Joshua David Harris

Houston Methodist Hospital | HOUSTONMETHODIST · Department of Orthopedics & Sports Medicine

Purpose of Review To evaluate the current evidence and literature on treatment options for proximal hamstring injuries. Recent Findings Patients with 3-tendon complete tears with greater than 2 cm of retraction have worse outcomes and higher complication rates compared to those with less severe injuries. Endoscopic and open proximal hamstring repa...

Hip arthroscopy is commonly performed to treat Femoroacetabular Impingement Syndrome. A post-assisted arthroscopic hip preservation surgery approach provides joint distraction for central compartment access. Due to its location, compression of the post in the perineum may cause injuries to the pudendal nerve, perineal soft tissue, or genitourinary...

Introduction Research is an important aspect of residency and fellowship programs across the country. Developing strategies to foster research productivity is worthwhile. An annual research project is one strategy that some programs implement. Methods All resident and fellow (Sports Medicine, Adult Reconstruction, Spine) presentations at an orthope...

Purpose To evaluate online, self-reported pudendal nerve or perineal injuries related to the use of a perineal post during hip arthroscopy. Methods Public posts on Reddit and the Health Organization for Pudendal Education were searched to identify anonymous individuals reporting symptoms of pudendal nerve or perineal injury following hip arthrosco...

Decreased mechanical loading after orthopaedic surgery predisposes patients to develop muscle atrophy. The purpose of this review was to assess whether the evidence supports oral protein supplementation can help decrease postoperative muscle atrophy and/or improve patient outcomes following orthopaedic surgery. A systematic review was conducted acc...

Introduction Basketball players are at increased risk of thumb collateral ligament injury (ulnar collateral ligament (UCL) and radial collateral ligament (RCL)). Methods The National Basketball Association (NBA) players with thumb collateral ligament surgery were identified using publicly available data. Performance statistics, ligament injuries (...

Purpose: To perform a systematic review to compare clinical outcomes of hip arthroscopy patients undergoing microfracture (MFx) versus other cartilage repair procedures for chondral lesions of the acetabulum. Methods: A systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) gu...

Evaluation and management of the endurance athlete with hip pain requires a thorough knowledge of the layered structure of normal anatomy and pathoanatomy in (intra-articular) and around (extra-articular) the hip joint. The subjective history and objective physical examination must be combined with imaging to properly “treat the athlete and not the...

Background The Patient-Reported Outcomes Measurement Information System (PROMIS) has not been fully evaluated for outcomes assessment after hip arthroscopy to correct femoroacetabular impingement syndrome (FAIS). Purpose/Hypothesis The purpose of this study was to compare the accuracy of the PROMIS Physical Function (PF) and Pain Interference (PI)...

Background: Injuries to the thumb represent 2.7% of all National Basketball Association (NBA) game-related injuries. Ligamentous thumb injuries are commonly characterized as ulnar collateral ligament (UCL) or radial collateral ligament (RCL) sprain or tears. Thumb collateral ligament injuries occur from a variety of mechanisms including catching a...

Background Routine hip magnetic resonance imaging (MRI) before arthroscopy for patients with femoroacetabular impingement syndrome (FAIS) offers questionable clinical benefit, delays surgery, and wastes resources. Purpose To assess the clinical utility of preoperative hip MRI for patients aged ≤40 years who were undergoing primary hip arthroscopy...

Introduction: Previous studies have evaluated the effect of the pericapsular nerve group block for hip arthroscopy and the transverse abdominis plane block for periacetabular osteotomy and have shown decreased narcotic consumption in both groups. No published study has evaluated the effectiveness of combining the blocks when performing hip arthros...

Background Previous studies have demonstrated the risks of pudendal nerve and/or soft tissue complications due to the use of a perineal post during hip arthroscopy. Recently, various postless hip arthroscopy techniques have been described in the literature. Purpose To assess the current international trends in the use of postless hip arthroscopy a...

Case: Large acetabular paralabral cysts can cause compression of the surrounding neurovascular structures leading to sensory and motor deficits. We present a 68-year-old man with obturator nerve denervation from a paralabral cyst secondary to a labral tear associated with femoroacetabular impingement syndrome. Resolution of symptoms and return to...

Purpose To identify and evaluate techniques used for postless hip arthroscopy. Methods A narrative review was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify surgical technique articles or clinical studies describing techniques for the use of postless hip arthroscopy. Specific items sought...

Patient-reported outcome measures (PROM) need to be responsive, reliable, and validated for the specific condition or treatment. PROMs also need to exhibit a dose-dependent response across a diverse patient population, unlimited by floor and ceiling effects. Statistically significant differences between compared groups might not always represent cl...

Purpose The objectives of this study were to develop recommendations for clinical and radiographic criteria to help define the “acceptable” surgical correction of femoroacetabular impingement syndrome (FAIS) and identify/define complications postoperatively. Methods A three-phase modified Delphi study was conducted involving a case-based survey; a...

The human pelvis represents a wonderful example of apparent idealistic simplicity overwhelmed by realistic complexity. Traditionally, the pelvis has been termed a “ring” linking the lower extremity to the spine via the sacroiliac joint. In essence, the pelvis is the lowest vertebral level—“the hip bone’s connected to the spine bone.” Thus, the law...

Pubic symphysis instability is an uncommon cause of hip or groin pain. This situation is observed mostly in patients with history of rheumatologic, obstetric, or urologic conditions and athletes with history of repetitive overuse hip, groin, pelvis, core, or spine injury. Traumatic separation of the joint can happen in females due to stretch or rup...

The proximal hamstring is a common location for athletic injuries. A complete, three-tendon (semitendinosus, semimembranosus, and long head of the biceps femoris) tear may occur in sports that involve eccentric contractions of the hamstrings with rapid hip flexion and knee extension. Surgical treatment of multi-tendon tears with retraction in activ...

Recognition of femoroacetabular impingementas a potential precursor to hip osteoarthritis has led to the development of hip preservation surgery techniques through both open and arthroscopic approaches. Successful short- and midterm clinical outcomes have been reported following hip preservation surgery. Improvements in technique and instrumentatio...

Purpose To determine the effectiveness of pericapsular nerve group (PENG) block for patients surgically treated for femoroacetabular impingement syndrome (FAIS). Methods Consecutive patients who underwent surgical treatment of FAIS either with or without preoperative PENG block by a single surgeon were retrospectively identified. Twenty-five patie...

Historically, medical students often match within the same geographic location or to an orthopaedic surgery residency program affiliated with their medical school. The objective of this investigation was to determine differences in geographic trends between orthopaedic residents matching before and during the Coronavirus-19 (COVID-19) pandemic. Me...

Objectives: Background The volume of hip arthroscopy for femoroacetabular impingement syndrome(FAIS) has dramatically risen, and data increasingly supports early intervention from symptom onset. In an increasingly value-conscious environment, the practice of routinely acquiring preoperative MRIs for primary hip arthroscopy patients in the setting o...

BACKGROUND Medical school ranking may become more important in orthopedic surgery resident selection with the impending transition of USMLE Step 1 to a pass/fail scoring system. OBJECTIVE The purpose of this study was to determine the strength of the association between medical school ranking and orthopedic surgery residency ranking using the cu...

Stress fractures are highly prevalent in ballet dancers and lead to notable time loss from dancing. Nutritional status, body composition, bone mineral density, and rate of increase in activity are among the components that influence risk for stress fractures. Proper evaluation and management of stress fractures is essential including a review of th...

Objective To demonstrate an ultra-high field (UHF) 7 T delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) protocol for quantitative post-traumatic osteoarthritis (PTOA) detection and monitoring in a rabbit anterior cruciate ligament transection (ACLT) model. Design ACL transections were performed unilaterally in 5 rabbits (33-weeks-old, 3.5 ±...

Purpose The purpose was to assess the clinical utility of preoperative MRI and quantify the delay in surgical care for patients aged 40 or younger undergoing primary hip arthroscopy with a history, physical examination, and radiographs concordant with femoroacetabular impingement syndrome (FAIS). Methods Between August 2015 and December 2020, 1,78...

Background Medial column procedures are commonly used to treat progressive collapsing foot deformity (PCFD) reconstruction. The aim of this research is to present the clinical results of plantar plating for medial naviculocuneiform (NC) arthrodesis when NC joint pathology contributes to medial arch collapse. The authors hypothesized that lag screws...

One of the core principles of hip arthroscopy is preservation of the acetabular labrum. Compromise of the biomechanical function of the labrum underlies a significant symptom source in patients undergoing hip preservation surgery. As surgical techniques continue to improve and evolve beyond labral repair, increased use of advanced arthroscopic proc...

FULL TEXT: https://authors.elsevier.com/c/1efK~6tEErZmP6 OBJECTIVE The purpose of this study was to determine the strength of the association between medical school ranking and orthopedic surgery residency ranking using the current cohort of orthopedic surgery residents. DESIGN We obtained a list of accredited programs from Doximity for orthopedi...

The use of blood flow restriction (BFR) within rehabilitation is rapidly increasing as further research is performed elucidating purported benefits such as improved muscular strength and size, neuromuscular control, decreased pain, and increased bone mineral density. Interestingly, these benefits are not isolated to structures distal to the occlusi...

PURPOSE To determine if there are differences in: 1) the incidence of post-related complications following hip arthroscopy between prospective and retrospective publications; and 2) between post-assisted and postless techniques. METHODS A systematic review was performed using PRISMA guidelines to characterize post-related complications following h...

Abdominal compartment syndrome (ACS) is a rare but potentially fatal complication that can occur during hip arthroscopy. This usually occurs as a result of arthroscopic fluid passing into the retroperitoneal space through the psoas tunnel. From the retroperitoneal space, the fluid can then enter the intraperitoneal space through defects in the peri...

The normal hip has a natural tendency to stability due to its depth, congruency, and surrounding contractile and inert tissues. Hip instability may occur either with or without trauma. Hip microinstability may also occur with or without trauma. However, microinstability is a concept that is currently unproven, but sound anatomically, biomechanicall...

The COVID-19 pandemic created an unprecedented challenge for orthopaedic surgery residency applicants when away rotations were canceled and interviews were held virtually. The authors hypothesized that (1) Instagram would have more total social media accounts compared with Twitter or Facebook, (2) most social media accounts on all platforms would b...

Clinical outcomes in arthroscopic hip preservation surgery have improved over the past two decades due to many factors, including advancements in technique and instrumentation. Complications following hip arthroscopy are associated with increased traction and overall surgical times. The purpose of this study was to compare traction and surgical tim...

Background Driving to the basket in basketball involves acceleration, deceleration, and lateral movements, which may expose players to increased anterior cruciate ligament (ACL) injury risk. It is unknown whether players who heavily rely on driving have decreased performance on returning to play after ACL reconstruction (ACLR). Hypothesis Players...

Objectives Previous work has shown a high return to sport (RTS) after Anterior Cruciate Ligament Reconstruction (ACLR) in National Basketball Association (NBA) players. Data on performance outcomes after RTS are less clear, with some demonstrating no difference compared to controls and others showing decreased performance. Two fundamentals of baske...

Background Open fractures are debilitating injuries for athletes. No prior studies have investigated open fractures in National Football League (NFL) players. Purpose To compare outcomes after open fracture in NFL players in terms of (1) time to return to sport (RTS), (2) postinjury career length and games played per season, (3) postinjury perform...

Stress fractures about the hip are common overuse injuries in athletes which can result from increased stress on normal bone or normal stress on abnormal bone. The aim of this chapter is to review the epidemiology of the most common stress fractures of the hip, discuss optimal management of these stress fractures, and outline return to play followi...

The optimal classification system in arthroscopic and related surgery research and clinical practice should be clinically relevant, descriptive, reproducible, simple, inexpensive, safe, and widely applicable. For the hip, classification systems that characterize intra-articular disorders like femoroacetabular impingement (FAI) syndrome, dysplasia,...

Background: Hip arthroscopy is a rapidly growing surgical approach to treat femoroacetabular impingement (FAI) syndrome with a significant learning curve pertaining to complication risk, reoperation rate, and total hip arthroplasty conversion. Hip arthroscopy is more frequently being taught in residency and fellowship training. The key, or critical...

Background: Dancers possess a large degree of hip range of motion that results from a combination of innate and acquired osseous morphology and permissive soft tissues. Generalized hypermobility in dancers may predispose them to a spectrum of hip instability. The objective of this narrative review is to discuss the anatomical characteristics, path...

Recently, the risk of hip injury during row exercise training has been illuminated by advances in diagnostic and imaging technology. PURPOSE: (1) To determine if a maximal effort 2000m row test commonly performed as a fitness assessment in rowers places participants in ranges of motion (ROM) associated with increased risk of hip injury (RISK THRESH...

Virtual reality (VR) simulation has enormous potential utility in technically demanding manual activities. Hip arthroscopy is a perfect example of a challenging surgical technique with an extensive learning curve. The literature has recently consistently demonstrated that both career and annual maintenance case volume significantly influences patie...

Background: Work relative value units (wRVUs) are part of Resource Based Relative Value Scale system. It is expected that a more difficult and time-consuming procedure would yield higher wRVUs. Brachial plexus nerve decompression surgery is a more time-consuming procedure compared with carpal and cubital tunnel procedures. The aim of this study wa...

Machine learning and artificial intelligence are increasingly used in modern health care, including arthroscopic and related surgery. Multiple high-quality, Level I evidence, randomized, controlled investigations have recently shown the ability of hip arthroscopy to successfully treat femoroacetabular impingement syndrome and labral tears. Contempo...

PURPOSE To perform a systematic review that determines the percentage of published Orthopedic Surgery and Sports Medicine systematic reviews and meta-analyses that have a conclusive conclusion. METHODS A systematic review was performed using PRISMA guidelines. Six high-quality orthopedics journals were chosen for analysis over a ten-year eligibili...

It is increasingly recognized that a variety of musculoskeletal disorders significantly influence sleep. In individuals with sleep dysfunction caused by hip pain (coxalgia somnia) from osteoarthritis, total hip arthroplasty has reliably improved pain and sleep quality in most patients. In nonarthritic, nondysplastic individuals with femoroacetabula...

Background: Methodological quality and author internationality are increasing in orthopaedic surgery. The purpose of this study was to evaluate the methodological quality and author geography trends from 1994 to 2019 in high-quality foot and ankle journals. Methods: Analyses of 1,242 foot and ankle publications in Foot and Ankle International, A...

Background: Capsule management has emerged as an important topic in the field of hip arthroscopy. The 2 most popular techniques are interportal capsulotomy and T-type capsulotomy, but few studies have compared outcomes between these 2 techniques. Purpose: To compare 2-year (±2 months) patient-reported outcomes (PROs) between patients who underwe...

Purpose To perform a systematic review to identify macroscopic and microscopic patterns and differences in hip capsule innervation between normal hips and hips with osteoarthritis (OA), femoroacetabular impingement (FAI) syndrome, and developmental dysplasia of the hip (DDH). Methods A systematic review was performed using Preferred Reporting Item...

Background The Beighton score is commonly used to assess the degree of hypermobility in patients with hypermobility spectrum disorder. Since proper diagnosis and treatment in this challenging patient population require valid, reliable, and responsive clinical assessments such as the Beighton score, studies must properly evaluate efficacy and effect...

Acetabular dysplasia represents a structural pathomorphology associated with hip pain, instability, and osteoarthritis. The wide spectrum of dysplasia anatomically refers to a 3-dimensional volumetric- and surface area-based insufficiency in coverage and is classified based on the magnitude and location of undercoverage. Borderline dysplasia has be...

Background Transthyretin and immunoglobulin light-chain amyloidoses cause amyloid deposition throughout various organ systems. Recent evidence suggests that soft tissue amyloid deposits may lead to orthopedic conditions before cardiac manifestations occur. Pharmacologic treatments reduce further amyloid deposits in these patients. Thus, early diagn...

Introduction: The purpose of this study was to review and compare clinical outcomes between percutaneous needle fasciotomy (PNF) and collagenase Clostridium histolyticum (CCH) injection for the treatment of Dupuytren’s contracture. Materials and Methods: A systematic review was performed including all level I-III evidence studies investigating the...

Physician rating websites (PRWs) rate physicians based on experiences of previous patients. Although a high rating is desirable, it may not correlate with quality of care, experience, or other physician-specific variables. This study examined the impact of physician-specific variables, such as American Board of Orthopaedic Surgery Sports Certificat...

Purpose To perform a systematic review of biomechanical and clinical studies to determine whether the iliopsoas is a femoral head stabilizer. Methods A systematic review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Inclusion criteria were any human clinical (Levels I-IV evidence) or la...

EC Orthopaedics 11(10): 83-93, 2020. Background: Pain assessment using the visual analog scale (VAS) is common during patient evaluation in orthopedic settings. However, several factors contribute to variability in patient pain scoring when only assessed in clinic. As a subjective psychological measure, we hypothesized that patient VAS scores woul...

In the field of hip preservation, arthroscopic labral reconstruction is indicated for acetabular labral deficiency. Controversies regarding hip labral reconstruction abound, including primary versus revision indications, and circumferential versus segmental reconstruction. The goal of hip preservation surgery is to correct bony cam and pincer lesio...

The purpose of this narrative review is to identify the anatomy and relevant blood supply to the femoral head as it pertains to hip arthroscopy and lateral cam morphology. The primary blood supply to the femoral head are the lateral ascending superior retinacular vessels, which are terminal branches of the medial femoral circumflex artery. These ve...

“Arthroscrapes” are unintended iatrogenic articular cartilage injuries caused by the arthroscope or surgical instruments during arthroscopy. Even the most benign superficial injuries to articular cartilage, including temporary deformation, may result in chondrocyte death. We thus declare a call to action: arthroscopic and related surgeons must crea...