The Hip-Spine Challenge.

➤: The proper diagnosis and treatment of patients with concurrent hip and spine pathological processes can be challenging because of the substantial overlap in symptomatology.

➤: There is no consensus on which pathological condition should be addressed first.

➤: Factors such as advanced spinal degeneration, deformity, and prior fusion alter the biomechanics of the spinopelvic unit.

Preoperative planning for intraoperative navigation guidance.

Intraoperative navigation for spinal procedures has continued to gain popularity. Numerous platforms are currently on the market and offer a spectrum of features. Preoperative considerations when utilizing this technology begin with understanding the fundamental concepts and methods of navigation.

The current state of navigation in robotic spine surgery.

The advent and widespread adoption of pedicle screw instrumentation prompted the need for image guidance in spine surgery to improve accuracy and safety. Although the conventional method, fluoroscopy, is readily available and inexpensive, concerns regarding radiation exposure and the drive to provide better visual guidance spurred the development of computer-assisted navigation. Contemporaneously, a non-navigated robotic guidance platform was also introduced as a competing modality for pedicle screw placement.

Radiographic Evaluation of Cervical Disk Replacement: The Impact of Preoperative Arthrosis and Implant Positioning on Patient-report Outcomes.

Study Design: This was a retrospective review.

Objective: Provide a validated method of radiographic evaluation of cervical disk replacement (CDR) patients linked to outcomes.

Summary Of Background Data: Preoperative radiographic criteria for CDRs and the impact of intraoperative positioning remain without formalized guidelines.

Outcomes of Revision Surgery for Pseudarthrosis After Anterior Cervical Fusion: Case Series and Systematic Review.

Study Design: Case series/systematic review.

Objectives: To report on patients undergoing posterior cervical fusion for symptomatic pseudarthrosis following anterior cervical discectomy and fusion (ACDF), and to assess outcomes reporting in the literature.

Methods: Patients undergoing posterior instrumented fusion for pseudarthrosis after primary ACDF from 2013 to 2018 by a single surgeon were reviewed consecutively.

Cervical, Thoracic, and Spinopelvic Compensation After Proximal Junctional Kyphosis (PJK): Does Location of PJK Matter?

Study Design: Retrospective case series.

Objective: Compensatory changes above a proximal junctional kyphosis (PJK) have not been defined. Understanding these mechanisms may help determine optimal level selection when performing revision for PJK.

Congenital Unilateral Hypertrophy of the Foot Intrinsics: A Rare Case and Review of Literature.

Introduction: Congenital hypertrophy of the intrinsic muscles of the foot is a rare disorder of unknown incidence characterized by unilateral muscular hypertrophy of one or more of the intrinsic muscles. Few cases have been reported in literature, many presenting with hypertrophy of a single muscle.

Case Report: A 12-year-oldCaucasian female with hypertrophy of all intrinsic muscles of the right foot present since birth presented with muscle imbalance resulting in hammer toe deformities of the second and third toes with the second toe crossing over the hallux.

Sagittal Reconstruction and Clinical Outcome Using Traditional ACDF, Versus Stand-alone ACDF Versus TDR: A Systematic Review and Quantitative Analysis.

Study Design: Systematic review.

Objective: To determine the difference in postoperative sagittal alignment when single level cervical radiculopathy or myelopathy is treated with an anterior cervical discectomy and fusion (ACDF) using a structural graft and plate, a stand-alone ACDF, or a total disc arthroplasty (TDR). We also wanted to determine if postoperative sagittal alignment impacted clinical outcomes in this patient population.

Correction to: The relationship of pelvic incidence to post-operative total hip arthroplasty dislocation in patients with lumbar fusion.

The original publication of this paper contain an error. The author name "Alan S. McGee Jr" is incorrect for it should have been "Alan W.

The relationship of pelvic incidence to post-operative total hip arthroplasty dislocation in patients with lumbar fusion.

Purpose: To determine if lumbar fusion increases the risk of dislocation following total hip arthroplasty (THA) via a posterior approach and to investigate anatomic variables associated with this increased risk.

Methods: Five-year retrospective review of THAs performed through a posterior approach identifying cases of post-operative dislocation. Patients were grouped into those with or without previous lumbar spine fusion.

Radiographic Evaluation of Acetabular Fractures: Review and Update on Methodology.

Despite increased availability of modern imaging techniques, plain radiographs remain the initial step in the classification of acetabular fractures. The ability to interpret the injury configuration allows the surgeon to develop a thorough preoperative plan and to evaluate the quality of reduction and fixation intraoperatively. Proficiency in the mental conversion of a two-dimensional radiograph into a three-dimensional conceptual image is imperative.

Degenerative Scoliosis.

Purpose Of Review: The purpose of this review is to provide an updated review of adult degenerative scoliosis (ADS). Epidemiology, classification, pathophysiology, and natural history are discussed along with a summary of commonly used outcome measures. Operative vs non-operative outcomes and new surgical techniques are discussed.

Joint Preservation Techniques in Orthopaedic Surgery.

Context: With increasing life expectancy, there is growing demand for preservation of native articular cartilage to delay joint arthroplasties, especially in younger, active patients. Damage to the hyaline cartilage of a joint has a limited intrinsic capacity to heal. This can lead to accelerated degeneration of the joint and early-onset osteoarthritis.

Allografts: Osteochondral, Shell, and Paste.

There is an increasing need for articular cartilage restoration procedures. Hyaline cartilage lacks intrinsic healing capacity. Persistent osteochondral defects can lead to early and rapid degenerative changes.

Orthopaedic trauma surgeons and direct anterior total hip arthroplasty: evaluation of learning curve at a level I academic institution.

Background: Interest in the direct anterior approach for total hip arthroplasty has increased over recent years; however, the potential for substantial complications exists, especially during the surgeon's learning curve. We evaluated the change in various metrics to help identify a single surgeon's learning curve. Additionally, we examined whether the learning curve was different for primarily arthroplasty versus trauma-trained surgeons.

Injuries to the great toe.

Purpose Of Review: Injuries to the great toe are common in athletes. While most are managed nonoperatively and allow return to sports activity, some great toe injuries are highly problematic and can impact function. The purpose of this review is to highlight several specific injuries and disease processes involving the hallux and to detail current recommendations and management options in order to help raise suspicion for injuries that can result in long-term dysfunction.

Allografts for Ligament Reconstruction: Where Are We Now?

The use of musculoskeletal allografts by orthopedic surgeons continues to rise. The process of procuring and sterilizing allografts is evolving with much consideration to limiting the spread of infectious diseases and preserving tissue integrity. Research involving the application of allografts, particularly for ligament repair, is quite active, necessitating an update for the practicing orthopedist.

Total hip arthroplasty via the anterior approach: tips and tricks for primary and revision surgery.

Purpose: Described for the first time in the 1950s, the direct anterior approach to the hip has been gaining in popularity over the last decade following the trend of minimally invasive surgery. This paper provides an overview of the approach and its indications and various uses and focuses on its utility in the revision setting. A detailed overview of the technique including tips and tricks as well as an explanation of common errors are included.