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 arthroplasty
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 increaseRacial/Ethnic Disparities in Physical Therapy Utilization After Total Knee Arthroplasty
Ratnasamy P, Oghenesume O, Rudisill K, Grauer J. Racial/Ethnic Disparities in Physical Therapy Utilization After Total Knee Arthroplasty. Journal Of The American Academy Of Orthopaedic Surgeons 2023, 31: 357-363. PMID: 36735406, PMCID: PMC10038831, DOI: 10.5435/jaaos-d-22-00733.Peer-Reviewed Original ResearchConceptsTotal knee arthroplastyRace/ethnicityPhysical therapyLower household incomeKnee arthroplastyUtilization of PTPatient race/ethnicityPhysical therapy utilizationRacial/Ethnic DisparitiesElixhauser Comorbidity IndexHealth administrative dataOutpatient physical therapyPatient demographic factorsCommon orthopaedic proceduresMedicare data setExpansion of careHousehold incomeComorbidity indexTKA patientsPredictive factorsTherapy utilizationMedicare patientsOrthopedic proceduresPatientsLevel III
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 surgeryReadmissionPatients
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 ScoresDoes 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 riskHospital 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 experienceCenters 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 LOS
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 readmission
2019
Abnormally High, as Well as Low, Preoperative Platelet Counts Correlate With Adverse Outcomes and Readmissions After Elective Total Knee Arthroplasty
Malpani R, Haynes MS, Clark MG, Galivanche AR, Bovonratwet P, Grauer JN. Abnormally High, as Well as Low, Preoperative Platelet Counts Correlate With Adverse Outcomes and Readmissions After Elective Total Knee Arthroplasty. The Journal Of Arthroplasty 2019, 34: 1670-1676. PMID: 31072745, DOI: 10.1016/j.arth.2019.04.012.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAnemiaArthroplasty, Replacement, KneeDatabases, FactualDiabetes ComplicationsElective Surgical ProceduresFemaleHumansLength of StayMaleMiddle AgedPatient ReadmissionPlatelet CountPostoperative ComplicationsPostoperative PeriodPreoperative PeriodRetrospective StudiesThrombocytopeniaThrombocytosisTreatment OutcomeUnited StatesYoung AdultConceptsTotal knee arthroplastyElective total knee arthroplastyMinor adverse eventsPreoperative platelet countAbnormal platelet countLow platelet countPlatelet countHigher platelet countsAdverse eventsPostoperative complicationsTKA patientsAdverse outcomesKnee arthroplastyNational Surgical Quality Improvement Program databaseElective primary total knee arthroplastyMultivariate analysisQuality Improvement Program databasePrimary total knee arthroplastyMulticenter patient populationImprovement Program databasePostoperative adverse outcomesPlatelet count thresholdRetrospective comparative studyNormal platelet countLarger patient sample sizeChanges in Discharge to Rehabilitation: Potential Unintended Consequences of Medicare Total Hip Arthroplasty/Total Knee Arthroplasty Bundled Payments, Should They Be Implemented on a Nationwide Scale?
Zogg CK, Falvey JR, Dimick JB, Haider AH, Davis KA, Grauer JN. Changes in Discharge to Rehabilitation: Potential Unintended Consequences of Medicare Total Hip Arthroplasty/Total Knee Arthroplasty Bundled Payments, Should They Be Implemented on a Nationwide Scale? The Journal Of Arthroplasty 2019, 34: 1058-1065.e4. PMID: 30878508, PMCID: PMC6884960, DOI: 10.1016/j.arth.2019.01.068.Peer-Reviewed Original ResearchMeSH KeywordsAgedArthroplasty, Replacement, HipArthroplasty, Replacement, KneeComputer SimulationDecision TreesElective Surgical ProceduresHumansMedicareMiddle AgedMonte Carlo MethodPatient DischargePatient Protection and Affordable Care ActPatient ReadmissionQuality of LifeRehabilitationReimbursement MechanismsSkilled Nursing FacilitiesUnited StatesConceptsExtent of therapyHealth-related qualityType of rehabilitationFunctional recoveryPatients' health-related qualitySkilled nursing facility useElective total hipPrimary TKA patientsOutcomes of patientsPatient-centered outcomesPatients' functional recoveryInpatient rehabilitation facilityNursing facility useEpisode of careAverage functional outcomeBundled payment programsDischarge dispositionTKA patientsUnplanned readmissionTotal hipFunctional outcomeAffordable Care ActOutcome measuresRehabilitation facilityBundled Payments
2018
Dialysis Patients Undergoing Total Knee Arthroplasty Have Significantly Increased Odds of Perioperative Adverse Events Independent of Demographic and Comorbidity Factors
Ottesen TD, Zogg CK, Haynes MS, Malpani R, Bellamkonda KS, Grauer JN. Dialysis Patients Undergoing Total Knee Arthroplasty Have Significantly Increased Odds of Perioperative Adverse Events Independent of Demographic and Comorbidity Factors. The Journal Of Arthroplasty 2018, 33: 2827-2834. PMID: 29754981, DOI: 10.1016/j.arth.2018.04.012.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overArthroplasty, Replacement, KneeComorbidityElective Surgical ProceduresFemaleHumansInpatientsLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioPatient DischargePatient ReadmissionPostoperative ComplicationsQuality ImprovementRegression AnalysisRenal DialysisReoperationRetrospective StudiesRisk AssessmentConceptsTotal knee arthroplastyDialysis-dependent patientsAdverse eventsPatient demographicsDialysis patientsAdverse outcomesKnee arthroplastyNational Surgical Quality Improvement Program databaseOverall healthRisk-adjusted logistic regressionElective total knee arthroplastyQuality Improvement Program databaseImprovement Program databaseMinor adverse eventsNational inpatient databaseSevere adverse eventsBone health statusNondialysis cohortNondialysis patientsPerioperative periodTKA patientsAdult patientsPreoperative riskComorbidity factorsInstitutional cohort
2017
Comparison of Outpatient vs Inpatient Total Knee Arthroplasty: An ACS-NSQIP Analysis
Bovonratwet P, Ondeck NT, Nelson SJ, Cui JJ, Webb ML, Grauer JN. Comparison of Outpatient vs Inpatient Total Knee Arthroplasty: An ACS-NSQIP Analysis. The Journal Of Arthroplasty 2017, 32: 1773-1778. PMID: 28237215, DOI: 10.1016/j.arth.2017.01.043.Peer-Reviewed Original ResearchMeSH KeywordsAgedAmbulatory Surgical ProceduresArthroplasty, Replacement, KneeBlood TransfusionCohort StudiesComorbidityDatabases, FactualFemaleHumansInpatientsMaleMiddle AgedMultivariate AnalysisOutcome Assessment, Health CareOutpatientsPatient ReadmissionPostoperative ComplicationsPropensity ScoreQuality ImprovementConceptsTotal knee arthroplastyOutpatient total knee arthroplastyAdverse eventsKnee arthroplastyOutpatient procedureSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseMultivariate analysisInpatient total knee arthroplastyElective total knee arthroplastyQuality Improvement Program databasePrimary total knee arthroplastyComparison of outpatientPerioperative outcome measuresImprovement Program databasePerioperative adverse eventsIndividual adverse eventsACS-NSQIP AnalysisInpatient cohortHospital lengthLess comorbiditySelect patientsTKA patientsOutpatient cohortPostoperative period
2015
How Much Do Adverse Event Rates Differ Between Primary and Revision Total Joint Arthroplasty?
Bohl DD, Samuel AM, Basques BA, Della Valle CJ, Levine BR, Grauer JN. How Much Do Adverse Event Rates Differ Between Primary and Revision Total Joint Arthroplasty? The Journal Of Arthroplasty 2015, 31: 596-602. PMID: 26507527, DOI: 10.1016/j.arth.2015.09.033.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overArthroplasty, Replacement, HipArthroplasty, Replacement, KneeComorbidityFemaleHumansMaleMiddle AgedQuality Assurance, Health CareQuality ImprovementQuality of Health CareReoperationRetrospective StudiesRiskSocieties, MedicalSurgical Wound InfectionUnited StatesYoung AdultConceptsTotal knee arthroplastyTotal joint arthroplastyTotal hip arthroplastyRevision proceduresAdverse eventsTKA patientsTHA patientsPrimary procedureJoint arthroplastyDeep incisional surgical site infectionSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramOrgan/space infectionIncisional surgical site infectionPrimary total joint arthroplastySurgical Quality Improvement ProgramRevision total joint arthroplastyUnderwent revision proceduresAdverse event ratesDeep vein thrombosisSurgical site infectionQuality Improvement ProgramHigh rateSystemic sepsisComorbidity characteristics