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 ResearchConceptsBilateral 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 ResearchConceptsTotal 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 LOSIncreased complications in geriatric patients with a fracture of the hip whose postoperative weight-bearing is restricted: an analysis of 4918 patients.
Ottesen TD, McLynn RP, Galivanche AR, Bagi PS, Zogg CK, Rubin LE, Grauer JN. Increased complications in geriatric patients with a fracture of the hip whose postoperative weight-bearing is restricted: an analysis of 4918 patients. The Bone & Joint Journal 2018, 100-B: 1377-1384. PMID: 30295535, DOI: 10.1302/0301-620x.100b10.bjj-2018-0489.r1.Peer-Reviewed Original ResearchConceptsWeight-bearing restrictionsLength of stayAdverse eventsPostoperative weight-bearing restrictionsMajor adverse eventsEvidence-based guidelinesBone Joint JOperating theatreMultivariate regression analysisMultivariate oddsFrail patientsThromboembolic eventsElderly patientsHip fractureGeriatric patientsProcedural characteristicsInclusion criteriaPatientsGreater riskProcedural factorsHipReadmissionDeliriumTransfusionSurgery
2024
90-Day Complication and Readmission Rates for Geriatric Patients With Hip Fracture at Different Time Points From COVID-19 Positivity: A Database Study
Sanchez J, Jiang W, Dhodapkar M, Radford Z, Rubin L, Grauer J. 90-Day Complication and Readmission Rates for Geriatric Patients With Hip Fracture at Different Time Points From COVID-19 Positivity: A Database Study. JAAOS Global Research And Reviews 2024, 8: e24.00069. PMID: 39330875, PMCID: PMC11412709, DOI: 10.5435/jaaosglobal-d-24-00069.Peer-Reviewed Original ResearchConceptsHip fracture surgeryHip fractureGeriatric patientsFracture surgeryAdverse eventsRate of minor adverse eventsCOVID-19 diagnosisWeeks of surgeryMinor adverse eventsTime pointsAssociated with increased oddsComplication rateAssess complicationsCOVID-19 positivityCOVID-19 infectionMultivariate analysisSurgeryComplicationsPatientsDatabase studyReadmission ratesCare algorithmWeeksDiagnosisCOVID-19
2023
Management 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 ResearchConceptsHeart 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 ResearchConceptsTotal 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 ResearchConceptsTotal knee arthroplastyMagnetic resonance imagingElixhauser Comorbidity IndexComorbidity indexKnee arthroplastyDegenerative changesHigher Elixhauser comorbidity indexAdvanced degenerative changesLower extremity magnetic resonance imagingExtremity magnetic resonance imagingEvidence-based medicineComparing Race/Ethnicity and Zip Code Socioeconomic Status for Surgical versus Nonsurgical Management of Proximal Humerus Fractures in a Medicare Population
Joo P, Wilhelm C, Adeclat G, Halperin S, Moran J, Elaydi A, Rubin L, Grauer J. Comparing Race/Ethnicity and Zip Code Socioeconomic Status for Surgical versus Nonsurgical Management of Proximal Humerus Fractures in a Medicare Population. JAAOS Global Research And Reviews 2023, 7: e22.00205. PMID: 37141180, PMCID: PMC10162786, DOI: 10.5435/jaaosglobal-d-22-00205.Peer-Reviewed Original ResearchConceptsProximal humerus fracturesRace/ethnicityHumerus fracturesNonsurgical managementSocioeconomic statusSurgical utilizationMedian household incomeHigher Elixhauser comorbidity indexElixhauser Comorbidity IndexMultivariable logistic regressionLower median household incomeComorbidity indexMedicare cohortRace/ethnicity dataProximal humerusSurgical decisionMedicare populationIndependent significanceLogistic regressionPatientsHealth equityRacial disparitiesHousehold incomeEthnicity dataSurgery
2022
Prosthetic Joint Infections of the Hip and Knee Among the Elderly: A Retrospective Study
Spichler-Moffarah A, Rubin LE, Bernstein JA, O'Bryan J, McDonald E, Golden M. Prosthetic Joint Infections of the Hip and Knee Among the Elderly: A Retrospective Study. The American Journal Of Medicine 2022, 136: 100-107. PMID: 36063860, DOI: 10.1016/j.amjmed.2022.08.006.Peer-Reviewed Original ResearchConceptsProsthetic joint infectionJoint infectionTotal joint arthroplasty increasesMortality of patientsTertiary medical centerPeriprosthetic joint infectionYears of ageClinical characteristicsOlder patientsGeriatric populationArthroplasty increasesRisk factorsMedical CenterPopulation agesPatientsInfectionMortalityAgeEtiologyHipPrevalenceKneeIncidence, Timing, and Predictors of Hip Dislocation After Primary Total Hip Arthroplasty for Osteoarthritis
Gillinov SM, Joo PY, Zhu JR, Moran J, Rubin LE, Grauer JN. Incidence, Timing, and Predictors of Hip Dislocation After Primary Total Hip Arthroplasty for Osteoarthritis. Journal Of The American Academy Of Orthopaedic Surgeons 2022, 30: 1047-1053. PMID: 35947825, PMCID: PMC9588560, DOI: 10.5435/jaaos-d-22-00150.Peer-Reviewed Original ResearchConceptsPrimary total hip arthroplastyTotal hip arthroplastyElixhauser Comorbidity IndexBody mass indexComorbidity indexMass indexHip dislocationRevision surgeryRisk factorsHip arthroplastyIndex total hip arthroplastyHigher Elixhauser comorbidity indexPrimary THA patientsFirst-time dislocationCumulative incidenceMost patientsPostoperative dataTHA patientsRecurrent episodesControl subjectsFemale sexLarge cohortPatientsMultivariate analysisYounger agePredictors of Physical Abuse in Elder Patients With Fracture
Gardezi M, Moore HG, Rubin LE, Grauer JN. Predictors of Physical Abuse in Elder Patients With Fracture. JAAOS Global Research And Reviews 2022, 6: e22.00144. PMID: 35819835, PMCID: PMC9278940, DOI: 10.5435/jaaosglobal-d-22-00144.Peer-Reviewed Original ResearchConceptsAbuse patientsNational Emergency Department Sample databasePhysical abuseHigh-risk patientsMultivariate regressionPublic health issueLowest income quartileElderly patientsFracture patientsRisk patientsAnkle fracturesIndependent predictorsPediatric populationElder patientsEmergency departmentRib fracturesVolume depletionOdds ratioElder physical abuseElder abusePatientsUnivariate comparisonsMental disordersIncome quartileHealth issuesJump 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 ResearchConceptsTotal 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 arthroplastyThe case for decreased surgeon-reported complications due to surgical volume and fellowship status in the treatment of geriatric hip fracture: An analysis of the ABOS database
Ottesen TD, Mercier MR, Brand J, Amick M, Grauer JN, Rubin LE. The case for decreased surgeon-reported complications due to surgical volume and fellowship status in the treatment of geriatric hip fracture: An analysis of the ABOS database. PLOS ONE 2022, 17: e0263475. PMID: 35213546, PMCID: PMC8880652, DOI: 10.1371/journal.pone.0263475.Peer-Reviewed Original ResearchConceptsHip fracture patientsSurgical complicationsFracture patientsHip fractureCase volumeFellowship trainingBinary multivariate logistic regressionSurgeon-reported complicationsGeriatric hip fracturesOdds of complicationsSurgical adverse eventsMultivariate logistic regressionFellowship statusAdverse eventsComplication riskSurgical interventionSurgical outcomesABOS databaseSurgical volumeSurgeon cohortComplicationsType of fellowshipIndependent factorsPatientsOrthopaedic surgeons
2021
Clinical Characteristics and Perioperative Complication Profiles of COVID-19–Positive Patients Undergoing Hip Fracture Surgery
Galivanche AR, Mercier MR, Schneble CA, Brand J, Pathak N, Varthi AG, Rubin LE, Grauer JN. Clinical Characteristics and Perioperative Complication Profiles of COVID-19–Positive Patients Undergoing Hip Fracture Surgery. JAAOS Global Research And Reviews 2021, 5: e21.00104. PMID: 34653097, PMCID: PMC8522872, DOI: 10.5435/jaaosglobal-d-21-00104.Peer-Reviewed Original ResearchConceptsHip fracture surgeryCOVID-19 positive patientsMinor adverse eventsAdverse eventsCOVID-19 positivityFracture surgeryHigh incidenceCOVID-19 positive groupCOVID-19 positive statusCOVID-19-negative groupGeriatric hip fracture surgeryPerioperative complication profilePostoperative adverse eventsHip fracture patientsSerious adverse eventsPatient risk factorsAdministrative claims dataCOVID-19 infectionAdverse event informationOngoing global pandemicClinical characteristicsFracture patientsPostoperative eventsPreoperative variablesPropensity matchingHospital 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 experiencePredictors and Sequelae of Postoperative Delirium in a Geriatric Patient Population With Hip Fracture
Haynes MS, Alder KD, Toombs C, Amakiri IC, Rubin LE, Grauer JN. Predictors and Sequelae of Postoperative Delirium in a Geriatric Patient Population With Hip Fracture. JAAOS Global Research And Reviews 2021, 5: e20.00221. PMID: 33989253, PMCID: PMC8133215, DOI: 10.5435/jaaosglobal-d-20-00221.Peer-Reviewed Original ResearchConceptsHip fracture populationPostoperative deliriumPreoperative dementiaHip fractureGeriatric hip fracture populationDependent functional statusFracture populationAdverse postoperative outcomesHigher American SocietyIndependent risk factorPostoperative adverse outcomesGeriatric patient populationNongeneral anesthesiaPreoperative diabetesPostoperative outcomesIndependent predictorsMale sexAdverse outcomesPatient populationFunctional statusRevision surgeryRisk factorsDeliriumHigher oddsRisk subpopulationsLong-term Corticosteroid Use Independently Correlates With Complications After Posterior Lumbar Spine Surgery.
Kebaish KJ, Galivanche AR, Varthi AG, Ottesen TD, Rubin LE, Grauer JN. Long-term Corticosteroid Use Independently Correlates With Complications After Posterior Lumbar Spine Surgery. Orthopedics 2021, 44: 172-179. PMID: 34039214, DOI: 10.3928/01477447-20210416-01.Peer-Reviewed Original ResearchConceptsLong-term corticosteroid usePosterior lumbar spine surgeryPosterior lumbar surgeryLumbar spine surgeryPerioperative adverse outcomesCorticosteroid useAdverse eventsLumbar surgerySpine surgeryPropensity matchingAdverse outcomesNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseMinor adverse eventsEffect of immunosuppressionImprovement Program databaseLong-term corticosteroidsSerious adverse eventsBody mass indexMultiple surgical specialtiesAnesthesiologists classComparable patientsPerioperative outcomesSurgical factorsMore patients
2020
Patients' and Physicians' Knowledge of Radiation Exposure Related to Spine Surgery.
Scott MC, Galivanche AR, Mets EJ, Pathak N, Kahan JB, Burroughs PJ, Varthi AG, Rubin LE, Grauer JN. Patients' and Physicians' Knowledge of Radiation Exposure Related to Spine Surgery. Spine 2020, 45: e1507-e1515. PMID: 32858741, DOI: 10.1097/brs.0000000000003650.Peer-Reviewed Original ResearchConceptsSpine surgeryMagnetic resonance imagingRadiation exposureOutpatient settingPhysicians' knowledgeLumbar radiographsO-armCT imagingIntraoperative radiation exposureCross-sectional imagingCross-sectional surveyPhysician estimatesSpine proceduresBACKGROUND DATACare settingsIntraoperative fluoroscopyLumbar imagingPatientsSurgeryResonance imagingIntraoperative CTSurgeonsAwareness/knowledgeIntraoperative imagingRobotic spine surgeryCoagulopathies 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 readmissionPerioperative Outcomes of Hemiarthroplasty Versus Total Hip Arthroplasty for Geriatric Hip Fracture: The Importance of Studying Matched Populations
Haynes MS, Ondeck NT, Ottesen TD, Malpani R, Rubin LE, Grauer JN. Perioperative Outcomes of Hemiarthroplasty Versus Total Hip Arthroplasty for Geriatric Hip Fracture: The Importance of Studying Matched Populations. The Journal Of Arthroplasty 2020, 35: 3188-3194. PMID: 32654940, DOI: 10.1016/j.arth.2020.06.015.Peer-Reviewed Original ResearchConceptsTotal hip arthroplastyHip fractureAdverse eventsPropensity matchingBlood transfusionHip arthroplastyNational Surgical Quality Improvement databaseGeriatric femoral neck fracturesGreater readmission ratesGeriatric hip fracturesLower transfusion rateMajor adverse eventsMinor adverse eventsPostoperative adverse outcomesFemoral neck fracturesQuality improvement databaseRetrospective comparative studyMultivariate logistic regressionTransfusion ratePerioperative outcomesReadmission ratesSelect patientsTHA groupGeriatric patientsNeck fractures