About
223
Publications
198,474
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Introduction
Professor of Orthopaedic Surgery -
Sports Medicine and Shoulder Surgery -
Boston University Athletics - Team Physician
Boston University School of Medicine - Boston Medical Center -
Department of Orthopaedic Surgery -
Boston, MA 02118
xinning.li@gmail.com
website: www.tigerortho.com
Additional affiliations
March 2013 - April 2013
Centre Orthopèdique Santy
Position
- International Traveling Shoulder Fellowship
Description
- Mentor - Gilles Walch, M.D.
February 2013 - March 2013
Alps Surgery Institute
Position
- International Traveling Shoulder Fellowship
Description
- Mentor - Laurent LaFosse, M.D.
Education
August 2012 - July 2013
Massachusetts General Hospital (Harvard Medical School)
Field of study
- Shoulder and Elbow Surgery Fellowship
August 2011 - July 2012
Hospital for Special Surgery (Cornell Medical School)
Field of study
- Sports Medicine and Shoulder Surgery Fellowship
July 2005 - June 2011
Publications
Publications (223)
The North American Traveling Fellowship (NATF) is one of the flagship tours of the American Orthopaedic Association (AOA). NATF is geared toward advancing the careers of young orthopaedic surgeons through the promotion of clinical, scientific, and social exchange. The 2015 tour had a major emphasis on the development of leadership in the field of o...
Background:
Shoulder arthroplasty is an effective procedure for managing patients with shoulder pain secondary to end-stage arthritis. Insurance status has been shown to be a predictor of patient morbidity and mortality. The current study evaluated the effect of patient insurance status on perioperative outcomes after shoulder replacement surgery....
Background:
Computed tomography (CT) scan is the standard for the preoperative assessment of glenoid version and morphology before total shoulder arthroplasty. However, the capacity of magnetic resonance imaging (MRI) to visualize bone morphology has improved with advancing technology. The purpose of this study was to compare the accuracy of MRI t...
Obesity is increasingly prevalent in the United States. There are several reports of outcomes in obese patients after total knee or hip replacement. The purpose of this study was to compare the functional outcomes and complications of obese patients undergoing shoulder arthroplasty with those of overweight or normal-weight patients.
Seventy-six pat...
Several studies have focused on management of shoulder instability in the adolescent and young adult population. However, a paucity of literature exists regarding shoulder dislocation in the skeletally immature population. The presence of an open physis makes the dislocated pediatric shoulder a challenging clinical problem. In general, management i...
Background
Social determinants of health (SDOHs) affect health outcomes outside the hospital, and understanding them can enhance postoperative outcomes in orthopaedic surgery patients. This study aimed to describe the prevalence of randomized controlled trials (RCTs) in pediatric orthopaedic journals reporting on the SDOHs of their patient cohorts....
Introduction
The nature of wrestling may lead athletes to mask injuries with the delayed presentations of youth wrestling-related injuries not being well characterized.
Methods
This descriptive epidemiological study queried the National Electronic Injury Surveillance System database to characterize delayed presentations of wrestling-related injuri...
Background
An increasing reliance on patient-reported outcomes has led to greater emphasis on minimal clinically important difference (MCID), substantial clinical benefit (SCB), and Patient Acceptable Symptom State (PASS) thresholds in assessing rotator cuff repairs.
Purpose
To review the MCID, SCB, and PASS thresholds reported for patient-reporte...
Objective
Marrow stimulation is used to address knee cartilage defects. In this study, we used the fragility index (FI), reverse fragility index (rFI), and fragility quotient (FQ) to evaluate statistical fragility of outcomes reported in randomized controlled trials (RCTs) evaluating marrow stimulation.
Design
PubMed, Embase, and MEDLINE were quer...
Quadriceps tendon (QT) ruptures are relatively uncommon injuries that, if not managed appropriately, have the potential to cause significant disability. When surgical repair of the tendon is performed acutely (within 2–3 weeks of injury), most patients will return to pre-injury activity levels. Several surgical repair techniques exist, with the mos...
Patellar tendon (PT) ruptures are relatively uncommon injuries that can cause meaningful disability. When surgical repair is performed acutely, most patients will have good to excellent outcomes and return to activity levels comparable to before injury. Several surgical techniques are commonly used, with graft augmentation, particularly in the case...
Background
Knowledge of acromioclavicular (AC) joint kinematics and distance may provide insight into the biomechanical function and development of new treatment methods. However, accurate data on in vivo AC kinematics and distance between the clavicle and acromion remain unknown.
Purpose/Hypothesis
The purpose of this study was to investigate 3-d...
Introduction
Division Chiefs (DCs) and department leadership play an integral role within the service. The goal of this study is to assess the demographics and scholarly work of the leadership in pediatric orthopaedics services across the United States and comment on the role of diversity within leadership positions.
Methods
Academic medical cente...
Background
Numerous studies have been published on the use of platelet-rich plasma (PRP) for knee osteoarthritis (OA), with conflicting results.
Purpose
To determine the fragility index (FI) and fragility quotient (FQ) of randomized controlled trials (RCTs) that evaluated the use of PRP to treat knee OA.
Study Design
Systematic review.
Methods
R...
Purpose:
This study aimed to assess the statistical fragility of recently published randomized controlled trials (RCTs) comparing the use of hamstring tendon (HT) autograft to bone-patellar tendon-bone (BPTB) autograft for anterior cruciate ligament (ACL) reconstruction.
Methods:
PubMed/EMBASE/MEDLINE were queried for RCTs published since 2010 c...
Traumatic anterior shoulder dislocations are estimated to occur in approximately 2% of the population, frequently with concomitant anterior-inferior labral tears and associated Hill-Sachs lesions of the humeral head. So-called bipolar (or engaging) lesions with attritional bone loss may be exacerbated by recurrent instability, in terms of both prev...
Background:
The purpose of this present study was to perform a fragility analysis to assess the robustness of randomized controlled trials (RCTs) evaluating the distal biceps tendon repairs. We hypothesize that the dichotomous outcomes will be statistically fragile and higher fragility will exist among statistically significant outcomes comparable...
An acromioclavicular (AC) joint separation is a common injury of the upper extremity that can lead to both functional and cosmetic problems, particularly in young, active patients and overhead athletes. The joint, at the distal clavicle, is composed of the AC ligament and the coracoclavicular (CC) ligaments. There exist many differing open surgical...
Glenoid superior biceps-labral pathology diagnosis, treatment and outcomes is an evolving area of shoulder surgery. Historically, described as SLAP tears (Superior Labrum Anterior Posterior) these lesions were identified as a source of pain in throwing athletes. Diagnosis and treatments applied to these SLAP lesions resulted in less than optimal ou...
Background:
Acute traumatic posterior sternoclavicular (SC) joint dislocation is a serious injury given its potential to cause cardiovascular and airway compromise that typically will require emergent closed reduction. There are limited data on the rate of return to sports (RTS) after this injury pattern when treated in a closed fashion.
Purpose:...
Background:
Physicians utilize P-values to interpret clinical trial data and guide patient-care decisions. Fragility analysis assesses the stability of statistical findings in relation to outcome event reversals. This study assessed the statistical fragility of recent randomized controlled trials (RCTs) investigating tourniquet use in total knee a...
PurposeThis study aimed to investigate clinical and radiological results of arthroscopic repair for isolated medial degenerative meniscus tears (DMTs) in patients over 45 years old at a minimum 2-year follow-up.Methods
From 2013 to 2017, patients aged over 45 years with isolated medial DMT refractory to conservative management or with true mechanic...
Background:. Peripheral nerve blocks improve both pain control and functional outcomes following total knee arthroplasty (TKA). However, few studies have examined the effects of different peripheral nerve block protocols on postoperative range of motion. The present study assessed the impact of a single-shot femoral nerve block (SFNB) versus contin...
Background
The epidemiology of acute vertebral fractures (AVFs) sustained while skiing and snowboarding remains poorly defined in the United States.
Hypothesis
It was hypothesized that there would be no significant differences across sex and a greater number of AVFs in younger age groups associated with skiing and snowboarding.
Study Design
Descr...
Background
Primary reverse shoulder arthroplasty (rTSA) is an effective treatment option for reducing pain and improving function for patients with rotator cuff tear arthropathy, irreparable rotator cuff tears, glenoid deformity, and other challenging clinical scenarios including fracture sequelae and revision shoulder arthroplasty. There has been...
Clinical research using patient-reported outcome measures has been critical within the field of shoulder, elbow, and sports medicine in helping clinicians deliver evidence-based and value-based medicine. Recently, however, clinicians have advocated for improving the process of obtaining clinically meaningful information from patients while decreasi...
Focal cartilage lesions are common pathologies at the knee joint that are considered important risk factors for the premature development of osteoarthritis. A wide range of surgical options, including but not limited to marrow stimulation, osteochondral auto- and allografting, and autologous chondrocyte implantation, allows for targeted treatment o...
Background
The coronavirus disease 2019 (COVID-19) pandemic has caused the cancellation or postponement of virtually every sporting event, resulting in training disruptions, income loss, and career uncertainties for athletes around the world. At present, the effect of the COVID-19 pandemic on the mental and emotional health of athletes is not well...
Hypothesis
The purpose of this study was to perform a systematic review of the available literature evaluating surgical outcomes after chronic distal biceps tendon rupture. Surgical techniques including primary repair, autograft reconstruction, and allograft reconstruction were compared, as well as subjective and objective clinical outcomes and com...
:
Muscle tendon transfers (MTTs) are effective surgical procedures for reducing pain and for improving active shoulder range of motion and patient-reported outcomes for a wide range of pathologies, including serratus anterior and trapezius muscle palsy, irreparable subscapularis tears, irreparable posterosuperior rotator cuff tears, irreparable po...
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Financial, personal, and structural barriers affect access to all aspects of orthopaedic specialty care.
»:
Disparities in access to care are present across all subspecialties of orthopaedic surgery in the United States.
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Improving timely access to care in orthopaedic surgery is crucial for both health equity and optimizing patient outcom...
Objectives:
To evaluate COVID-19 transmission rates in athletes upon return to sport (RTS), as well as the effectiveness of preventive and surveillance measures associated with RTS.
Methods:
In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the PubMed, Embase, and Cochrane Library databases were se...
With the increased use of reverse shoulder arthroplasty, the complication of postoperative scapular fracture is increasingly recognized. The incidence is variable and dependent on a combination of factors including patient age, sex, bone mineral density, diagnosis of inflammatory arthritis, acromial thickness, and implant-related factors. Acromial...
Introduction:
Division chiefs (DCs) play an integral role within the department, making critical decisions and helping shape the future of both the division and the department. This study aimed to investigate the demographic characteristics and scholarly work of DCs in academic orthopaedic sports medicine division in the United States.
Methods:...
Background Missed fractures are a common cause of diagnostic discrepancy between initial radiographic interpretation and the final read by board-certified radiologists. Purpose To assess the effect of assistance by artificial intelligence (AI) on diagnostic performances of physicians for fractures on radiographs. Materials and Methods This retrospe...
Objective
The purpose of this study was to utilize fragility analysis to assess the robustness of randomized controlled trials (RCTs) evaluating the management of articular cartilage defects of the knee. We hypothesize that the cartilage restorative literature will be fragile with the reversal of only a few outcome events required to change statist...
The purpose of the present study was to perform the first examination of the utility of p values and the degree of statistical fragility in the hip arthroscopy literature by applying both the Fragility Index (FI) and the Fragility Quotient (FQ) to dichotomous comparative trials. We hypothesized that dichotomous comparative trials evaluating categor...
Background:
In recent years, superior capsular reconstruction (SCR) has emerged as a promising treatment for massive rotator cuff tears and has been performed with an array of graft options, most commonly dermal allograft and tensor fascia lata (TFL) autograft.
Purpose:
To compare the clinical outcomes, functional outcomes, and complication rate...
Background:
Fragility analysis is increasingly utilized to evaluate the robustness of results within the orthopaedic literature and has frequently revealed instability of reported outcomes.
Purpose/hypothesis:
The purpose of this investigation was to utilize a fragility analysis to evaluate the stability of reported results in the patellofemoral...
Purpose
Evidenced-based decision-making is rooted in comparative clinical studies; however, a small number of outcome event reversals have the potential to change study significance. The purpose of this study was to determine the utility of applying fragility analysis to comparative studies in the published orthopaedic shoulder literature.
Methods...
Background
With recent improvements in transducer strength, image resolution, and operator training, ultrasound (US) provides an excellent alternative imaging modality for the diagnosis of rotator cuff tears.
Purpose
To evaluate the diagnostic accuracy of US for partial- and full-thickness rotator cuff tears and biceps tendon tears, compare diagno...
Background:
There is controversy regarding the optimal treatment for infection following shoulder arthroplasty. The purpose of this systematic review is to analyze the bias in treatment selection, infection clearance rates, and functional outcomes after 1 versus 2-stage revision surgery for periprosthetic shoulder infections.
Methods:
A systemat...
Introduction:
Probability analysis with the reporting of P values is often used to determine the statistical significance of study findings in the Achilles literature. The purpose of this study was to determine the utility of applying a fragility analysis to comparative trials evaluating Achilles tendon injuries.
Methods:
We identified all dicho...
Introduction:
Scholarly impact has been used to measure faculty productivity and academic contribution throughout academia. Traditionally, the number of articles authored has been the primary metric for scholarly impact regarding academic promotion and reputation. We hypothesize that over time, the nature of authorship has evolved to include more...
Background
Walch B2 glenoid morphology with glenohumeral osteoarthritis is a difficult degenerative pattern to manage for shoulder surgeons. Anatomic total shoulder arthroplasty (TSA) in combination with eccentric reaming or bone grafting are the traditional methods of treatment. Newer approaches such as TSA with posteriorly augmented glenoid compo...
Background
Total elbow arthroplasty (TEA) is an effective intervention for multiple elbow disorders including complex fracture in elderly patients, post-traumatic arthropathy, inflammatory arthropathy, and distal humerus nonunion. Given its known therapeutic value and low utilization rate, an investigation into the thresholds for TEA institutional...
Background:
Clinicians of many specialties within sports medicine care for athletes with shoulder instability, but successful outcomes are inconsistent. Consistency across specialties in the diagnosis of shoulder instability is critical for care of the athlete, yet the extent of divergence in its diagnosis is unknown.
Hypothesis:
Physicians diff...
The elbow is primarily a ginglymus or hinge joint but consists of three bony articulations including ulnohumeral, radiocapitellar, and radioulnar motions. In elbow extension, contributions to valgus stability remain fairly constant that includes the bone architecture, anterior capsule, and medial ulnar collateral ligament. However, with increased f...
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Chronic quadriceps tendon (QT) ruptures are uncommon injuries that present treatment challenges due to their complex nature and the limited evidence to guide management.
»:
Timely diagnosis and surgical management of acute QT injury are imperative to optimize patient outcomes as delayed diagnosis leads to poorer results regardless of treatmen...
Introduction:
The purpose of this investigation was to assess the utilization of telehealth capabilities by pediatric orthopaedic departments across the United States in response to the COVID-19 pandemic.
Methods:
One hundred four pediatric orthopaedic departments were investigated regarding each institution's current telehealth utilization as a...
PurposeTo describe a non-anatomic arthroscopic all-inside repair technique for middle-aged and older patients with medial meniscus posterior root tears (MMPRTs) and to evaluate the short- to mid-term clinical and radiologic results. The hypothesis was that this procedure would yield good clinical outcome results and structural healing in middle- an...
Background:
The practice of evidence-based medicine relies on objective data to guide clinical decision-making with specific statistical thresholds conveying study significance.
Purpose:
To determine the utility of applying the fragility index (FI) and the fragility quotient (FQ) analysis to randomized controlled trials (RCTs) evaluating the uti...
Posterior glenohumeral instability is a relatively uncommon cause of shoulder instability. Recurrent posterior instability with static posterior humeral head subluxation is often associated with critical glenoid bone loss. Unlike anterior instability, the amount of bone loss for posterior instability that requires surgical reconstruction remains a...
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Cold therapy, also known as cryotherapy, includes the use of bagged ice, ice packs, compressive cryotherapy devices, or whole-body cryotherapy chambers. Cryotherapy is commonly used in postoperative care for both arthroscopic and open orthopaedic procedures.
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Cryotherapy is associated with an analgesic effect caused by microvasculature alte...
Addressing subscapularis tendon pathology has garnered increased attention during shoulder arthroscopy in attempt to adequately restore glenohumeral force couples. The appropriate rebalancing of force couples of the rotator cuff musculature by repairing subscapularis tendon tears in patients with large rotator cuff tears has been shown to improve f...
Introduction
Arthroscopic rotator cuff repair (RCR) is an effective treatment for patients with symptomatic rotator cuff tears. Ensuring timely and appropriate postoperative access to physical therapy (PT) is paramount to the achievement of optimal patient outcomes. Extended immobility due to a lack of formal rehabilitation can lead to decreased ra...
Background:
Anterior cruciate ligament (ACL) tears are debilitating injuries frequently suffered by athletes. ACL reconstruction is indicated to restore knee stability and allow patients to return to prior levels of athletic performance. While existing literature suggests that patient-reported outcomes are similar between bone–patellar tendon–bone...
Case
A 57-year old female with multiple comorbidities including arrhythmogenic right ventricular dysplasia, prior patent foramen ovale closure, and history of transient ischemic attack developed acute unilateral sensorineural hearing loss following arthroscopic shoulder surgery in the beach-chair position. The hearing loss persisted despite acute m...
Trapezius paralysis following injury to the spinal accessory nerve can be a debilitating complication resulting from lymph node biopsy, radical neck dissection, or penetrating trauma in the region of the posterior cervical triangle. Disruption of the delicate muscular balance in the shoulder girdle may result in lateral scapular winging, ipsilatera...
Shoulder metallosis with giant cell tumor formation is rarely seen in shoulder surgery. With an increase in shoulder arthroplasty and complex revision shoulder surgeries, clinicians should have an index of suspicion for possible metallosis in patients that presents with unexplained persistent pain with metal components on both the glenoid and humer...
Background
Shoulder arthroplasty is an increasingly popular treatment option for various shoulder pathologies. The purpose of this study is to evaluate changes in the national demand for shoulder arthroplasty, both anatomic (aTSA) and reverse (rTSA), in the United States and to predict future trends in utilization.
Methods
National Inpatient Sampl...
Background
Biceps tenodesis is a surgical treatment for both superior labral anterior-posterior (SLAP) tears and long head of the biceps tendon (LHBT) abnormalities. Biceps tenodesis can be performed either above or below the pectoralis major tendon with arthroscopic or open techniques.
Purpose
To analyze the outcomes and complications comparing p...
Purpose
To determine the risk of postoperative humeral fracture following tenotomy, open tenodesis and arthroscopic tenodesis of the long head of the biceps brachii.
Methods
A retrospective review of deidentified patient data from the Medicare Standard Analytic File using the PearlDiver software was conducted to identify procedures performed betwe...
Both rotator cuff repair (RCR) and reverse total shoulder arthroplasty (RTSA) are effective treatment options for chronic large degenerative rotator cuff tear (RCT) in the elderly. The goal of this study was to evaluate national trends for surgical management of chronic RCT among patients without glenohumeral arthritis. The authors conducted a retr...