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Steven D. Levin, M.D.

Steven D. Levin, M.D.

Steven D. Levin, M.D.

Orthopaedic Sports Medicine, Shoulder Arthroplasty
  • Locations
    Locations
    A

    NorthShore Medical Group

    9650 Gross Point Rd.
    Suite 2900
    Skokie, IL 60076
    847.866.7846 224.251.2905 fax Get Directions This location is wheelchair accessible.
    B

    NorthShore Medical Group

    2180 Pfingsten Rd.
    Suite 3100
    Glenview, IL 60026
    847.866.7846 866.954.5787 fax Get Directions This location is wheelchair accessible.
  • Publications
    Publications
    • Biomechanical strain characteristics of soft tissue biceps tenodesis and bony tenodesis.

      Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2013 Sep

      Authors: Levin SD, Wellman DS, Liu C, Li Y, Ren Y, Shah NA, Zhang LQ
      Abstract
      Biomechanical analysis of biceps tenodesis procedures has historically focused on load to failure models. Minimal data exists for the analysis of biomechanical strain properties of the biceps tendon in a sub-failure, physiologic cadaver model.
      Tendon strain characteristics are different between bony and soft tissue tenodesis surgery, and the soft tissue tenodesis procedure reproduces a strain pattern more similar to the native biceps tendon.
      Eight fresh frozen cadaver upper extremities were mounted onto a custom device that controls shoulder abduction and rotation. Strain on the tendon was measured using a differential variable reluctance transducer as the arm was moved through cycles of abduction and external rotation. Each arm was mounted once, and all 3 testing procedures were performed on each of the 8 specimens. Statistical analysis was completed using ANOVA, followed by multiple comparisons with Bonferroni correction.
      The bony tenodesis model placed higher strain on the biceps tendon than the soft tissue tenodesis (p = 0.025). Also, the bony tenodesis model increased the strain on the biceps tendon when compared to the native tendon (p = 0.031). In contrast, the soft tissue tenodesis did not significantly alter strain when compared to the native tendon (p = 0.089).
      The soft tissue tenodesis procedure better maintained the native strain environment when compared to the bony tenodesis using an interference screw. Due to this closer approximation of native biceps tendon biomechanics, the soft tissue procedure may be more preferable clinically than the bony tenodesis.
      1, Controlled Laboratory Study.
      PMID: 23892426 [PubMed - as supplied by publisher]
    • Neer Award 2012: cerebral oxygenation in the beach chair position: a prospective study on the effect of general anesthesia compared with regional anesthesia and sedation.

      Journal of shoulder and elbow surgery 2013 Oct

      Authors: Koh JL, Levin SD, Chehab EL, Murphy GS
      Abstract
      Devastating neurologic ischemic episodes, such as stroke and deafness, have occurred in patients undergoing shoulder surgery in the beach chair position. We hypothesized that awake patients would be able to avoid significant cerebral deoxygenation events (CDEs) compared with anesthetized patients when procedures were performed in the beach chair position.
      Sixty patients underwent elective shoulder surgery in the beach chair position. Thirty patients underwent an interscalene block and monitored sedation (awake group); 30 patients underwent general anesthesia (asleep group). Cerebral oxygenation saturation (Scto2) was measured during the procedure. Scto2 values below critical thresholds were defined as CDEs and treated.
      Baseline mean arterial pressure and Scto2 values were lower in the asleep group during the operation (P < .0001). A higher incidence of CDEs was seen in the asleep group (56.7% vs 0% awake group), and more CDEs were seen per patient (2.97 in asleep vs 0 awake, P < .0001). Scto2 below a threshold value of 55% was seen in 23.3% in the asleep group vs 3.3% in the awake group. A total of 89 combined desaturation events were documented in the asleep vs 1 in the awake group (P < .0001).
      Patients in the beach chair position treated with regional anesthesia and sedation had almost no cerebral desaturation events, unlike patients who had general anesthesia. Avoidance of general anesthesia in the beach chair position may reduce the risk of ischemic neurologic injury.
      PMID: 23571083 [PubMed - as supplied by publisher]
    • Shoulder arthroscopy in patients with a cardiac pacemaker or defibrillator: a case report and discussion of perioperative management.

      Journal of shoulder and elbow surgery 2010 Dec

      Authors: Yang S, Park HS, Flores S, Levin SD, Makhsous M, Lin F, Koh J, Nuber G, Zhang LQ
      Abstract
      Treatment of partial thickness supraspinatus tendon tears is controversial with no clearly defined treatment algorithms based on severity of tears. This study aims to evaluate the relationship between depth of partial thickness tears and strain.
      Bursal-sided partial thickness tears were created at 1 mm increments in depth at the anterior portion of the supraspinatus tendon to 3/4 tendon width on ten fresh-frozen shoulder specimens. The supraspinatus muscle was dynamically loaded from 0-50N, and strain recorded at both the anterior and posterior portions of the tendon.
      Strain in the intact posterior portion increased monotonically with tear depth and supraspinatus force. Strain in the torn anterior portion decreased with increasing tear thickness and loading force. At 60% thickness tear, strain was significantly higher (P = 0.023) in the intact posterior portion compared to intact tendon. As the tear thickness exceeded 50% tendon thickness, the strain in the intact tendon rapidly increased nonlinearly.
      Biomechanical results herein suggest increasing potential for tear propagation in the transverse plane with increasing depth of tears, and biomechanically supports repairs of grade III (>50% thickness).
      PMID: 20656525 [PubMed - as supplied by publisher]
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