Featured Publications
Increased 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-19
2023
Magnetic 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 incidence
2022
Adverse Events After Total Hip Arthroplasty are not Sufficiently Characterized by 30-Day Follow-Up: A Database Study
Maloy GC, Kammien AJ, Rubin LE, Grauer JN. Adverse Events After Total Hip Arthroplasty are not Sufficiently Characterized by 30-Day Follow-Up: A Database Study. The Journal Of Arthroplasty 2022, 38: 525-529. PMID: 36272511, DOI: 10.1016/j.arth.2022.10.020.Peer-Reviewed Original ResearchConceptsTotal hip arthroplastyPostoperative adverse eventsAdverse eventsDay of surgeryHip arthroplastyDays of THAHigher Elixhauser-Comorbidity Index scoresElixhauser comorbidity index scoreComorbidity Index scoreLate adverse eventsTime of diagnosisPostoperative day 31THA patientsPredictive factorsPatient counselingPatient riskDatabase studyPrevention strategiesIndex scoreDay 31SurgeryInterquartile rangeAdministrative datasetsPatientsArthroplastyIncidence, Timing, and Predictors of Hip Dislocation After Primary Total Hip Arthroplasty for Osteoarthritis
Gillinov SM, Joo PY, Zhu JR, Moran J, Rubin LE, Grauer JN. Incidence, Timing, and Predictors of Hip Dislocation After Primary Total Hip Arthroplasty for Osteoarthritis. Journal Of The American Academy Of Orthopaedic Surgeons 2022, 30: 1047-1053. PMID: 35947825, PMCID: PMC9588560, DOI: 10.5435/jaaos-d-22-00150.Peer-Reviewed Original ResearchConceptsPrimary total hip arthroplastyTotal hip arthroplastyElixhauser Comorbidity IndexBody mass indexComorbidity indexMass indexHip dislocationRevision surgeryRisk factorsHip arthroplastyIndex total hip arthroplastyHigher Elixhauser comorbidity indexPrimary THA patientsFirst-time dislocationCumulative incidenceMost patientsPostoperative dataTHA patientsRecurrent episodesControl subjectsFemale sexLarge cohortPatientsMultivariate analysisYounger agePredictors of Physical Abuse in Elder Patients With Fracture
Gardezi M, Moore HG, Rubin LE, Grauer JN. Predictors of Physical Abuse in Elder Patients With Fracture. JAAOS Global Research And Reviews 2022, 6: e22.00144. PMID: 35819835, PMCID: PMC9278940, DOI: 10.5435/jaaosglobal-d-22-00144.Peer-Reviewed Original ResearchConceptsAbuse patientsNational Emergency Department Sample databasePhysical abuseHigh-risk patientsMultivariate regressionPublic health issueLowest income quartileElderly patientsFracture patientsRisk patientsAnkle fracturesIndependent predictorsPediatric populationElder patientsEmergency departmentRib fracturesVolume depletionOdds ratioElder physical abuseElder abusePatientsUnivariate comparisonsMental disordersIncome quartileHealth issuesJump 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 patientsHospital 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 experience
2020
Patients' and Physicians' Knowledge of Radiation Exposure Related to Spine Surgery.
Scott MC, Galivanche AR, Mets EJ, Pathak N, Kahan JB, Burroughs PJ, Varthi AG, Rubin LE, Grauer JN. Patients' and Physicians' Knowledge of Radiation Exposure Related to Spine Surgery. Spine 2020, 45: e1507-e1515. PMID: 32858741, DOI: 10.1097/brs.0000000000003650.Peer-Reviewed Original ResearchConceptsSpine surgeryMagnetic resonance imagingRadiation exposureOutpatient settingPhysicians' knowledgeLumbar radiographsO-armCT imagingIntraoperative radiation exposureCross-sectional imagingCross-sectional surveyPhysician estimatesSpine proceduresBACKGROUND DATACare settingsIntraoperative fluoroscopyLumbar imagingPatientsSurgeryResonance imagingIntraoperative CTSurgeonsAwareness/knowledgeIntraoperative imagingRobotic spine surgeryCoagulopathies 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 readmissionPostoperative Pressure Ulcers After Geriatric Hip Fracture Surgery Are Predicted by Defined Preoperative Comorbidities and Postoperative Complications.
Galivanche AR, Kebaish KJ, Adrados M, Ottesen TD, Varthi AG, Rubin LE, Grauer JN. Postoperative Pressure Ulcers After Geriatric Hip Fracture Surgery Are Predicted by Defined Preoperative Comorbidities and Postoperative Complications. Journal Of The American Academy Of Orthopaedic Surgeons 2020, 28: 342-351. PMID: 31567615, DOI: 10.5435/jaaos-d-19-00104.Peer-Reviewed Original ResearchConceptsPostoperative pressure ulcersHip fracture surgeryPostoperative complicationsPressure ulcersRisk factorsPreoperative comorbiditiesFracture surgerySurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseGeriatric hip fracture patientsGeriatric hip fracture surgeryQuality Improvement Program databaseMultivariate regressionNSQIP Participant Use FilePreoperative risk factorsHip fracture patientsImprovement Program databaseUrinary tract infectionElevated platelet countInsulin-dependent diabetesParticipant Use FilePressure ulcer developmentQuality Improvement ProgramPostoperative deliriumPostoperative pneumonia
2019
Admission NarxCare Narcotics Scores are not Associated With Adverse Surgical Outcomes or Self-reported Patient Satisfaction Following Elective Spine Surgery.
Galivanche AR, Mercier MR, Adrados M, Pathak N, McLynn RP, Anandasivam NS, Varthi AG, Rubin LE, Grauer JN. Admission NarxCare Narcotics Scores are not Associated With Adverse Surgical Outcomes or Self-reported Patient Satisfaction Following Elective Spine Surgery. Spine 2019, 44: 1515-1522. PMID: 31356498, DOI: 10.1097/brs.0000000000003120.Peer-Reviewed Original ResearchConceptsMultivariate logistic regressionPatient satisfactionAdverse eventsNarcotic scoreSurvey response rateSpine surgeryResponse rateLogistic regressionSelf-reported patient satisfactionElective spine surgeryPreoperative opioid usePostoperative patient satisfactionTime of admissionAdverse surgical outcomesSpine surgery casesHospital Consumer AssessmentHCAHPS survey resultsDifferent narcoticsNarcotic usagePerioperative outcomesNarcotic utilizationOpioid usePatient characteristicsPostoperative outcomesNarcotic groupMatched 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 chargesA Practical Analgesia Approach to Fragility Hip Fracture
Li J, Dai F, Chang D, Harmon E, Ibe I, Sukumar N, Halaszynski TM, Rubin LE, OʼConnor M. A Practical Analgesia Approach to Fragility Hip Fracture. Journal Of Orthopaedic Trauma 2019, Publish Ahead of Print: &na;. PMID: 30570615, DOI: 10.1097/bot.0000000000001391.Peer-Reviewed Original ResearchConceptsFemoral nerve blockFragility hip fractureSubcapital femoral neck fracturesPain score reductionFemoral neck fracturesFemoral neck factureHip fracturePain scoresNeck fracturesIntertrochanteric fracturesScore reductionSingle-injection femoral nerve blockVisual analog scale pain scoreAcademic medical center patientsSignificant pain score reductionPain control modalitiesTherapeutic Level IVScale pain scoresHip fracture patientsObservational study SETTINGMedical Center patientsAnalgesic modalitiesFragility hipOpioid consumptionFracture patientsMatched 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
Dialysis is an independent risk factor for perioperative adverse events, readmission, reoperation, and mortality for patients undergoing elective spine surgery
Ottesen TD, McLynn RP, Zogg CK, Shultz BN, Ondeck NT, Bovonratwet P, Bellamkonda KS, Rubin LE, Grauer JN. Dialysis is an independent risk factor for perioperative adverse events, readmission, reoperation, and mortality for patients undergoing elective spine surgery. The Spine Journal 2018, 18: 2033-2042. PMID: 30077772, DOI: 10.1016/j.spinee.2018.04.007.Peer-Reviewed Original ResearchConceptsElective spine surgeryNon-dialysis patientsDialysis-dependent patientsPerioperative adverse eventsAdverse eventsDialysis patientsSpine surgeryUnplanned readmissionCohort studyPatient demographicsRisk factorsNational Surgical Quality Improvement Program databaseRisk-adjusted multivariate regressionsQuality Improvement Program databaseOperating roomDialysis-independent patientsInstitutional cohort studyMinor adverse eventsRetrospective cohort studyElective spinal surgeryImprovement Program databaseIndependent risk factorMajor adverse eventsPercentage of complicationsAdministrative database study