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 LOSEssential 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 proceduresTotal 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
2023
Emergency 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 ResearchMeSH KeywordsArthroplastyComorbidityEmergency Service, HospitalHumansMedicaidPain, PostoperativeUnited StatesConceptsPatellofemoral arthroplastyED utilizationPFA patientsPostoperative painED visitsPredictive factorsHigher Elixhauser comorbidity indexPerioperative pain managementElixhauser Comorbidity IndexEmergency department utilizationPostoperative metricsComorbidity indexIndependent predictorsPain managementMedicaid insuranceEmergency departmentOrthopedic patientsPayer typePatient carePatientsYounger ageVisitsPainArthroplastyDaysTotal 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 ResearchMeSH KeywordsAgedEthnicityHumansHumeral FracturesMaleMedicareShoulder FracturesSocial ClassSocioeconomic FactorsUnited StatesConceptsProximal 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 criteria
2022
Jump 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
COVID-positive ankle fracture patients are at increased odds of perioperative surgical complications following open reduction internal fixation surgery
Mercier MR, Galivanche AR, Brand JP, Pathak N, Medvecky MJ, Varthi AG, Rubin LE, Grauer JN. COVID-positive ankle fracture patients are at increased odds of perioperative surgical complications following open reduction internal fixation surgery. PLOS ONE 2021, 16: e0262115. PMID: 34972190, PMCID: PMC8719674, DOI: 10.1371/journal.pone.0262115.Peer-Reviewed Original ResearchConceptsCOVID-positive patientsAnkle fracture surgeryPerioperative adverse eventsAdverse eventsAnkle fracture patientsFracture surgeryFracture patientsOperative interventionAnkle fracturesPropensity matchingCOVID statusOpen reduction internal fixation surgeryPerioperative adverse outcomesPerioperative surgical complicationsMinor adverse eventsPostoperative adverse eventsSerious adverse eventsChronic kidney diseaseCOVID-19 Research DatabaseLong-term outcomesInternal fixation surgeryBasis of agePropensity-score matchingPostoperative complicationsNegative patientsPatient Factors and Perioperative Outcomes Affect Hospital Consumer Assessment of Healthcare Providers and Systems Survey Response Rates After Primary Total Hip Replacement.
Mercier MR, Pathak N, Adrados M, Galivanche AR, Malpani R, Hilibrand AS, Rubin LE, Grauer JN. Patient Factors and Perioperative Outcomes Affect Hospital Consumer Assessment of Healthcare Providers and Systems Survey Response Rates After Primary Total Hip Replacement. JAAOS Global Research And Reviews 2021, 5 PMID: 33798127, DOI: 10.5435/jaaosglobal-d-21-00052.Peer-Reviewed Original ResearchConceptsTotal hip arthroplastyHospital Consumer AssessmentSurvey response rateAdverse eventsHCAHPS surveyElective primary total hip arthroplastyResponse rateHealthcare providersPrimary total hip replacementPrimary total hip arthroplastyPatient satisfaction survey resultsConsumer AssessmentHigher American SocietyMajor adverse eventsMinority of patientsSurgical patient populationHCAHPS survey resultsTotal hip replacementMultivariate regression analysisHospital reimbursement ratesAnesthesia scorePerioperative outcomesPerioperative variablesAdult patientsPatient characteristics
2019
Matched 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 chargesMatched Cohort Analysis of Total Hip Arthroplasty in Patients With and Without Parkinson’s Disease: Complications, Mortality, Length of Stay, and Hospital Charges
Kleiner JE, Eltorai AEM, Rubin LE, Daniels AH. Matched Cohort Analysis of Total Hip Arthroplasty in Patients With and Without Parkinson’s Disease: Complications, Mortality, Length of Stay, and Hospital Charges. The Journal Of Arthroplasty 2019, 34: s228-s231. PMID: 30982760, DOI: 10.1016/j.arth.2019.03.023.Peer-Reviewed Original ResearchMeSH KeywordsAgedArthroplasty, Replacement, HipCohort StudiesDatabases, FactualFemaleHealth Care CostsHospital ChargesHospital MortalityHospitalizationHumansInpatientsLength of StayLogistic ModelsMaleMiddle AgedOsteoarthritis, HipParkinson DiseasePatient SafetyPostoperative ComplicationsPropensity ScoreRetrospective StudiesUnited StatesConceptsTotal hip arthroplastyLength of stayCharlson Comorbidity IndexPD patientsComplication rateComorbidity indexHospital chargesDisease patientsCohort analysisHip arthroplastyParkinson's diseaseUtilization Project Nationwide Inpatient SampleGreater Charlson Comorbidity IndexHospital complication ratesMatched Cohort AnalysisHospital mortality rateTotal hospital chargesNationwide Inpatient SampleMultivariable logistic regressionCost of hospitalizationYear of admissionParkinson's disease patientsModel of careHospital mortalityControl patients
2018
Trends in Medicare Reimbursement for Orthopedic Procedures: 2000 to 2016.
Eltorai AEM, Durand WM, Haglin JM, Rubin LE, Weiss AC, Daniels AH. Trends in Medicare Reimbursement for Orthopedic Procedures: 2000 to 2016. Orthopedics 2018, 41: 95-102. PMID: 29494748, DOI: 10.3928/01477447-20180226-04.Peer-Reviewed Original Research
2017
Revision Total Knee Arthroplasty in Octogenarians: An Analysis of 957 Cases
Bovonratwet P, Tyagi V, Ottesen TD, Ondeck NT, Rubin LE, Grauer JN. Revision Total Knee Arthroplasty in Octogenarians: An Analysis of 957 Cases. The Journal Of Arthroplasty 2017, 33: 178-184. PMID: 28844628, DOI: 10.1016/j.arth.2017.07.032.Peer-Reviewed Original ResearchConceptsRevision total knee arthroplastyTotal knee arthroplastyBlood transfusionOctogenarian patientsKnee arthroplastyPatient populationNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseLonger lengthYoung populationHigh rateImprovement Program databaseYoung patient populationNumber of octogenariansLarger patient populationYear oldsHospital stayIntraoperative characteristicsPerioperative complicationsPerioperative coursePropensity matchingAdvanced ageProgram databaseOctogenariansStayReported Litigation Associated With Primary Hip and Knee Arthroplasty
Bokshan SL, Ruttiman RJ, DePasse JM, Eltorai AEM, Rubin LE, Palumbo MA, Daniels AH. Reported Litigation Associated With Primary Hip and Knee Arthroplasty. The Journal Of Arthroplasty 2017, 32: 3573-3577.e1. PMID: 28781019, DOI: 10.1016/j.arth.2017.07.001.Peer-Reviewed Original ResearchConceptsKnee arthroplastyNerve injuryCommon complicationTechnical complicationsPhysician lossTotal joint arthroplastyCauses of litigationMalpractice lawsuitsPrimary hipTotal hipLikely complicationsJoint arthroplastyRetrospective analysisHip arthroplastyComplicationsArthroplasty surgeonsArthroplastyPainPatientsInjuryHipSurgeonsAverage paymentVerdictSearchCasesOutpatient and Inpatient Unicompartmental Knee Arthroplasty Procedures Have Similar Short-Term Complication Profiles
Bovonratwet P, Ondeck NT, Tyagi V, Nelson SJ, Rubin LE, Grauer JN. Outpatient and Inpatient Unicompartmental Knee Arthroplasty Procedures Have Similar Short-Term Complication Profiles. The Journal Of Arthroplasty 2017, 32: 2935-2940. PMID: 28602533, DOI: 10.1016/j.arth.2017.05.018.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAmbulatory Surgical ProceduresArthroplasty, Replacement, KneeCohort StudiesComorbidityDatabases, FactualFemaleHumansInpatientsLength of StayMaleMiddle AgedOutcome Assessment, Health CareOutpatientsPatient ReadmissionPatient SatisfactionPostoperative ComplicationsPropensity ScoreQuality ImprovementUnited StatesConceptsUnicompartmental knee arthroplastyNational Surgical Quality Improvement Program databaseInpatient Unicompartmental Knee ArthroplastyQuality Improvement Program databaseLength of hospitalImprovement Program databasePerioperative complicationsProgram databaseOutpatient unicompartmental knee arthroplastyShort-term complication profileUnicompartmental knee arthroplasty (UKA) proceduresNational patient populationPerioperative outcome measuresHigh patient satisfactionKnee arthroplasty proceduresPotential confounding factorsInpatient cohortPerioperative outcomesPostdischarge complicationsPatient characteristicsComplication profileOutpatient surgeryPatient populationKnee arthroplastyOutpatient procedure
2013
Rehabilitation for total joint arthroplasty.
Ritterman S, Rubin LE. Rehabilitation for total joint arthroplasty. Rhode Island Medical Journal 2013, 96: 19-22. PMID: 23641458.Peer-Reviewed Original ResearchConceptsPreoperative medical preparationSuccessful elective surgeryTotal joint arthroplastyPhysical deconditioningPostoperative therapyPostoperative rehabilitationElective surgeryTotal hipElective proceduresJoint arthroplastyKnee replacementTobacco useSpecific surgerySuccessful outcomeSurgeryMedical preparationsRehabilitationOutcomesObesityPatientsArthroplastyDeconditioningTherapyHipIndependent activity