This framework should help future scholars across disciplines as they identify and interrogate important laws, policies, and norms that have differentially constrained opportunities for health among racial and ethnic groups.Why do racial inequalities endure despite numerous attempts to expand civil rights in certain sectors? A major reason for this endurance is due to lack of attention to structural racism. Although structural and institutional racism are often conflated, they are not the same. Herein, we provide an analogy of a “bucky ball” (Buckminsterfullerene) to distinguish the two concepts. Structural racism is a system of interconnected institutions that operates with a set of racialized rules that maintain White supremacy. These connections and rules allow racism to reinvent itself into new forms and persist, despite civil rights interventions directed at specific institutions. To illustrate these ideas, we provide examples from the fields of environmental justice, criminal justice, and medicine. Racial inequities in power and health will persist until we redirect our gaze away from specific institutions (and specific individuals), and instead focus on the resilient connections among institutions and their racialized rules.The purpose of this study was to identify preoperative and intraoperative factors that influence extension-flexion gap imbalance in total knee arthroplasty (TKA). Ninety-three knees undergoing TKA with the modified gap balancing technique were included. Preoperative range of motion, intraoperative extension-flexion gap balance, thickness of the resected bone and radiological parameters were investigated. The preoperative flexion contracture, bone resection thickness in the medial proximal tibia, and the medial distal femur all correlated with the extension-flexion gap balance in TKA. Bone resection thickness in the medial proximal tibia and the medial distal femur were predictive of extension-flexion imbalance.

This study examined the possible clinical utility of “parsicle screws” in securing C2 instrumentation.

Ten patients’ C2 vertebrae were virtually reconstructed using computer-aided design software. Pedicle, pars, and parsicle screws were virtually placed in the vertebrae.

In addition to establishing the trajectory and theoretical safety of parsicle screws, this study determined that parsicle screws were significantly longer than pars screws (p=0.005).

The additional length of parsicle screws may improve construct stability. As such, parsicle screws should be examined as an alternative to pars screws in patients unable to receive C2 pedicle screws.

The additional length of parsicle screws may improve construct stability. As such, parsicle screws should be examined as an alternative to pars screws in patients unable to receive C2 pedicle screws.

The purpose was to compare robotic assisted (RA), computer navigated (CN), and conventional UKA techniques.

Databases were queried for data on study characteristics, UKA systems, complications, and tibiofemoral alignment.

Four RA and six CN RCTs were identified. No significant differences were found in operative time, tibiofemoral alignment, and reoperation rates when comparing RA or CN to conventional UKA. RA UKA resulted in a significantly lower risk of complications compared to conventional UKA.

RA UKA results in fewer complications than conventional UKA with a clinically significant increase in operative time. All groups were similar in remaining evaluated parameters.

RA UKA results in fewer complications than conventional UKA with a clinically significant increase in operative time. All groups were similar in remaining evaluated parameters.

Aging populations and expanding indications will greatly increase the volume of total hip arthroplasty (THA) in all age groups, including patients over 70 years old. Minimally invasive, uncemented direct anterior THA offers potential advantages for treating elderly patients. However, literature indicates higher risks of postoperative periprosthetic femur fractures (PPFFs) with both direct anterior THA and uncemented femoral stems. This retrospective study investigates the influence of femoral stem design on PPFF incidence in uncemented direct anterior THA among patients older than 70 years.

557 primary THAs in patients aged 70 or over were reviewed for PPFFs from a consecutive series of 2011 patients undergoing direct anterior THA from a fellowship-trained adult reconstruction surgeon from 2015 to 2020. Exclusion criteria included age (<70) and posterior approach. For the first cohort of 361 patients (79 of which passed exclusion criteria) the surgeon used a single-tapered, proximally porous coated, collarless titanium stem. For the next 1650, (478 of which passed exclusion), the surgeon used a dual-tapered, collared, hydroxyapatite-coated titanium stem. Cefodizime cell line Included patients were carefully monitored until March 2021 for PPFFs. A Fisher’s exact test was used to compare the incidence PPFFs between the 2 implant designs.

2 of 79 (2.5%) patients had atraumatic PPFFs at an average of 19.5 days post-operatively in the first cohort. Both experienced a Vancouver type B2 periprosthetic fracture and required femoral revision. No patients (0/478, 0%) in the second group sustained a PPFF. (P=0.0199).

In this comparison, the dual-taper, hydroxyapatite-coated implant had a significantly lower PPFF rate among elderly patients than a single-taper, proximally porous stem without a collar.

In this comparison, the dual-taper, hydroxyapatite-coated implant had a significantly lower PPFF rate among elderly patients than a single-taper, proximally porous stem without a collar.

This systematic review characterizes the safety and efficacy of total knee arthroplasty (TKA) in end stage renal disease (ESRD) patients due to the unique challenges they face.

The cumulative complication rate for 3684 patients on dialysis for ESRD after primary TKA was 25%(N=925/3702), with incidence rates of 2.5%(N=92/3702) for periprosthetic joint infection, 3.7%(N=71/1895) for reoperations, and 2.5%(N=90/3578) for mortality.

Patients on dialysis for ESRD face significant mortality rates after primary TKA, in addition to other major complications. Careful counseling regarding risks and benefits should be provided prior to TKA in this population.

Patients on dialysis for ESRD face significant mortality rates after primary TKA, in addition to other major complications. Careful counseling regarding risks and benefits should be provided prior to TKA in this population.