Publications
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Evaluating the Morphology of Unique Superficial Fissured Cartilage Lesions at the Femoral Head-Neck Junction in Patients with Femoroacetabular Impingement Syndrome
The Orthopaedic Journal of Sports Medicine, February 8, 2024
While an association between femoroacetabular impingement (FAI) and osteoarthritis (OA) has been reported, the mechanistic differences and transition between the 2 conditions is not fully understood. In FAI, cartilage lesions at the femoral head-neck junction can sometimes be visualized during hip arthroscopy. The purpose of this study was to describe a unique dimpled pattern of superficial fissured cartilage lesions on the femoral head-neck junction at impingement site in patients with FAI syndrome (FAIS) and to evaluate the clinical, histological, and genetic phenotype of this cartilage. We hypothesized that the cartilage lesions may indicate risk for, or predict occurrence of, OA.
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Biomechanical Comparison Between Double-Row Repair and Soft Tissue Tenodesis for Treatment of Proximal Rectus Femoris Avulsions
The Orthopaedic Journal of Sports Medicine, February 20, 2024
Some patients with proximal rectus femoris (PRF) avulsions require surgical treatment after failed nonoperative treatment. There is no consensus on the superiority of suture anchor repair with the suture-bridge repair (SBR) technique versus tenodesis repair (TR) for PRF avulsions.
The purpose of this study is to compare the failure load and elongation at the failure between SBR and TR and to compare the stiffness of these two repair techniques versus the native state
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Adhesions in the setting of hip arthroscopy
EFORT Open Reviews (the official journal of the European Federations of National Associations of Orthopaedics and Traumatology), November 1, 2023
With the growing number of primary arthroscopies performed, patients requiring revision hip arthroscopies for various issues is high including postoperative adhesion formation, a source of pain, mechanical symptoms, range of motion limitation, stiffness, and microinstability. Adhesions are a consequence of biological pathways that have been stimulated by injury or surgical interventions leading to an increased healing response. Preventative efforts have included surgical adjuncts during/after primary hip arthroscopy, biologic augmentation, and postoperative rehabilitation. Treatment options for adhesion formation includes surgical lysis of adhesions with or without placement of biologic membranes aimed at inhibiting adhesion reformation as well as systemic medications to further reduce the risk. Postoperative rehabilitation exercises have also been demonstrated to prevent adhesions as a result of hip arthroscopy. Ongoing clinical trials are further investigating pathways and prevention of adhesion formation.
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Microinstability of the Hip: a previously unrecognized pathology
Muscles, Ligaments and Tendons Journal 2016
Hip microinstability is an established diagnosis; however, its occurrence is still debated by many physicians. Diagnosis of hip microinstability is often challenging, due to a lack of specific signs or symptoms, and patients may remain undiagnosed for long periods. This may lead to early manifestation of degenerative joint disease. Consequently, careful patient and family history must be obtained and diagnostic imaging should follow. After a thorough clinical evaluation of the patient with suspected hip microinstability, the physician should focus on how to improve symptoms and functionality in daily and sports activities.
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Comparison of Radiographs and Computed Tomography for the Screening of Anterior Inferior Iliac Spine Impingement.
The Journal of Arthroscopic and Related Surgery 2016
To compare radiographic and 3-dimensional (3D) computed tomography (CT) imaging modalities for the screening of anterior inferior iliac spine (AIIS) impingement by establishing imaging measurement related to the AIIS.
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Anatomic Arthroscopic Ligamentum Teres Reconstruction for Hip Instability.
The Journal of Arthroscopic and Related Surgery 2016
There has been growing interest in recent years on the functional importance of the ligamentum teres and its role in hip stability. Partial or complete tearing has previously been treated with debridement or radiofrequency ablation with good results; however, a subset of patients will continue to experience persistent pain or instability with injury to this structure. Advances in arthroscopic instruments and techniques have led to our ability to provide improved care for these patients by performing a ligamentum teres reconstruction. The purpose of this technical note is to describe our method of ligamentum teres reconstruction with a tibialis anterior allograft.
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Hip Capsular Closure: A Biomechanical Analysis of Failure Torque
The American Journal of Sports Medicine September 2016
Hip capsulotomy is routinely performed during arthroscopic surgery to achieve adequate exposure of the joint. Iatrogenic instability can result after hip arthroscopic surgery because of capsular insufficiency, which can be avoided with effective closure of the hip capsule. There is currently no consensus in the literature regarding the optimal quantity of sutures upon capsular closure to achieve maximal stability postoperatively.
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Arthroscopic Technique for Acetabular Labral Reconstruction Using Iliotibial Band Autograft
The Journal of Arthroscopic and Related Surgery June 2016
The dynamic function of the acetabular labrum makes it an important structure for both hip stability and motion. Because of this, injuries to the labrum can cause significant dysfunction, leading to altered hip kinematics. Labral repair is the gold standard for symptomatic labral tears to keep as much labral tissue as possible; however, in cases where the labrum has been injured to such a degree that it is either deficient or repair is not possible, arthroscopic labral reconstruction is preferred. This article describes our preferred approach for reconstruction of the acetabular labrum using iliotibial band autograft.
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Hip Arthroscopy in Patients Age 40 or Older: A Systematic Review
The Journal of Arthroscopic and Related Surgeries September June 2016
To (1) report clinical outcomes, complication rates, and total hip arthroplasty (THA) conversion rates for patients age 40 or older who underwent hip arthroscopy, and (2) report any age-related predictors of outcome identified in the literature.
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Hip Capsular Reconstruction Using Dermal Allograft
The Journal of Arthroscopic and Related May June 2016
Because hip arthroscopic procedures are increasing in number, complications related to the operation itself are starting to emerge. Whereas the capsule has been recognized as an important static stabilizer for the hip, it has not been until recently that surgeons have realized the importance of its preservation and restoration. Disruption of the capsule during arthroscopic procedures is a potential contributor to postoperative iatrogenic hip instability. In cases of a symptomatic deficient capsule, a capsular reconstruction is mandatory because instability may lead to detrimental chondral and labral changes. The purpose of this report was to describe our technique for arthroscopic hip capsular reconstruction using dermal allograft.
