2024
Trends in Total Hip Arthroplasty Length of Stay and Coding Status From 2018 to 2021: Two-Year Impact of the Removal From the Inpatient-Only List
Sanchez J, Dhodapkar M, Halperin S, Jiang W, Grauer J, Rubin L. Trends in Total Hip Arthroplasty Length of Stay and Coding Status From 2018 to 2021: Two-Year Impact of the Removal From the Inpatient-Only List. Arthroplasty Today 2024, 30: 101568. DOI: 10.1016/j.artd.2024.101568.Peer-Reviewed Original ResearchLength of stayInpatient-onlyCode statusCenters for MedicareAverage length of stayPearson chi-square testOutpatient total hip arthroplastyCurrent Procedural Terminology codesChi-square testTotal hip arthroplasty patientsSmoking statusMethods DataTotal hip arthroplastyTwo-year impactProcedural Terminology codesNational Surgical Quality Improvement Program databaseAmerican Society of Anesthesiologists classificationAnalysis of variance testQuality Improvement Program databaseOutpatient statusOutpatient casesAge groupsYear of surgeryCategorical variablesTerminology codes
2022
Unicompartmental Knee Arthroplasty in Octogenarians: A National Database Analysis Including Over 700 Octogenarians
Moore HG, Schneble CA, Kahan JB, Grauer JN, Rubin LE. Unicompartmental Knee Arthroplasty in Octogenarians: A National Database Analysis Including Over 700 Octogenarians. Arthroplasty Today 2022, 15: 55-60. PMID: 35399988, PMCID: PMC8991237, DOI: 10.1016/j.artd.2022.02.009.Peer-Reviewed Original ResearchUnicompartmental knee arthroplastyAdverse eventsMedical comorbiditiesKnee arthroplastyNational Surgical Quality Improvement Program databaseLarge national surgical databaseQuality Improvement Program databaseHigher comorbidity burdenMinor adverse eventsPostoperative adverse eventsSerious adverse eventsImprovement Program databaseProlonged hospital stayUrinary tract infectionDay of surgeryNational database analysisNational surgical databaseShort-term mortalityMultivariate regression analysisComorbidity burdenOctogenarian cohortHospital lengthHospital stayNonhome dischargeSelect patientsJump 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 arthroplastyUnderweight patients are the highest risk body mass index group for perioperative adverse events following stand-alone anterior lumbar interbody fusion
Ottesen TD, Galivanche AR, Greene JD, Malpani R, Varthi AG, Grauer JN. Underweight patients are the highest risk body mass index group for perioperative adverse events following stand-alone anterior lumbar interbody fusion. The Spine Journal 2022, 22: 1139-1148. PMID: 35231643, DOI: 10.1016/j.spinee.2022.02.012.Peer-Reviewed Original ResearchConceptsBody mass indexNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseAnterior lumbar interbody fusionObese class 1Improvement Program databaseClass 2 patientsAdverse eventsUnderweight patientsBMI categoriesAdverse outcomesBMI spectrumInterbody fusionProgram databaseTwo-level anterior lumbar interbody fusionSurgeons National Surgical Quality Improvement Program databaseMultivariate analysisThirty-day adverse eventsWorld Health Organization categoriesBody mass index groupsPostoperative adverse eventsRetrospective cohort studyPerioperative adverse eventsNormal-weight subjectsPost-operative infectionGeneral Versus Neuraxial Anesthesia in Revision Surgery for Periprosthetic Joint Infection
Serino J, Galivanche AR, Grauer JN, Haynes M, Karas V, Della Valle CJ. General Versus Neuraxial Anesthesia in Revision Surgery for Periprosthetic Joint Infection. The Journal Of Arthroplasty 2022, 37: s971-s976. PMID: 35017049, DOI: 10.1016/j.arth.2022.01.002.Peer-Reviewed Original ResearchConceptsPeriprosthetic joint infectionNeuraxial anesthesiaAdverse eventsGeneral anesthesiaRevision surgeryJoint infectionLower riskNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement Program databaseQuality Improvement Program databaseMinor adverse eventsSerious adverse eventsThirty-day outcomesImprovement Program databasePropensity-score matchingIntraspinal abscessProgram databaseRevision arthroplastyAmerican CollegeAnesthesiaMultivariate analysisProcedural variablesSurgeryPatientsInfection
2021
Ambulatory Single-level Posterior Cervical Foraminotomy for Cervical Radiculopathy
Bovonratwet P, Retzky JS, Chen AZ, Ondeck NT, Samuel AM, Qureshi SA, Grauer JN, Albert TJ. Ambulatory Single-level Posterior Cervical Foraminotomy for Cervical Radiculopathy. Clinical Spine Surgery A Spine Publication 2021, 35: e306-e313. PMID: 34654773, DOI: 10.1097/bsd.0000000000001252.Peer-Reviewed Original ResearchConceptsSingle-level posterior cervical foraminotomyPosterior cervical foraminotomyCervical radiculopathyInpatient proceduresCervical foraminotomyPerioperative complicationsAmbulatory proceduresSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databasePropensity scoreRetrospective cohort comparison studyImprovement Program databaseSurgical site infectionCohort comparison studyHospital lengthPain controlPerioperative outcomesPostoperative complicationsThromboembolic eventsWound complicationsNSQIP databasePatient characteristicsSite infectionIndividual complicationsDoes dehydration prior to primary total joint arthroplasty increase risk of perioperative complications?
Moore HG, Justen MA, Kirwin DS, Burroughs PJ, Rubin LE, Grauer JN. Does dehydration prior to primary total joint arthroplasty increase risk of perioperative complications? Arthroplasty 2021, 3: 34. PMID: 35236481, PMCID: PMC8796573, DOI: 10.1186/s42836-021-00090-8.Peer-Reviewed Original ResearchPreoperative dehydrationPerioperative complicationsTotal joint arthroplastyTKA patientsTHA patientsJoint arthroplastyNational Surgical Quality Improvement Program databaseElective total joint arthroplastyQuality Improvement Program databasePrimary total joint arthroplastyTotal knee arthroplasty patientsImprovement Program databaseRisk of transfusionShort-term complicationsTHA/TKAKnee arthroplasty patientsMethodsThe 2012Perioperative outcomesBlood transfusionArthroplasty patientsSpecific complicationsTotal hipProgram databaseBackgroundPrior studiesIncrease riskCenters 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 LOSLong-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 patientsCement Augmentation of Vertebral Compression Fractures May Be Safely Considered in the Very Elderly
Galivanche AR, Toombs C, Adrados M, David WB, Malpani R, Saifi C, Whang PG, Grauer JN, Varthi AG. Cement Augmentation of Vertebral Compression Fractures May Be Safely Considered in the Very Elderly. Neurospine 2021, 18: 226-233. PMID: 33819949, PMCID: PMC8021820, DOI: 10.14245/ns.2040620.310.Peer-Reviewed Original ResearchVertebral compression fracturesAdverse eventsCompression fracturesCement augmentationAge categoriesNational Surgical Quality Improvement Program databaseInpatient/outpatient statusQuality Improvement Program databaseProcedural variablesMinor adverse eventsImprovement Program databaseSerious adverse eventsMultivariate logistic regressionYear old cohortPeriprocedure complicationsOlder patientsComorbidity statusOutpatient statusRetrospective reviewAdverse outcomesGeriatric populationProcedure typeProgram databaseProvider specialtyChi-square analysisPatients with insulin-dependent diabetes are at greater risk for perioperative adverse outcomes following total hip arthroplasty
Webb ML, Justen MA, Kerbel YE, Scanlon CM, Nelson CL, Grauer JN. Patients with insulin-dependent diabetes are at greater risk for perioperative adverse outcomes following total hip arthroplasty. Hip International 2021, 32: 730-736. PMID: 33566714, DOI: 10.1177/1120700020988834.Peer-Reviewed Original ResearchConceptsTotal hip arthroplastyPerioperative adverse outcomesAdverse outcomesDiabetes mellitusHip arthroplastyNational Surgical Quality Improvement Program databaseQuality Improvement Program databasePrimary total hip arthroplastyAdditional adverse outcomesImprovement Program databaseInsulin-dependent diabeticsPreoperative risk stratificationInsulin-dependent diabetesQuality improvement initiativesInsulin useDependent diabeticsRisk stratificationProgram databasePatientsMultivariate analysisGreater riskImprovement initiativesDiabeticsOutcomesDiabetesUnderweight Patients Are the Greatest Risk Body Mass Index Group for 30-Day Perioperative Adverse Events After Total Shoulder Arthroplasty.
Ottesen TD, Hsiang WR, Malpani R, Nicholson AD, Varthi AG, Rubin LE, Grauer JN. Underweight Patients Are the Greatest Risk Body Mass Index Group for 30-Day Perioperative Adverse Events After Total Shoulder Arthroplasty. Journal Of The American Academy Of Orthopaedic Surgeons 2021, 29: e132-e142. PMID: 32568997, DOI: 10.5435/jaaos-d-20-00049.Peer-Reviewed Original ResearchConceptsBody mass indexPerioperative adverse eventsTotal shoulder arthroplastyNormal weight patientsAdverse eventsTSA patientsBMI categoriesUnderweight patientsShoulder arthroplastyNational Surgical Quality Improvement Program databaseElective total shoulder arthroplastyOverweight/obese categoriesRisk-adjusted multivariate regressionsQuality Improvement Program databaseElevated body mass indexBody mass index groupsLower body mass indexPrimary total shoulder arthroplastyNormal BMI patientsComplications of patientsSerious adverse eventsImprovement Program databaseNormal-weight subjectsBMI patientsFragile cohortDiabetes Status Affects Odds of Body Mass Index-dependent Adverse Outcomes After Total Hip Arthroplasty.
Kebaish KJ, Puvanesarajah V, Rao S, Zhang B, Ottesen TD, Grauer JN, Khanuja H. Diabetes Status Affects Odds of Body Mass Index-dependent Adverse Outcomes After Total Hip Arthroplasty. Journal Of The American Academy Of Orthopaedic Surgeons 2021, 29: 71-77. PMID: 32404681, DOI: 10.5435/jaaos-d-20-00028.Peer-Reviewed Original ResearchConceptsBody mass indexSerious adverse eventsTotal hip arthroplastyAdverse eventsAdverse outcomesHip arthroplastyNational Surgical Quality Improvement Program databaseInsulin-dependent diabetes mellitus (IDDM) patientsQuality Improvement Program databaseNormal body mass indexPrimary total hip arthroplastyImprovement Program databaseDiabetes mellitus patientsDependent diabetes mellitusMultivariate logistic regressionPatient's medical historyDiabetes groupPerioperative outcomesPerioperative riskObese patientsDiabetes mellitusMellitus patientsNIDDM patientsBMI cutoffsIncreased oddsA Matched Comparison of Postoperative Complications Between Smokers and Nonsmokers Following Open Reduction Internal Fixation of Distal Radius Fractures
Galivanche AR, FitzPatrick S, Dussik C, Malpani R, Nduaguba A, Varthi AG, Grauer JN. A Matched Comparison of Postoperative Complications Between Smokers and Nonsmokers Following Open Reduction Internal Fixation of Distal Radius Fractures. The Journal Of Hand Surgery 2021, 46: 1-9.e4. PMID: 33390240, DOI: 10.1016/j.jhsa.2020.09.020.Peer-Reviewed Original ResearchConceptsMinor adverse eventsDistal radius fracturesOpen reduction internal fixationSerious adverse eventsReduction internal fixationAdverse eventsRadius fracturesPropensity-score matchingInternal fixationSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseSTUDY/LEVELImprovement Program databasePerioperative adverse eventsMultivariable logistic analysisDemographic characteristicsSimilar demographic characteristicsHigh rateNonsmoker cohortPostoperative complicationsOperative treatmentPatient characteristicsSmoking groupComorbidity status
2020
Perioperative Outcomes in 17,947 Patients Undergoing 2-Level Anterior Cervical Discectomy and Fusion Versus 1-Level Anterior Cervical Corpectomy for Treatment of Cervical Degenerative Conditions: A Propensity Score Matched National Surgical Quality Improvement Program Analysis
Galivanche AR, Gala R, Bagi PS, Boylan AJ, Dussik CM, Coutinho PD, Grauer JN, Varthi AG. Perioperative Outcomes in 17,947 Patients Undergoing 2-Level Anterior Cervical Discectomy and Fusion Versus 1-Level Anterior Cervical Corpectomy for Treatment of Cervical Degenerative Conditions: A Propensity Score Matched National Surgical Quality Improvement Program Analysis. Neurospine 2020, 17: 871-878. PMID: 33401865, PMCID: PMC7788425, DOI: 10.14245/ns.2040134.067.Peer-Reviewed Original ResearchBody mass indexCervical degenerative conditionsAnterior cervical corpectomyAnterior cervical discectomyOperative timeFunctional statusCervical corpectomyAdverse eventsCervical discectomyNational Surgical Quality Improvement Program analysisNational Surgical Quality Improvement Program databaseDegenerative conditionsQuality Improvement Program databasePropensity scoreMultivariate logistic regression analysisAnesthesiologists physical status classificationMinor adverse eventsSerious adverse eventsImprovement Program databasePhysical status classificationShorter operative timeHigher functional statusMultivariate logistic regressionLogistic regression analysisASA PS classificationUnderweight patients are an often under looked “At risk” population after undergoing posterior cervical spine surgery
Ottesen TD, Bagi PS, Malpani R, Galivanche AR, Varthi AG, Grauer JN. Underweight patients are an often under looked “At risk” population after undergoing posterior cervical spine surgery. North American Spine Society Journal (NASSJ) 2020, 5: 100041. PMID: 35141608, PMCID: PMC8820029, DOI: 10.1016/j.xnsj.2020.100041.Peer-Reviewed Original ResearchBody mass indexPosterior cervical spine surgeryCervical spine surgeryAdverse eventsBMI categoriesBMI spectrumSpine surgeryNational Surgical Quality Improvement Program databaseRisk-adjusted multivariate regressionsQuality Improvement Program databaseHigher body mass indexLower body mass indexOutcomes of patientsImprovement Program databaseNormal-weight subjectsCategory of patientsSpine surgery outcomesUnderweight patientsPatient demographicsBMI groupsMass indexAdverse outcomesSurgery outcomesProgram databaseInclusion criteriaPreoperative High, as well as Low, Platelet Counts Correlate With Adverse Outcomes After Elective Total Hip Arthroplasty
Malpani R, Bovonratwet P, Clark MG, Ottesen TD, Mercier MR, Grauer JN. Preoperative High, as well as Low, Platelet Counts Correlate With Adverse Outcomes After Elective Total Hip Arthroplasty. JAAOS Global Research And Reviews 2020, 4: e20.00049. PMID: 32890010, PMCID: PMC7470002, DOI: 10.5435/jaaosglobal-d-20-00049.Peer-Reviewed Original ResearchConceptsTotal hip arthroplastyNational Surgical Quality Improvement Program databaseQuality Improvement Program databasePreoperative platelet countAbnormal platelet countImprovement Program databasePlatelet countPerioperative complicationsAdverse eventsHospital readmissionTHA patientsAdverse outcomesProgram databaseHip arthroplastyElective primary total hip arthroplastyElective total hip arthroplastyPrimary total hip arthroplastyMulticenter patient populationPreoperative laboratory studiesMinor adverse eventsPostoperative adverse eventsLow platelet countPostoperative complication dataNormal platelet countHigher platelet countsReadmissions After Distal Radius Fracture Open Reduction and Internal Fixation: An Analysis of 11,124 Patients
Malpani R, John TS, Mercier MR, Ottesen TD, Nduaguba AM, Webb ML, Grauer JN. Readmissions After Distal Radius Fracture Open Reduction and Internal Fixation: An Analysis of 11,124 Patients. JAAOS Global Research And Reviews 2020, 4: e20.00110. PMID: 33969951, PMCID: PMC7384800, DOI: 10.5435/jaaosglobal-d-20-00110.Peer-Reviewed Original ResearchConceptsNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseImprovement Program databaseMultivariate analysisAnesthesiologists classOpen reductionInternal fixationRisk factorsProgram databaseMedical reasonsSurgeons National Surgical Quality Improvement Program databasePredictors of readmissionInsulin-dependent diabetesCommon surgical procedureQuality improvement initiativesAmerican SocietyPostoperative readmissionsIndex surgeryInsulin usePerioperative factorsUnplanned readmissionPatient demographicsPerioperative outcomesAdult patientsSurgical reasonsCoagulopathies 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 adverse events after different fusion approaches for single-level lumbar spondylosis
Gala RJ, Ottesen TD, Kahan JB, Varthi AG, Grauer JN. Perioperative adverse events after different fusion approaches for single-level lumbar spondylosis. North American Spine Society Journal (NASSJ) 2020, 1: 100005. PMID: 35141578, PMCID: PMC8820031, DOI: 10.1016/j.xnsj.2020.100005.Peer-Reviewed Original ResearchTransforaminal lumbar interbody fusionPerioperative adverse eventsPosterior spinal fusionLumbar spondylosisAdverse eventsLumbar fusionChi-squared testInterbody fusionNational Quality Improvement Program databaseQuality Improvement Program databaseSingle-level lumbar fusionPropensity scoreLong-term outcome studiesImprovement Program databaseGood surgical techniqueLong-term outcomesLow back painSingle-level fusionDifferent surgical approachesPosterior lumbar fusionLumbar interbody fusionPearson's chi-squared testDifferent fusion proceduresAP fusionPerioperative complications