Publications by authors named "Joseph Featherall"
Purpose: To evaluate the current utilization trends of practicing surgeons performing and lateral extra-articular augmentation (LEA) at the time of primary anterior cruciate ligament reconstruction (ACLR).
Methods: The survey was distributed via e-mail in August 2023 to members of the Arthroscopy Association of North America who identified as knee surgeons and was available online on the Arthroscopy Association of North America website from January to September 2023. The 18-question survey was designed regarding surgeons' surgical utilization patterns of LEA during ACLR.
Purpose: To investigate the incidence of heterotopic ossification (HO) in patients prescribed prophylactic nonsteroidal anti-inflammatory drugs (NSAIDs), both before and after the introduction of a standardized education protocol.
Methods: A retrospective review was conducted using a database of hip arthroscopy patients treated by a single surgeon at an academic hospital from 2015 to 2023. The inclusion criteria were (1) primary hip arthroscopy for the treatment of femoroacetabular impingement, (2) completion of a 2-week course of prophylactic postoperative NSAIDs (500 mg of naproxen twice daily), and (3) availability of follow-up radiographs at the 6-month postoperative visit.
Article Synopsis
- Stem cell therapies for cartilage disease are hindered by a lack of understanding of cartilage formation and maintenance.
- Human bone marrow stromal cells (hBMSCs) can create stable cartilage when using hyaluronic acid-coated microbeads, but the exact mechanisms are not fully understood.
- Although hBMSCs failed to repair cartilage in rodents, cells derived from chondrospheroids showed promising results by forming lasting non-hypertrophic cartilage.
Article Synopsis
- The study investigates how the acetabular sourcil and bone edges, common radiographic markers, relate to the weightbearing area of the acetabulum, highlighting potential confusion in surgical settings.
- It was hypothesized that the sourcil edge indicates anterolateral coverage while the bone edge shows anterior coverage in the acetabulum.
- Findings revealed that the sourcil edge aligns with the area behind the anterior inferior iliac spine (AIIS), while the bone edge targets a weightbearing region beneath it, with significant implications for hip surgeries.
Article Synopsis
- The study aimed to assess hip capsule thickness using advanced imaging in patients with and without hip dysplasia to see if there are differences between those with borderline and true dysplasia.
- Researchers analyzed data from 80 patients and found that those with dysplasia had significantly thinner hip capsules compared to those without, measuring 2.75 mm vs. 3.52 mm.
- The subanalysis indicated that there were no notable differences in capsular thickness between patients classified as having borderline dysplasia and those with true dysplasia, suggesting further research is needed to explore the implications of these findings on hip stability.
Background: Overprescription of opioids in the United States increases risks of opioid dependence, overdose, and death. Increased perioperative and postoperative opioid use during orthopedic shoulder surgery is a significant risk factor for long-term opioid dependence. The authors hypothesized that a multidisciplinary perioperative pain management program (Transitional Pain Service [TPS]) for major shoulder surgery would lead to a reduced amount of opioids required postoperatively.
View Article and Find Full Text PDFObjective: Patellar height changes after tibial tubercle osteotomy (TTO) have not yet been described. We aimed to evaluate whether TTO ± medial patellofemoral ligament reconstruction (MPFL-R) influences patellar height and tendon length, hypothesizing that TTO would decrease patellar height and tendon length.
Methods: A retrospective review was performed of skeletally mature adolescents (<18 y) receiving primary anteromedialization or medialization TTO ± MPFL-R.
Article Synopsis
- A study investigated the effectiveness of formal physical therapy (FPT) versus a home exercise program (HEP) in patients recovering from hip arthroscopic surgery for femoroacetabular impingement syndrome (FAIS).
- The research was a cohort study involving patients who self-selected either FPT or HEP, tracking their progress through various outcome measures at multiple intervals after surgery.
- Results showed no significant differences in recovery outcomes and patient satisfaction between the FPT and HEP groups after 12 months, indicating that both approaches may be equally effective.
Objectives: This study compared the maximal compression force before thread stripping of the novel bone-screw-fastener (BSF) with the traditional buttress screw (TBS) in synthetic osteoporotic and cadaveric bone models.
Methods: The maximum compression force of the plate-bone interface before loss of screw purchase during screw tightening was measured between self-tapping 3.5-mm BSF and 3.
Article Synopsis
- The study examines how repairing the hip capsule affects stability during the initial phase of hip distraction in patients with femoroacetabular impingement (FAI).
- Researchers measured joint space in three different conditions: native capsule, interportal capsulotomy, and capsular repair using fluoroscopic images during hip distraction.
- Results show that both the native and repaired capsule required a median force of 75 lb to distract the hip by 3 mm, while the unrepaired capsulotomy only needed 50 lb, indicating that i) restoration of the capsule improves hip stability.
Article Synopsis
- The study focuses on how accurately a perfect lateral knee X-ray represents the anatomical features of the femoral physis, given that X-rays are 2D images of a 3D structure.
- By analyzing pediatric CT scans, researchers created digitally reconstructed radiographs (DRRs) and measured the differences between the actual physis and its projection on these X-rays.
- Results showed that the actual position of the physis on the medial cortex was significantly higher than what was seen in the X-ray, indicating a consistent discrepancy in visualization across all measured areas.
Purpose: Abnormal patellar height has been identified as a source of aberrant mechanical functioning within the patellofemoral joint. The purpose of this study is to examine the statistical agreement among three commonly used classification methods: Blackburne-Peel (BPI), Caton-Deschamps (CDI) and Insall-Salvati (ISR), by evaluating (1) the rates of patella alta identification and (2) the ability for one index to predict another.
Methods: One hundred lateral knee radiographs were evaluated using BPI, CDI and ISR to classify each knee as patella normal, patella alta or patella baja.
Article Synopsis
- Thinner anterior hip capsules are linked to hip laxity and potential instability after hip arthroscopic surgery, but the relationship specifically regarding capsular thickness and surgical outcomes remains unclear.
- This study examined patients who underwent revision hip arthroscopy due to instability and compared them to a control group, finding that those with instability had significantly thinner hip capsules (average 1.9 mm) compared to those without instability (average 3.4 mm).
- The results suggest that decreased capsular thickness is notably associated with hip instability after surgery, indicating that preoperative MRI assessments of capsular thickness could be crucial for predicting surgical outcomes.
Article Synopsis
- The study aims to find a reliable way to measure hip capsular thickness in patients with femoroacetabular impingement syndrome, comparing measurements obtained through MRI and MRA techniques.
- Two independent reviewers analyzed preoperative imaging of 85 patients to measure capsular thickness at various points, achieving high reliability scores (ICCs) for both MRI (0.981) and MRA (0.985).
- The findings suggest that while both imaging methods are generally interchangeable, a significant difference was noted only in the inferior aspect of the capsule, indicating some variation in measurements specific to the imaging technique.
Background: An elevated posterior tibial slope (PTS) is associated with an increased risk for anterior cruciate ligament and meniscal injury. Recent evidence suggests that the PTS is elevated in patients with Osgood-Schlatter disease.
Purpose: To determine whether there is an association between objective measures of anterior tibial tubercle growth and PTS.
Article Synopsis
- The study aimed to analyze the femoral deformity after fixing the hip in patients with a slipped capital femoral epiphysis (SCFE) and its connection to skeletal immaturity.
- Researchers reviewed data from 27 patients with unilateral SCFE who underwent a specific treatment and followed them for at least three years.
- Findings revealed that greater overgrowth in the trochanter was linked to wider triradiate cartilage and an open TRC, indicating that more caution is needed when performing prophylactic hip fixation.
Article Synopsis
- Patients undergoing hip arthroscopy with perineal post distraction have a higher risk of postoperative numbness compared to those using postless distraction methods.
- In a study of 195 patients, 30.9% in the postless group experienced numbness, while 44.6% in the post distraction group reported the same, with significant differences in groin numbness rates (1.1% vs. 18.8%).
- Multivariate analysis indicated that post distraction methods and traction time significantly increase the chances of groin numbness post-surgery.
Acetabular Labral Reconstruction: Review of Techniques and Outcomes.
Curr Rev Musculoskelet Med
October 2023
Purpose Of Review: To analyze advances in labral reconstruction, and to discuss the literature relating to efficacy, outcomes, and technical considerations of labral reconstruction.
Recent Findings: The available evidence suggests that labral reconstruction is a safe and effective procedure that can improve pain and function in patients with severe and/or complex labral tears. The superiority of labral reconstruction over labral repair is uncertain, and it remains unclear what graft type and technique should be used in labral reconstructions.
Article Synopsis
- Superior capsular reconstruction can help some people with really bad shoulder injuries that can’t be fixed easily.
- How well the repair works is linked to how much movement and function the shoulder has afterward.
- New methods are being tried that mix natural body parts and man-made materials to reduce the chances of the repair failing, but we need more time and tests to see if they really work better.
Article Synopsis
- The study aimed to analyze how venting the hip joint affects the traction force needed for arthroscopic procedures in the hip's central compartment.
- Researchers measured joint space before and after venting during surgeries on 50 hips, finding significant increases in joint space with venting.
- The results showed that venting the hip allows for at least a 50% reduction in necessary traction force for better visualization and access during arthroscopy.
Background: Operative treatment of scapulothoracic bursitis most commonly comprises arthroscopic scapulothoracic bursectomy with or without partial superomedial angle scapuloplasty. There is currently no consensus regarding whether or when scapuloplasty should be performed. Prior studies are limited to small case series, and optimal surgical indications are not yet established.
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- Opioid overprescribing in pediatric orthopaedic surgeries leads to leftover medication, prompting a study on opioid usage and disposal among young patients.
- The study involved 114 patients who were surveyed post-surgery, revealing that they were prescribed, on average, 12 opioid pills but only used about 4, indicating significant overprescribing.
- The findings suggest that orthopaedic surgeons could potentially reduce the amount of opioids prescribed, as a majority of patients reported having unused medication after their procedures.
Background: The outcomes of orthopaedic trauma are not solely determined by injury severity or surgical treatment. Studies of numerous orthopaedic outcomes have found that psychosocial factors are also important. Symptoms of anxiety have been linked to long-term pain and disability.
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