Featured Publications
Total Hip Arthroplasty Imageless Navigation Does Not Reduce 90-Day Adverse Events or Five-Year Revisions in a Large National Cohort
Jayaram R, Gillinov S, Caruana D, Kammien A, Joo P, Rubin L, Grauer J. Total Hip Arthroplasty Imageless Navigation Does Not Reduce 90-Day Adverse Events or Five-Year Revisions in a Large National Cohort. The Journal Of Arthroplasty 2022, 38: 862-867. PMID: 36529197, DOI: 10.1016/j.arth.2022.12.012.Peer-Reviewed Original ResearchConceptsTotal hip arthroplastyAdverse eventsImageless navigationMultivariate analysisLarge national administrative databaseElixhauser comorbidity index scorePrimary total hip arthroplastyComorbidity Index scoreFive-year incidencePostoperative adverse eventsNational administrative databaseLarge national cohortLarge national databaseCause revisionTHA patientsWound dehiscenceNational cohortTHA casesAdministrative databasesDislocation rateHip arthroplastyHigher oddsNavigation groupIndex scoreComputer navigationWhat 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 LOSAnatomic Navigation Using the Transverse Acetabular Ligament for Acetabular Component Positioning in Total Hip Arthroplasty Through the Direct Anterior Approach
Molho DA, Kuether JP, Rubin LE. Anatomic Navigation Using the Transverse Acetabular Ligament for Acetabular Component Positioning in Total Hip Arthroplasty Through the Direct Anterior Approach. Journal Of The American Academy Of Orthopaedic Surgeons 2021, 30: 100-103. PMID: 35772088, DOI: 10.5435/jaaos-d-20-00839.Peer-Reviewed Original ResearchConceptsDirect anterior approachTotal hip arthroplastyTransverse acetabular ligamentAnterior approachHip arthroplastyImplant positioningSingle-surgeon case seriesAcetabular component positioningLewinnek safe zoneCase seriesComponent positioningAnatomic landmarksPreoperative planImplant positionArthroplastyPilot dataLigamentSafe zoneExposureAcetabulumEssential 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 proceduresIncreased 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 factorsHipReadmissionDeliriumTransfusionSurgeryTotal 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 ResearchConceptsTotal hipKnee arthroplastyOlder patientsLength of hospitalRisk of morbidityAge 80 yearsTotal knee arthroplastyPain reliefElderly patientsMinor complicationsPerioperative safetyYounger patientsClinical outcomesFunctional outcomePatient satisfactionRevision surgeryAdvanced ageMortality ratePatientsOrthopaedic surgeonsArthroplastyHipMorbidityDemographic profileSurgeons
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-19Increasing Value in Subspecialty Training: A Comparison of Variation in Surgical Complications for Pediatric Versus Other Fellowship-trained American Board of Orthopaedic Surgery Candidates in the Treatment of Supracondylar Fractures
Ottesen T, Amick M, Kirwin D, Mercier M, Brand J, Frumberg D, Grauer J, Rubin L. Increasing Value in Subspecialty Training: A Comparison of Variation in Surgical Complications for Pediatric Versus Other Fellowship-trained American Board of Orthopaedic Surgery Candidates in the Treatment of Supracondylar Fractures. JAAOS Global Research And Reviews 2024, 8: e22.00239. PMID: 38252550, PMCID: PMC10805463, DOI: 10.5435/jaaosglobal-d-22-00239.Peer-Reviewed Original ResearchConceptsSurgical complicationsTreatment of supracondylar fracturesSupracondylar fracturesCase volumeABOS candidatesPredictive factors of complicationsSubspecialty trainingFactors of complicationsSurgeon-reported complicationsBinary multivariate logistic regressionFellowship-trained surgeonsYear of procedureComplex fracture typesMultivariate logistic regressionIncreasing case volumeComplication rateAmerican BoardPredictive factorsPatient sexFracture complicationsTargeted educational effortsComplicationsFracture typeSurgery candidatesSurgical caseload
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 ResearchConceptsTotal 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 arthroplastyEmergency Department Visits Following Patellofemoral Arthroplasty
Ratnasamy P, Halperin S, Dhodapkar M, Rubin L, Grauer J. Emergency Department Visits Following Patellofemoral Arthroplasty. JAAOS Global Research And Reviews 2023, 7: e23.00054. PMID: 37947430, PMCID: PMC10635600, DOI: 10.5435/jaaosglobal-d-23-00054.Peer-Reviewed Original ResearchConceptsPatellofemoral arthroplastyED utilizationPFA patientsPostoperative painED visitsPredictive factorsHigher Elixhauser comorbidity indexPerioperative pain managementElixhauser Comorbidity IndexEmergency department utilizationPostoperative metricsComorbidity indexIndependent predictorsPain managementMedicaid insuranceEmergency departmentOrthopedic patientsPayer typePatient carePatientsYounger ageVisitsPainArthroplastyDaysManagement 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 medicineUrgent Care Visits Sought After Primary Total Hip Arthroplasty: A Potentially Overlooked Resource
Dhodapkar M, Gouzoulis M, Halperin S, Radford Z, Rubin L, Grauer J. Urgent Care Visits Sought After Primary Total Hip Arthroplasty: A Potentially Overlooked Resource. The Journal Of Arthroplasty 2023, 38: 2361-2365. PMID: 37196730, DOI: 10.1016/j.arth.2023.05.012.Peer-Reviewed Original ResearchConceptsUrgent care visitsTotal hip arthroplastyPrimary total hip arthroplastyUrgent care utilizationCare visitsED utilizationCare utilizationUrgent careHip arthroplastyLess comorbidity burdenEmergency department visitsLarge national databaseLow-acuity diagnosesComorbidity burdenPostoperative EDED visitsDepartment visitsIndependent predictorsTHA patientsMultivariable analysisPostoperative weekUrgent evaluationSurgical sitePatient needsGreater incidenceComparing 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 dataSurgeryComparison of Differences in Surgical Complications Between Fellowship-Trained Orthopedic Foot and Ankle Surgeons and All Other Orthopedic Surgeons Using the ABOS Database.
Ottesen T, Pathak N, Mercier M, Kirwin D, Lukasiewicz A, Grauer J, Rubin L. Comparison of Differences in Surgical Complications Between Fellowship-Trained Orthopedic Foot and Ankle Surgeons and All Other Orthopedic Surgeons Using the ABOS Database. Orthopedics 2023, 46: e237-e243. PMID: 36719412, DOI: 10.3928/01477447-20230125-05.Peer-Reviewed Original ResearchConceptsSurgical complicationsOrthopaedic surgeonsFellowship trainingBinary multivariate logistic regressionFellowship-trained orthopedic footFellowship-trained orthopaedic surgeonsAnkle fracture repairSpecific patient comorbiditiesSurgeon-reported complicationsTrauma fellowship trainingMultivariate logistic regressionFellowship-trained surgeonsOrthopaedic Surgery databaseComplexity of casesAmerican BoardOrthopaedic FootAdverse eventsPatient comorbiditiesComorbidity dataABOS databaseAnkle surgeryPatient complicationsSurgery DatabaseSurgical complexityInclusion criteriaIs There Utility to Requiring Spine MRI Pre-authorizations? Pre-authorizations
Kebaish K, Galivanche A, Mercier M, Varthi A, Rubin L, Grauer J. Is There Utility to Requiring Spine MRI Pre-authorizations? Pre-authorizations. Clinical Spine Surgery A Spine Publication 2023, 36: 186-189. PMID: 36728293, DOI: 10.1097/bsd.0000000000001422.Peer-Reviewed Original ResearchConceptsSpine magnetic resonance imagingMagnetic resonance imagingSpine centerAcademic spine centerRetrospective cohort studySignificant increased oddsMultivariate logistic regressionPatient undergoing treatmentEventual dispositionInsurance carriersCohort studyIncreased oddsCommercial insurance carriersMRI requestsMRI ordersUndergoing treatmentBACKGROUND DATAGreater oddsPreauthorization processCommercial insuranceResonance imagingSpine scansLogistic regressionPreauthorizationScans
2022
Comparing Venous Thromboembolism Prophylactic Agents After Hip Fracture Surgery: A National Database Study
Joo P, Modrak M, Park N, Brand J, Rubin L, Grauer J, Bernstein J. Comparing Venous Thromboembolism Prophylactic Agents After Hip Fracture Surgery: A National Database Study. JAAOS Global Research And Reviews 2022, 6: e22.00228. PMID: 36732301, PMCID: PMC9746777, DOI: 10.5435/jaaosglobal-d-22-00228.Peer-Reviewed Original ResearchConceptsHip fracture surgeryFracture surgeryAdverse eventsOdds ratioProphylactic agentGreater oddsAnticoagulant-naïve patientsDifferent anticoagulant agentsVenous thromboembolism chemoprophylaxisVTE prophylactic agentNational database studyDistal femoral fracturesCoumadin groupLower transfusionVTE prophylaxisVTE ratesPatient characteristicsComorbidity profilesFemoral fracturesChemoprophylactic agentAnticoagulant agentsCoumadinDatabase studyLower oddsPatientsAdmission 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 ResearchConceptsPrimary 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 surgeryReadmissionPatients