The American Association of Latino Orthopaedic Surgeons: Our History, Achievements, and Future Goals.

ABSTRACT: The mission of the American Association of Latino Orthopaedic Surgeons (AALOS) is to provide collegiality, advancement, education, and social justice for Latino orthopaedic surgeons and the minority populations they represent. We strive to enhance diversity within the field of orthopaedic surgery by increasing the visibility of AALOS, highlighting its core focus, and emphasizing its mission. The purposes of this article are to discuss the need for this organization and highlight its history and future goals. As AALOS recently celebrated its 15-year anniversary, we are excited to continue advancing the field of orthopaedic surgery and improving our patients' care.

Movement Is Life-Optimizing Patient Access to Total Joint Arthroplasty: Mental Health Disparities.

Mental illness affects 20.6% of American adults. The lifetime prevalence of depression and anxiety is 17% and 29%, respectively. In particular, women suffer more from mental illness than men. Racial and ethnic minorities experience disproportionate discrimination, which has been linked to depression, anxiety, and psychological distress. African Americans are more likely to be chronically depressed, have higher levels of impairment and more severe symptoms, and often have challenges accessing treatment. Poor mental health is associated with low socioeconomic status, prolonged hospital stays, psychosis, postoperative anemia, infection, and pulmonary embolism. For total hip and knee arthroplasty, mental health conditions have been linked to higher hospital charges, higher rates of nonroutine discharges, and an increased Charlson Comorbidity Index. Mechanisms to address mental health are varied and range from psychosocial to pharmacologic modalities. Optimization in these vulnerable patients includes appropriate preoperative screening, assessment of support systems, identifying resources, and providing a safe discharge plan.

Movement Is Life-Optimizing Patient Access to Total Joint Arthroplasty: Cardiovascular Health Disparities.

Cardiovascular disease includes a collection of conditions with 6.7% of American adults having coronary artery disease and 45% having hypertension. Proper management of these conditions is low (<25%). Hypertension is highest among African Americans and is associated with lower socioeconomic status and education level. Heart disease is associated with postoperative complications, such as cardiovascular and cerebrovascular events, pulmonary and coagulopathy complications, and mortality. Underserved communities can be optimized beginning with a thorough preoperative assessment, which includes evaluating for food security, instituting dietary modifications and exercise regimens, and improving cardiovascular health with pharmacologic modalities and specialty care. Nurse navigators can be invaluable for guiding patients through a cardiovascular preoperative optimization pathway.

Examination of surface and material properties of explanted zirconia femoral heads.

The crystalline structure of Zirconia femoral heads provides for superior fracture toughness when compared with alumina. Transformation of the crystalline structure that takes place with time in service may produce changes in the surface and biomechanical properties of these implants. This study examines surface and mechanical property changes of Zirconia femoral heads that occur with time in situ. Eighteen retrieved Zirconia femoral heads were compared to 5 factory-sealed controls. The retrieved implants demonstrated significant transformation to a monoclinic phase. This phase transformation was associated with decreased surface hardness. There was evidence of increased surface roughness with increasing time of implantation. The phase transformation that takes place in Zirconia femoral heads may render these implants less desirable as a bearing surface in total hip arthroplasty.

Surface crystalline phases and nanoindentation hardness of explanted zirconia femoral heads.

One new and nine explanted zirconia femoral heads were studied using glancing angle X-ray diffraction, scanning electron microscopy, and nanoindentation hardness techniques. All starting zirconia implants consisted only of tetragonal zirconia polycrystals (TZP). For comparison, one explanted alumina femoral head was also studied. Evidence for a surface tetragonal-to-monoclinic zirconia phase transformation was observed in some implants, the extent of which was varied for different in-service conditions. A strong correlation was found between increasing transformation to the monoclinic phase and decreasing surface hardness. Microscopic investigations of some of the explanted femoral heads revealed ultra high molecular weight polyethylene and metallic transfer wear debris.