Featured Publications
Perineural Methylprednisolone Depot Formulation Decreases Opioid Consumption After Total Knee Arthroplasty
Del Toro-Pagán NM, Dai F, Banack T, Berlin J, Makadia SA, Rubin LE, Zhou B, Huynh P, Li J. Perineural Methylprednisolone Depot Formulation Decreases Opioid Consumption After Total Knee Arthroplasty. Journal Of Pain Research 2022, 15: 2537-2546. PMID: 36061486, PMCID: PMC9432382, DOI: 10.2147/jpr.s378243.Peer-Reviewed Original ResearchWhite blood cell countTotal knee arthroplastyActive pain scoresCumulative opioid consumptionOpioid consumptionPostoperative opioid consumptionMethylprednisolone acetateMPA groupPain scoresPostoperative dayNerve blockDEX groupKnee arthroplastySingle-injection nerve blocksConsecutive TKA patientsDaily opioid consumptionPosterior knee (IPACK) blockLocal anesthetic adjuvantBlood cell countLength of stayHigher restKnee blockHospital stayTKA patientsSecondary outcomesWhat 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 LOSTotal 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
Continuous Adductor Canal Block Compared to Epidural Anesthesia for Total Knee Arthroplasty
Freedman I, Mercier M, Galivanche A, Sandhu M, Hocevar M, Moore H, Grauer J, Rubin L, Li J. Continuous Adductor Canal Block Compared to Epidural Anesthesia for Total Knee Arthroplasty. Journal Of Pain Research 2024, 17: 3729-3740. PMID: 39559456, PMCID: PMC11572497, DOI: 10.2147/jpr.s462079.Peer-Reviewed Original ResearchContinuous adductor canal blockAdductor canal blockEpidural analgesiaEA patientsNon-home dischargeCanal blockMultivariate analysisIncidence of postoperative adverse eventsPostoperative adverse eventsMorphine equivalentsEpidural anesthesiaAdverse eventsRetrospective analysisHospital lengthProlonged LOSLevel IIIPatientsSteroidsTotal knee arthroplastyAdjuvantTKA patientsLogistic regressionDischarge dispositionAnalgesiaKnee arthroplastyRisk of Adverse Events Following Total Knee Arthroplasty in Asthma Patients
Smith-Voudouris J, Rubin L, Grauer J. Risk of Adverse Events Following Total Knee Arthroplasty in Asthma Patients. Journal Of The American Academy Of Orthopaedic Surgeons 2024, 32: 543-549. PMID: 38657178, DOI: 10.5435/jaaos-d-23-01142.Peer-Reviewed Original ResearchAdverse eventsTotal knee arthroplastyElixhauser Comorbidity IndexOne-tenth of patientsAsthma patientsOdds of adverse eventsRisk of adverse eventsIncreasing severity of asthmaMultivariate logistic regressionInflammatory airway diseasesSeverity of asthmaKnee arthroplastyTotal knee arthroplasty patientsPerioperative outcomesAggregate adverse eventsAdult patientsNon-pulmonaryAirway diseaseComorbidity indexMultivariate analysisPatient factorsAsthma groupEmergency department visitsPatientsIncreased odds
2023
Patients With Cystic Fibrosis Undergoing Total Hip and Total Knee Arthroplasty Are at Increased Risk for Perioperative Complications
Halperin S, Dhodapkar M, Radford Z, Kaszuba S, Rubin L, Grauer J. Patients With Cystic Fibrosis Undergoing Total Hip and Total Knee Arthroplasty Are at Increased Risk for Perioperative Complications. Journal Of The American Academy Of Orthopaedic Surgeons 2023, 32: 309-315. PMID: 38165956, DOI: 10.5435/jaaos-d-23-00783.Peer-Reviewed Original ResearchTotal knee arthroplastyTotal hip arthroplastyUrinary tract infectionPostoperative eventsCystic fibrosisPerioperative outcomesAdverse eventsTract infectionsPleural effusionKnee arthroplastyControl subjectsRevision rateAcute kidney injuryElixhauser Comorbidity IndexRisk of surgeryMultivariable logistic regressionComorbidity indexKidney injuryPerioperative complicationsRespiratory failureTKA patientsCardiac eventsPearlDiver databaseImplant survivalTotal hipPatients 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 arthroplastyTotal 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 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 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 surgeryReadmissionPatientsJump 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 arthroplasty
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 ResearchConceptsRevision 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 experienceTotal Joint Arthroplasty in Patients With Achondroplasia: Comparison of 90-Day Adverse Events and 5-Year Implant Survival
Moore HG, Schneble CA, Kahan JB, Polkowski GG, Rubin LE, Grauer JN. Total Joint Arthroplasty in Patients With Achondroplasia: Comparison of 90-Day Adverse Events and 5-Year Implant Survival. Arthroplasty Today 2021, 11: 151-156. PMID: 34584919, PMCID: PMC8452593, DOI: 10.1016/j.artd.2021.08.011.Peer-Reviewed Original ResearchTotal joint arthroplastyAdverse eventsImplant survivalJoint arthroplastyFive-year implant survivalShort-term adverse eventsPrimary total hipSurgical site infectionLong-term implant successMultivariate logistic regressionTotal knee arthroplastyCommon skeletal dysplasiaMedical comorbiditiesSite infectionTotal hipPatient populationKnee arthroplastyAdministrative databasesHigher oddsLarge cohortGreater oddsPatientsImplant successSurvival curvesArthroplasty
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 readmissionTotal knee arthroplasty in hemophilia A
Pathak N, Munger AM, Charifa A, Laskin WB, Bisson E, Kupfer GM, Rubin LE. Total knee arthroplasty in hemophilia A. Arthroplasty Today 2020, 6: 52-58.e1. PMID: 32211475, PMCID: PMC7083729, DOI: 10.1016/j.artd.2019.12.008.Peer-Reviewed Original ResearchTotal knee arthroplastyHemophilia AKnee arthroplastyCoagulation factor replacement therapyPrimary total knee arthroplastyVenous thromboembolic eventsFactor replacement therapySevere knee osteoarthritisTotal joint arthroplastyFactor VIII levelsAdult reconstructive surgeonsUnique clinical scenarioRare genetic disorderHemophilic arthropathyThromboembolic eventsKnee osteoarthritisRecurrent hemarthrosisReplacement therapyFactor infusionJoint arthroplastyVIII levelsRare caseClinical scenariosReconstructive surgeonFactor VIIIPreoperative 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 ResearchConceptsED 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
Telerehabilitation for Total Hip and Knee Arthroplasty Patients: A Pilot Series with High Patient Satisfaction
Kuether J, Moore A, Kahan J, Martucci J, Messina T, Perreault R, Sembler R, Tarutis J, Zazulak B, Rubin LE, O’Connor M. Telerehabilitation for Total Hip and Knee Arthroplasty Patients: A Pilot Series with High Patient Satisfaction. HSS Journal ® 2019, 15: 221-225. PMID: 31624476, PMCID: PMC6778164, DOI: 10.1007/s11420-019-09715-w.Peer-Reviewed Original ResearchPrimary total hipTotal knee arthroplastyPatient-reported outcome scoresEmergency department visitsHigh patient satisfactionTotal hipKnee arthroplastyTelerehabilitation protocolDepartment visitsOutcome scoresKnee manipulationPatient satisfactionPhysical therapyPrimary total knee arthroplastyHigher patient satisfaction scoresConclusionOur early experienceFace physical therapyKnee arthroplasty patientsPatient satisfaction scoresTotal joint arthroplastyPatient satisfaction surveyVirtual physical therapyTelerehabilitation groupReadmission ratesArthroplasty patientsMatched 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 ResearchConceptsTotal 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