first step in evaluating these patients is determining if the instability is associated with any neurologic findings, as almost all patients with progressive neurologic symptoms should undergo surgical stabilization. (Source: Oper...
Source: Operative Techniques in Orthopaedics - June 5, 2015 Category: Orthopaedics Authors: Gregory D. Schroeder, EmiFor CE:Please check affiliation link.ly K. Albert, Christopher K. Kepler Source Type: research

Treatment of Spinal Conditions in the Young Adult
There are many considerations when formulating a treatment algorithm for painful spinal conditions, and when the young adult is seen, there are potentially even more consequences. Much of the recent developments in surgical technique, hardware technology, and outcomes research have focused on longer-term outcomes and return to a high activity level. For this patient population, effects from treatment decisions can greatly affect one's quality of life. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - June 5, 2015 Category: Orthopaedics Authors: Wellington K. Hsu Source Type: research

Percutaneous Lumbar Pedicle Screw Insertion
Percutaneous pedicle screw fixation is a viable alternative to the traditional open technique. It can be applied to virtually any case where conventional open procedures are indicated. Advantages of this minimally invasive approach include the potential to insert screw in a more ideal trajectory, avoidance of supradjacent facet violation, shorter hospital stay, reduced blood loss, decreased post-operative opioid use and generally faster post-surgical recovery. Lack of direct visualization of osseous structures can be challenging to a surgeon new to the technique. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - June 5, 2015 Category: Orthopaedics Authors: Jonathan N. Sembrano, Sharon C. Yson Source Type: research

Cervical Disc Replacement Versus Anterior Cervical Discectomy and Fusion
Cervical disc arthroplasty (CDA) is an option for younger patients with degenerative disc disease resulting in radiculopathy or myelopathy. This newer surgical technique has been com- pared to the gold standard of anterior cervical discectomy and fusion (ACDF) with similar excel- lent outcomes in terms of neurologic function and resolution of pain and other radicular symp- toms. CDA is attractive for the younger patient because it is a motion sparing implant and there- fore is thought to have a decreased risk of adjacent level disease. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - June 5, 2015 Category: Orthopaedics Authors: Abigail L. Mantica, Clifton Meals, Joseph O'Brien Source Type: research

Treatment of Spinal Conditions in the Young Adult
Spinal stenosis of the cervical spine, or cervical spondylotic myelopathy, is a debilitating, typically progressive condition, and surgery has been shown to produce better outcomes than conservative measures. Surgical options include single- or multilevel anterior cervical discectomy with fusion, single-level or multilevel anterior corpectomy with fusion, posterior laminectomy with or without fusion, and posterior laminoplasty. The location of the pathology, geometry of the spinal canal, in addition to the risks and benefits of each surgical approach, will determine the procedure chosen. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - June 5, 2015 Category: Orthopaedics Authors: M. Craig McMains, Safdar N. Khan Source Type: research

Management of Sports-Related Lumbar Conditions
While low back pain is common in the general population, there are unique considerations when athletes present with this complaint. The most common etiologies include degenerative disc disease, lumbar disc herniation, and spondylolysis. Genetic predisposition has recently been identified as a predominant determinant of DDD but the intense physical loading and training demands of elite athletes may play a more significant role in athletes than in the general population. The evidence-based literature regarding LDH in athletes suggests that despite having career-ending potential, it would be reasonable for athletes to expect ...
Source: Operative Techniques in Orthopaedics - June 5, 2015 Category: Orthopaedics Authors: Harry T. Mai, Wellington K. Hsu Source Type: research

Treatment of Spinal Conditions in the Young Adult Cortical Lumbar Screw Techniques
Cortical screws in the lumbar spine are an alternative to traditional pedicle screw fixation. The starting point is on the dorsal pars and the trajectory is up and out towards the lateral junction of the pedicle with the vertebral body. It allows for a smaller incision and less lateral dissection when compared to pedicle screw placement. Biomechanical studies have shown that cortical screws are equivalent to pedicle screws and there is limited evidence of improved fixation with this technique in the setting of low bone density. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - June 5, 2015 Category: Orthopaedics Authors: Brian W. Su, Christopher D. Chaput Source Type: research

Masthead
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Source: Operative Techniques in Orthopaedics - June 1, 2015 Category: Orthopaedics Source Type: research

Editorial Board
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Source: Operative Techniques in Orthopaedics - June 1, 2015 Category: Orthopaedics Source Type: research

Table of Contents
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Source: Operative Techniques in Orthopaedics - June 1, 2015 Category: Orthopaedics Source Type: research

Contributors
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Source: Operative Techniques in Orthopaedics - June 1, 2015 Category: Orthopaedics Source Type: research

Robotically Assisted Unicompartmental Knee Arthroplasty with a Handheld Image-Free Sculpting Tool
Unicompartmental knee arthroplasty is a successful procedure for the treatment of focal arthritis or osteonecrosis of the medial or lateral compartments of the knee. Although unicompartmental knee arthroplasty may pose lower risk of perioperative complications and achieve better functional outcomes than total knee arthroplasty, a high degree of accuracy of implant positioning and soft tissue balance are required to optimize durability and implant survivorship. First-generation robotic technology improved substantially implant position compared with conventional methods; however, high capital costs, uncertainty regarding th...
Source: Operative Techniques in Orthopaedics - March 25, 2015 Category: Orthopaedics Authors: Jess H. Lonner Source Type: research

Robotically-Assisted Unicompartmental Knee Arthroplasty with a Hand-Held Image-Free Sculpting Tool
Unicompartmental arthroplasty (UKA) is a successful procedure for the treatment of focal arthritis or osteonecrosis of the medial or lateral compartments of the knee. While UKA may pose lower risk of perioperative complications and achieve better functional outcomes than TKA, a high degree of accuracy of implant positioning and soft tissue balance are required to optimize durability and implant survivorship. First generation robotic technology improved substantially implant position compared to conventional methods; however, high capital costs, uncertainty regarding the value of advanced technologies, and the need for preo...
Source: Operative Techniques in Orthopaedics - March 25, 2015 Category: Orthopaedics Authors: Jess H. Lonner Source Type: research

Bi-Unicompartmental, Robot-Assisted Knee Arthroplasty
Robot-assisted surgery has had a significant effect on modern arthroplasty in the United States. Extensive research has hinted at the potential of robotics to improve different aspects of surgery (eg, higher precision and associated favorable clinical outcomes). In addition to technical advances in surgery, there is also progress regarding knee implant design, for example, implants designed to obviate the need for sacrificing cruciate ligaments of the knee during surgery, which is believed to lead to preferable functional outcomes and more natural knee motion. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - March 24, 2015 Category: Orthopaedics Authors: Marius Dettmer, Stefan W. Kreuzer Source Type: research

All-Polyethylene Tibial Components for Unicompartmental Knee Arthroplasty
All-polyethylene and metal-backed tibial components are available for unicompartmental knee arthroplasty. Although the early design of all-polyethylene component was largely replaced by metal-backed components, improvements in polyethylene wear characteristics, component design, and surgical technique have renewed interest in all-polyethylene (InLay) components. In comparison with metal-backed (OnLay) designs, InLays require less bone resection and are easier to revise total knee replacements. Early aseptic loosening, tibial component subsidence, and anterior knee pain were found to be the primary contributors to failure o...
Source: Operative Techniques in Orthopaedics - March 24, 2015 Category: Orthopaedics Authors: Johannes F. Plate, Marco A. Augart, Daniel N. Bracey, Alex Jinnah, Riyaz H. Jinnah, Gary G. Poehling Source Type: research