Featured Publications
What Factors Affect Whether Patients Return to the Same Surgeon to Replace the Contralateral Joint? A Study of Over 200,000 Patients
Moore HG, Schneble CA, Kahan JB, Sculco PK, Grauer JN, Rubin LE. What Factors Affect Whether Patients Return to the Same Surgeon to Replace the Contralateral Joint? A Study of Over 200,000 Patients. The Journal Of Arthroplasty 2021, 37: 425-430. PMID: 34871749, DOI: 10.1016/j.arth.2021.11.036.Peer-Reviewed Original ResearchMeSH KeywordsAgedArthroplasty, Replacement, HipArthroplasty, Replacement, KneeHumansMedicaidMedicareRetrospective StudiesRisk FactorsSurgeonsUnited StatesConceptsBilateral total hip arthroplastyTotal knee arthroplastyTotal hip arthroplastyContralateral total hip arthroplastySame surgeonDifferent surgeonsAdverse eventsContralateral jointGreater oddsSurgery-related adverse eventsBilateral total knee arthroplastyNational Provider Identifier numberFirst joint replacementFirst total hip arthroplastyPossible independent predictorsContralateral replacementIndependent predictorsSicker patientsKnee arthroplastyAdministrative databasesHip arthroplastyLower oddsPatientsArthroplastyJoint replacementCenters for Medicare & Medicaid Services' 2018 Removal of Total Knee Arthroplasty From the Inpatient-only List Led to Broad Changes in Hospital Length of Stays
Rankin KA, Freedman IG, Rubin LE, Grauer JN. Centers for Medicare & Medicaid Services' 2018 Removal of Total Knee Arthroplasty From the Inpatient-only List Led to Broad Changes in Hospital Length of Stays. Journal Of The American Academy Of Orthopaedic Surgeons 2021, 29: 1061-1067. PMID: 33960970, DOI: 10.5435/jaaos-d-20-01228.Peer-Reviewed Original ResearchMeSH KeywordsAgedArthroplasty, Replacement, KneeCenters for Medicare and Medicaid Services, U.S.HospitalsHumansInpatientsLength of StayMedicaidMedicareRetrospective StudiesUnited StatesConceptsTotal knee arthroplastyHospital lengthKnee arthroplastyNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseMedicare eligibilityCategorical data comparisonsOverall practice patternsRetrospective cohort studyImprovement Program databaseSame dayRemoval of TKAPearson's chi-squared testChi-squared testMann-Whitney testLOS daysProlonged LOSMost patientsTKA patientsCohort studyMore patientsPractice patternsPatient characterizationProgram databaseActual LOSEssential elements of an outpatient total joint replacement programme.
Li J, Rubin LE, Mariano ER. Essential elements of an outpatient total joint replacement programme. Current Opinion In Anaesthesiology 2019, 32: 643-648. PMID: 31356361, DOI: 10.1097/aco.0000000000000774.Peer-Reviewed Original ResearchMeSH KeywordsAmbulatory Surgical ProceduresArthroplasty, Replacement, HipArthroplasty, Replacement, KneeCritical PathwaysFeasibility StudiesHealth Plan ImplementationHumansLength of StayMedicaidMedicarePatient Education as TopicPatient ReadmissionPatient SatisfactionPatient SelectionPostoperative ComplicationsProgram EvaluationTreatment OutcomeUnited StatesConceptsTotal joint arthroplastyOutpatient total joint arthroplastyPatient satisfactionLong-term functional outcomePatient/family educationTotal knee arthroplasty patientsOpioid-sparing analgesiaShort-term complicationsTotal joint replacement programKnee arthroplasty patientsSubset of patientsStandardized clinical pathwayPositive surgical outcomesProper patient selectionJoint replacement programEvidence-based guidanceNew care paradigmPostdischarge planningAdverse eventsArthroplasty patientsPatient selectionSurgical outcomesFunctional outcomeOutpatient surgeryInpatient proceduresTotal Hip and Knee Arthroplasty in Patients Older Than Age 80 Years
Rubin LE, Blood TD, Defillo-Draiby JC. Total Hip and Knee Arthroplasty in Patients Older Than Age 80 Years. Journal Of The American Academy Of Orthopaedic Surgeons 2016, 24: 683-690. PMID: 27579814, DOI: 10.5435/jaaos-d-15-00278.Peer-Reviewed Original ResearchMeSH KeywordsAccidental FallsAge FactorsAged, 80 and overArthroplasty, Replacement, HipArthroplasty, Replacement, KneeFemaleHip JointHumansJoint DiseasesKnee JointReoperationRisk FactorsUnited StatesConceptsTotal hipKnee arthroplastyOlder patientsLength of hospitalRisk of morbidityAge 80 yearsTotal knee arthroplastyPain reliefElderly patientsMinor complicationsPerioperative safetyYounger patientsClinical outcomesFunctional outcomePatient satisfactionRevision surgeryAdvanced ageMortality ratePatientsOrthopaedic surgeonsArthroplastyHipMorbidityDemographic profileSurgeons
2023
Patients With Down Syndrome and Total Hip and Total Knee Arthroplasty: Outcome Measures Show Increased Risk of Perioperative Complications
Halperin S, Dhodapkar M, Radford Z, Frumberg D, Rubin L, Grauer J. Patients With Down Syndrome and Total Hip and Total Knee Arthroplasty: Outcome Measures Show Increased Risk of Perioperative Complications. JAAOS Global Research And Reviews 2023, 7: e23.00108. PMID: 38054749, PMCID: PMC10697628, DOI: 10.5435/jaaosglobal-d-23-00108.Peer-Reviewed Original ResearchMeSH KeywordsAdultArthroplasty, Replacement, HipArthroplasty, Replacement, KneeDown SyndromeHumansOsteoarthritisOutcome Assessment, Health CarePostoperative ComplicationsConceptsTotal knee arthroplastyTotal hip arthroplastyAcute kidney injuryUrinary tract infectionAdverse eventsDown syndromePostoperative eventsKnee arthroplastyRevision ratePerioperative risk assessmentMinor adverse eventsOutcomes of patientsMultivariable logistic regressionTotal joint arthroplastyPatient/family counselingKidney injuryPerioperative complicationsTKA patientsAdult patientsTract infectionsDS patientsIncreased riskTotal hipCare pathwayJoint arthroplastyManagement of Bilateral Synchronous Knee Prosthetic Joint Infection in a Patient with Infected Heart Transplant
Jeong S, Yang A, Rubin L, Arsoy D. Management of Bilateral Synchronous Knee Prosthetic Joint Infection in a Patient with Infected Heart Transplant. JBJS Case Connector 2023, 13: e23.00182. PMID: 37506219, DOI: 10.2106/jbjs.cc.23.00182.Peer-Reviewed Original ResearchMeSH KeywordsAgedAnti-Bacterial AgentsArthritis, InfectiousArthroplasty, Replacement, KneeHumansKnee JointKnee ProsthesisMaleReoperationConceptsHeart transplantKnee prosthetic joint infectionProsthetic knee infectionProsthetic joint infectionResection arthroplastyKnee infectionRadical debridementSeptic shockEnterococcal endocarditisJoint infectionProsthetic knee jointRegular implantsKnee jointTransplantInfectionPatientsFirst reportEndocarditisDebridementArthroplastyPlacementTotal Knee Arthroplasty: Variables Affecting 90-day Overall Reimbursement
Halperin S, Dhodapkar M, Radford Z, Li M, Rubin L, Grauer J. Total Knee Arthroplasty: Variables Affecting 90-day Overall Reimbursement. The Journal Of Arthroplasty 2023, 38: 2259-2263. PMID: 37279847, DOI: 10.1016/j.arth.2023.05.072.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAgedArthroplasty, Replacement, HipArthroplasty, Replacement, KneeHumansMedicaidMedicarePatient ReadmissionUnited StatesConceptsTotal knee arthroplastyTKA patientsPrimary total knee arthroplastyPostoperative emergency departmentPostoperative adverse eventsRisk of readmissionMultivariable linear regressionPerioperative periodPostoperative eventsAdverse eventsAppropriate patientsKnee osteoarthritisEmergency departmentPatients surgeryKnee arthroplastyOncologic indicationsCost-containment strategiesSurgical proceduresExclusion criteriaPatientsOptimize deliveryOverall reimbursementAdmissionReimbursementGreater increaseMagnetic Resonance Imaging in the Year Prior to Total Knee Arthroplasty: A Potential Overutilization of Healthcare Resources
Rudisill K, Ratnasamy P, Joo P, Rubin L, Grauer J. Magnetic Resonance Imaging in the Year Prior to Total Knee Arthroplasty: A Potential Overutilization of Healthcare Resources. JAAOS Global Research And Reviews 2023, 7: e22.00262. PMID: 37205731, PMCID: PMC10566819, DOI: 10.5435/jaaosglobal-d-22-00262.Peer-Reviewed Original ResearchMeSH KeywordsAgedArthroplasty, Replacement, KneeDelivery of Health CareFemaleHumansKnee JointMagnetic Resonance ImagingMedicareUnited StatesConceptsTotal knee arthroplastyMagnetic resonance imagingElixhauser Comorbidity IndexComorbidity indexKnee arthroplastyDegenerative changesHigher Elixhauser comorbidity indexAdvanced degenerative changesLower extremity magnetic resonance imagingExtremity magnetic resonance imagingEvidence-based medicine
2022
Admission NarxCare Narcotic Scores Are Associated With Increased Odds of Readmission and Prolonged Length of Hospital Stay After Primary Elective Total Knee Arthroplasty
Galivanche A, Zhu J, Mercier M, McLean R, Wilhelm C, Varthi A, Grauer J, Rubin L. Admission NarxCare Narcotic Scores Are Associated With Increased Odds of Readmission and Prolonged Length of Hospital Stay After Primary Elective Total Knee Arthroplasty. JAAOS Global Research And Reviews 2022, 6: e22.00040. PMID: 36732305, PMCID: PMC9726283, DOI: 10.5435/jaaosglobal-d-22-00040.Peer-Reviewed Original ResearchMeSH KeywordsArthroplasty, Replacement, KneeHospitalizationHumansLength of StayNarcoticsPatient ReadmissionConceptsPrimary elective total knee arthroplastyElective total knee arthroplastyTotal knee arthroplastyNarcotic scoreOverall opioid usageAdverse eventsTKA patientsHospital stayKnee arthroplastyRisk of AEsOdds of readmissionPrimary TKA patientsPreoperative narcotic useTime of admissionDose-dependent increaseOpioid usagePostoperative outcomesPatient characteristicsProlonged lengthNarcotic useAdverse outcomesSingle institutionRevision surgeryReadmissionPatientsAdverse Events After Total Hip Arthroplasty are not Sufficiently Characterized by 30-Day Follow-Up: A Database Study
Maloy GC, Kammien AJ, Rubin LE, Grauer JN. Adverse Events After Total Hip Arthroplasty are not Sufficiently Characterized by 30-Day Follow-Up: A Database Study. The Journal Of Arthroplasty 2022, 38: 525-529. PMID: 36272511, DOI: 10.1016/j.arth.2022.10.020.Peer-Reviewed Original ResearchMeSH KeywordsAdultArthroplasty, Replacement, HipArthroplasty, Replacement, KneeBlood TransfusionDatabases, FactualFemaleHumansMalePostoperative ComplicationsRetrospective StudiesRisk FactorsConceptsTotal hip arthroplastyPostoperative adverse eventsAdverse eventsDay of surgeryHip arthroplastyDays of THAHigher Elixhauser-Comorbidity Index scoresElixhauser comorbidity index scoreComorbidity Index scoreLate adverse eventsTime of diagnosisPostoperative day 31THA patientsPredictive factorsPatient counselingPatient riskDatabase studyPrevention strategiesIndex scoreDay 31SurgeryInterquartile rangeAdministrative datasetsPatientsArthroplastyJump in Elective Total Hip and Knee Arthroplasty Numbers at Age 65 Years: Evidence for Moral Hazard?
Rankin KA, Freedman IG, Moore HG, Halperin SJ, Rubin LE, Grauer JN. Jump in Elective Total Hip and Knee Arthroplasty Numbers at Age 65 Years: Evidence for Moral Hazard? JAAOS Global Research And Reviews 2022, 6: e22.00035. PMID: 35315795, PMCID: PMC8942773, DOI: 10.5435/jaaosglobal-d-22-00035.Peer-Reviewed Original ResearchMeSH KeywordsAgedArthroplasty, Replacement, HipArthroplasty, Replacement, KneeFemaleHumansMaleMedicareMoralsPostoperative ComplicationsRetrospective StudiesUnited StatesConceptsTotal knee arthroplastyTotal hip arthroplastyAge 65 yearsNational Surgical Quality Improvement Program databaseIncidence of TKAElective total knee arthroplastyQuality Improvement Program databaseLower body mass indexElective total hipPostoperative adverse eventsPreoperative American SocietyImprovement Program databaseLower functional statusBody mass indexNon-Hispanic whitesNumber of proceduresAnesthesiologists classPreoperative characteristicsOlder patientsAdverse eventsTHA patientsMass indexTotal hipFunctional statusKnee arthroplastyTotal Hip Arthroplasty in Patients With Classic Hemophilia: A Matched Comparison of 90-Day Outcomes and 5-Year Implant Survival
Gillinov SM, Burroughs PJ, Moore HG, Rubin LE, Frumberg DB, Grauer JN. Total Hip Arthroplasty in Patients With Classic Hemophilia: A Matched Comparison of 90-Day Outcomes and 5-Year Implant Survival. The Journal Of Arthroplasty 2022, 37: 1333-1337. PMID: 35257821, PMCID: PMC9177736, DOI: 10.1016/j.arth.2022.02.107.Peer-Reviewed Original ResearchMeSH KeywordsArthroplasty, Replacement, HipArthroplasty, Replacement, KneeHematomaHemophilia AHumansPostoperative ComplicationsPulmonary EmbolismRetrospective StudiesRisk FactorsVenous ThromboembolismVenous ThrombosisConceptsTotal hip arthroplastyNon-hemophilia patientsMinor adverse eventsSerious adverse eventsAdverse eventsClassic hemophiliaHaemophilia patientsImplant survivalHip arthroplastyGreater oddsMultivariate analysisFive-year implant survivalPrimary total hip arthroplastyAcute kidney injuryVenous thromboembolism prophylaxisElixhauser Comorbidity IndexKaplan-Meier analysisEvidence-based guidelinesThromboembolism prophylaxisVTE prophylaxisComorbidity indexKidney injuryTHA patientsFactor replacementRetrospective study
2021
Revision Total Hip and Knee Arthroplasty are Associated With Lower Hospital Consumer Assessment of Healthcare Providers and Systems Patient Satisfaction Scores Compared With Primary Arthroplasty
Mercier MR, Galivanche AR, Pathak N, Mets EJ, Molho DA, Elaydi AH, Grauer JN, Rubin LE. Revision Total Hip and Knee Arthroplasty are Associated With Lower Hospital Consumer Assessment of Healthcare Providers and Systems Patient Satisfaction Scores Compared With Primary Arthroplasty. Journal Of The American Academy Of Orthopaedic Surgeons 2021, 30: e336-e346. PMID: 34851861, DOI: 10.5435/jaaos-d-21-00839.Peer-Reviewed Original ResearchMeSH KeywordsAdultArthroplasty, Replacement, HipArthroplasty, Replacement, KneeHealth PersonnelHospitalsHumansPatient SatisfactionRetrospective StudiesConceptsRevision total hip arthroplastyTotal knee arthroplastyTotal hip arthroplastyRevision THA patientsHospital Consumer AssessmentTHA patientsHCAHPS surveyHCAHPS scoresTKA patientsKnee arthroplastyRevision proceduresHealthcare providersPrimary total joint arthroplastyPrimary total knee arthroplastyPrimary total hip arthroplastyConsumer AssessmentLonger hospital lengthRevision TKA patientsHigher American SocietyPatient satisfaction outcomesPatient satisfaction scoresRate of revisionRevision total hipTotal joint arthroplastySystems Patient Satisfaction ScoresHospital Consumer Assessment of Healthcare Providers and Systems survey response rates are significantly affected by patient characteristics and postoperative outcomes for patients undergoing primary total knee arthroplasty
Mercier MR, Galivanche AR, David WB, Malpani R, Pathak N, Hilibrand AS, Rubin LE, Grauer JN. Hospital Consumer Assessment of Healthcare Providers and Systems survey response rates are significantly affected by patient characteristics and postoperative outcomes for patients undergoing primary total knee arthroplasty. PLOS ONE 2021, 16: e0257555. PMID: 34582475, PMCID: PMC8478166, DOI: 10.1371/journal.pone.0257555.Peer-Reviewed Original ResearchConceptsTotal knee arthroplastyPrimary total knee arthroplastyHospital Consumer AssessmentPostoperative outcomesPatient characteristicsHCAHPS survey resultsHCAHPS surveySurvey response rateKnee arthroplastyResponse rateHealthcare providersConsumer AssessmentHigher American SocietyMultivariate regression analysisAnesthesia scorePostoperative variablesTKA patientsAdult patientsPrimary outcomePatient factorsSurgical variablesPatient populationPatient satisfactionSingle institutionHospital experience
2020
Coagulopathies Are a Risk Factor for Adverse Events Following Total Hip and Total Knee Arthroplasty.
Malpani R, Mclynn RP, Bovonratwet P, Bagi PS, Yurter A, Mercier MR, Rubin LE, Grauer JN. Coagulopathies Are a Risk Factor for Adverse Events Following Total Hip and Total Knee Arthroplasty. Orthopedics 2020, 43: 233-238. PMID: 32674174, DOI: 10.3928/01477447-20200624-02.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overArthroplasty, Replacement, HipArthroplasty, Replacement, KneeBlood Coagulation DisordersDatabases, FactualFemaleHumansMaleMiddle AgedMultivariate AnalysisOutcome Assessment, Health CarePatient ReadmissionPostoperative ComplicationsRetrospective StudiesRisk FactorsYoung AdultConceptsHigher international normalized ratioInternational normalized ratioMajor adverse eventsTotal hip arthroplastyPartial thromboplastin timeHigher partial thromboplastin timeMinor adverse eventsAdverse eventsLow plateletsHematological conditionsSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseTotal knee arthroplasty (TKA) populationQuality Improvement Program databasePrimary total hip arthroplastyDependent functional statusImprovement Program databasePostsurgical adverse eventsTotal knee arthroplastyMultiple adverse eventsPreoperative coagulopathyTHA cohortTKA groupTKA patientsHospital readmissionPreoperative Risk Factor Optimization Lowers Hospital Length of Stay and Postoperative Emergency Department Visits in Primary Total Hip and Knee Arthroplasty Patients
Dlott CC, Moore A, Nelson C, Stone D, Xu Y, Morris JC, Gibson DH, Rubin LE, O'Connor MI. Preoperative Risk Factor Optimization Lowers Hospital Length of Stay and Postoperative Emergency Department Visits in Primary Total Hip and Knee Arthroplasty Patients. The Journal Of Arthroplasty 2020, 35: 1508-1515.e2. PMID: 32113812, DOI: 10.1016/j.arth.2020.01.083.Peer-Reviewed Original ResearchMeSH KeywordsArthroplasty, Replacement, HipArthroplasty, Replacement, KneeEmergency Service, HospitalHospitalsHumansLength of StayPatient ReadmissionPostoperative ComplicationsRetrospective StudiesRisk FactorsConceptsED visitsContemporary cohortHistorical cohortHospital lengthRisk factorsSignificant decreaseElective primary total hip arthroplastyPostoperative emergency department visitsPrimary total hip arthroplastyLower hospital lengthPostoperative emergency departmentRisk factor optimizationPrimary total hipModifiable risk factorsPercentage of patientsTotal joint replacement programEmergency department visitsKnee arthroplasty patientsSurgical site infectionOptimization of patientsTotal knee arthroplastyJoint replacement programTotal hip arthroplastyPatient-centered approachRisk factor identification
2019
Matched cohort analysis of peri-operative outcomes following total knee arthroplasty in patients with and without Parkinson's disease
Kleiner JE, Gil JA, Eltorai AEM, Rubin LE, Daniels AH. Matched cohort analysis of peri-operative outcomes following total knee arthroplasty in patients with and without Parkinson's disease. The Knee 2019, 26: 876-880. PMID: 31171425, DOI: 10.1016/j.knee.2019.05.003.Peer-Reviewed Original ResearchMeSH KeywordsAgedArthroplasty, Replacement, KneeFemaleHospital ChargesHospital MortalityHumansLength of StayMaleMatched-Pair AnalysisParkinson DiseasePostoperative ComplicationsUnited StatesConceptsTotal knee arthroplastyCharlson Comorbidity IndexLength of stayPD patientsComplication rateDisease patientsKnee arthroplastyCohort analysisGreater Charlson Comorbidity IndexHCUP Nationwide Inpatient SampleHospital complication ratesHospital mortality ratePeri-operative outcomesTotal hospital chargesMultivariable logistic regressionNationwide Inpatient SampleNon-PD patientsCost of hospitalizationYear of admissionParkinson's disease patientsHospital mortalityComorbidity indexTKA patientsControl patientsHospital charges
2018
Trends in Medicare Reimbursement for Orthopedic Procedures: 2000 to 2016.
Eltorai AEM, Durand WM, Haglin JM, Rubin LE, Weiss AC, Daniels AH. Trends in Medicare Reimbursement for Orthopedic Procedures: 2000 to 2016. Orthopedics 2018, 41: 95-102. PMID: 29494748, DOI: 10.3928/01477447-20180226-04.Peer-Reviewed Original Research
2017
Revision Total Knee Arthroplasty in Octogenarians: An Analysis of 957 Cases
Bovonratwet P, Tyagi V, Ottesen TD, Ondeck NT, Rubin LE, Grauer JN. Revision Total Knee Arthroplasty in Octogenarians: An Analysis of 957 Cases. The Journal Of Arthroplasty 2017, 33: 178-184. PMID: 28844628, DOI: 10.1016/j.arth.2017.07.032.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overArthroplasty, Replacement, KneeBlood TransfusionDatabases, FactualFemaleHumansLength of StayMaleMiddle AgedPostoperative ComplicationsPropensity ScoreQuality ImprovementUnited StatesConceptsRevision total knee arthroplastyTotal knee arthroplastyBlood transfusionOctogenarian patientsKnee arthroplastyPatient populationNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseLonger lengthYoung populationHigh rateImprovement Program databaseYoung patient populationNumber of octogenariansLarger patient populationYear oldsHospital stayIntraoperative characteristicsPerioperative complicationsPerioperative coursePropensity matchingAdvanced ageProgram databaseOctogenariansStayReported Litigation Associated With Primary Hip and Knee Arthroplasty
Bokshan SL, Ruttiman RJ, DePasse JM, Eltorai AEM, Rubin LE, Palumbo MA, Daniels AH. Reported Litigation Associated With Primary Hip and Knee Arthroplasty. The Journal Of Arthroplasty 2017, 32: 3573-3577.e1. PMID: 28781019, DOI: 10.1016/j.arth.2017.07.001.Peer-Reviewed Original ResearchMeSH KeywordsAgedArthroplasty, Replacement, HipArthroplasty, Replacement, KneeCompensation and RedressDatabases, FactualFemaleHumansMaleMalpracticeMiddle AgedRetrospective StudiesSurgeonsUnited StatesConceptsKnee arthroplastyNerve injuryCommon complicationTechnical complicationsPhysician lossTotal joint arthroplastyCauses of litigationMalpractice lawsuitsPrimary hipTotal hipLikely complicationsJoint arthroplastyRetrospective analysisHip arthroplastyComplicationsArthroplasty surgeonsArthroplastyPainPatientsInjuryHipSurgeonsAverage paymentVerdictSearchCases