Publications by authors named "William Levine"

Article Synopsis
  • The study assesses the return to performance of MLB pitchers after undergoing ulnar collateral ligament (UCL) surgery using advanced analytics and pitch-tracking metrics.
  • At 1, 2, and 3 years post-surgery, the data showed that only 1.6% of pitchers returned to play within the first year, but the rates increased significantly to 71.9% at 2 years and 82.0% at 3 years.
  • The research highlights the importance of modern metrics, examining factors like expected fielding independent pitching and velocity, to evaluate pitchers' recovery and performance levels after surgery.
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Introduction: Revision total elbow arthroplasty (TEA) is indicated for component loosening, periprosthetic joint infection, and fractures. Previous investigations into revision TEA complications have small sample sizes and limited exploration of acute complications. This study aims to characterize the 30-day complications and associated demographics of patients undergoing revision TEA using a large national database.

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Article Synopsis
  • The study explored which grafts are most favored by patients undergoing ACL reconstruction and what factors influence their decisions.* -
  • The most popular graft was the bone-patellar tendon-bone (BPTB), chosen by 56% of patients, with many selecting their graft based on recommendations from their surgeons.* -
  • Key concerns for patients included their ability to return to sports and the risks of graft failure, with media being the primary source of information for those researching options.*
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Surfer's neurapraxia is a rare surfing injury of the saphenous nerve secondary to persistent compression of the saphenous nerve along the medial thigh by the surfboard when paddling prone and while sitting upright on the board waiting for a wave. Symptoms may be nonspecific and consist of pain in the medial thigh with or without radiation along the saphenous nerve distribution (medial leg, medial ankle, medial arch of the foot). The saphenous nerve tension test can be utilized to reproduce the symptoms of surfer's neurapraxia.

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Rotator cuff repair surgeries fail frequently, with 20 to 94% of the 600,000 repairs performed annually in the United States resulting in retearing of the rotator cuff. The most common cause of failure is sutures tearing through tendons at grasping points. To address this issue, we drew inspiration from the specialized teeth of snakes of the Pythonoidea superfamily, which grasp soft tissues without tearing.

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Background: Recent liquid adhesive skin closure systems with a mesh patch and a 2-octyl cyanoacrylate liquid formula have shown promising results in total joint arthroplasty. Chemical accelerators are typically included to promote the rapid polymerization of 2-octyl cyanoacrylate. The goal of the study is to distinguish designs and wound complication differences between 2 similar systems.

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Article Synopsis
  • Reverse total shoulder arthroplasty (RTSA) is often evaluated using patient-reported outcome measures (PROMs) and relies on metrics like minimum clinically important difference (MCID) and substantial clinical benefit (SCB) to determine its effectiveness.
  • A systematic review analyzed 141 articles from various medical databases, ultimately including 39 studies with data on 11,984 patients who underwent RTSA, focusing on different thresholds used for MCID, SCB, patient acceptable symptom state (PASS), and maximal outcome improvement (MOI).
  • Findings showed significant variability in reported MCID and SCB values across studies, highlighting the need for more standardized methods in calculating and applying these thresholds to improve clinical assessment of RTSA outcomes.
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Article Synopsis
  • Management of AC joint injuries is contentious, with patients relying on internet resources for information; this study aims to identify common online questions and assess the quality of the information provided.
  • The most frequently searched topics include surgical indications, recovery timelines, and diagnosis, while less common inquiries focus on anatomy and surgery evaluation.
  • Government websites provided the highest quality information (average score of 4.0), while medical practice websites scored the lowest (average score of 0.3), indicating significant variability in the reliability of online resources for AC joint injuries.
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Article Synopsis
  • Rotator cuff injuries happen a lot in the U.S., leading to over 500,000 surgeries each year, but many do not work as well as hoped.
  • A special tissue called the subacromial bursa, which sits near the rotator cuff, seems to help with injury healing and might need to be kept during surgeries.
  • Research in rats showed that the bursa helps protect nearby tendons and promotes healing, and it might also be useful for delivering medicine to reduce pain and inflammation in damaged tendons.
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Introduction: For research to effectively guide clinical decision making, appropriate interpretation of data is paramount. The P -value is a useful tool for guiding the interpretation of data. However, despite its utility, the P -value is not without limitations.

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Case: A 19-year-old man underwent arthroscopic posterior glenoid reconstruction with a distal tibia allograft (DTA) after failing 2 posterior, soft-tissue instability surgeries. Although he experienced near-complete resolution of symptoms and return to sport, graft resorption was noted 7 months postoperatively. The patient underwent revision surgery for screw removal.

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Background: This study aims to determine the effect of time and imaging modality (three-dimensional (3D) CT vs. 3D magnetic resonance imaging (MRI)) on the surgical procedure indicated for shoulder instability. The hypothesis is there will be no clinical difference in procedure selection between time and imaging modality.

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Article Synopsis
  • The study examines upper extremity injuries in youth volleyball players presenting to U.S. emergency departments from 2012 to 2022, analyzing data on injury types, causes, and patient demographics.
  • A total of 131,624 injuries were estimated, with the majority affecting fingers and wrists, and the most common injuries being strains/sprains and fractures, predominantly among female players.
  • Overall injury rates showed a significant decrease over the years, with females experiencing more contusions and strains compared to males, indicating a trend that highlights the need for targeted prevention strategies.
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Background: The purpose of this study is to assess the current trends in fellowship training, career satisfaction, practice characteristics, and surgical case volume among shoulder and elbow surgeons.

Methods: A web-based, anonymous 25-item survey was sent to the membership of the American Shoulder and Elbow Surgeons (ASES) in October of 2022. Questions posed included respondent demographics, fellowship training, career satisfaction, practice characteristics, and surgical case characteristics.

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Background: There is limited data evaluating post-operative component position and fixation in reverse shoulder arthroplasty (RSA). Therefore, the purpose of this study was to evaluate baseplate position and fixation using routine pre-operative CT and post-operative radiographs.

Methods: A retrospective analysis of a series consecutive patient who underwent primary RSA was performed.

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Article Synopsis
  • The study investigates shoulder instability injuries among NFL athletes, emphasizing cases that did not lead to missed playtime, as prior research mainly focused on more severe injuries like dislocations.
  • Out of 546 recorded shoulder instability injuries from 2015 to 2019, 162 were categorized as non-missed time, predominantly being subluxations and occurring mostly during games.
  • The findings highlight that non-missed time injuries were most frequent in defensive secondary players and offensive linemen, with an overall incidence rate peaking during postseason games.
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Previous research established that readers acquire accurate and inaccurate information from fiction. The current study explored factors that might moderate these effects. Participants read fictional stories that each contained three assertions.

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Clavicle nonunion and malunion are relatively uncommon but, when symptomatic, can result in pain and dysfunction that requires surgical intervention. Various reconstructive and grafting techniques are available to achieve stable fixation and union. In the setting of persistent nonunion, vascularized bone grafting may be necessary.

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Objectives: The purpose of this study was to determine the stability of statistical findings among sham surgery randomized controlled trials (RCTs) in orthopaedic surgery using fragility analysis.

Methods: PubMed systematic review was conducted to include studies reporting dichotomous outcomes pertaining to sham surgery. The final review included eight RCTs involving only partial meniscectomies and vertebroplasties from 2009 to 2020.

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Background: Artificial intelligence (AI) aims to simulate human intelligence using automated computer algorithms. There has been a rapid increase in research applying AI to various subspecialties of orthopedic surgery, including shoulder surgery. The purpose of this review is to assess the scope and validity of current clinical AI applications in shoulder surgery literature.

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Unlabelled: Rotator cuff injuries result in over 500,000 surgeries performed annually, an alarmingly high number of which fail. These procedures typically involve repair of the injured tendon and removal of the subacromial bursa. However, recent identification of a resident population of mesenchymal stem cells and inflammatory responsiveness of the bursa to tendinopathy indicate an unexplored biological role of the bursa in the context of rotator cuff disease.

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Unlabelled: Immersive virtual reality (iVR) allows surgical trainees to practice skills without risking harm to patients or the need for cadaveric training resources. However, iVR has never been directly compared with cadaver training, the longtime gold standard for surgical skill training. We aimed to compare skill acquisition using cadaver laboratory and iVR training methods for augmented baseplate implantation during reverse total shoulder arthroplasty (rTSA).

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Background: There is minimal work defining the economic impact of resident participation in shoulder arthroplasty. Thus, this study quantified the opportunity cost of resident participation in total shoulder arthroplasty (TSA) and hemiarthroplasty (HA) by determining differences in operative time, relative value units (RVUs)/hour, and RVUs/case.

Methods: A retrospective analysis of shoulder arthroplasty procedures were identified from the ACS-NSQIP database from 2006 to 2014 using CPT codes.

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Introduction: Orthopaedic Residency Directors advised against visiting subinternship rotations in the peak of the pandemic. To adapt, programs offered multiple virtual experiences. The purpose of this study was to evaluate programs and applicants perceptions regarding the value of virtual experiences during the 2020 to 2021 application cycle and their utility in future application cycles.

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