2023
The Burden of Revision Total Ankle Replacement Has Markedly Increased from 2010 to 2020
Ratnasamy P, Maloy G, Oghenesume O, Peden S, Grauer J, Oh I. The Burden of Revision Total Ankle Replacement Has Markedly Increased from 2010 to 2020. Foot & Ankle Orthopaedics 2023, 8: 2473011423s00199. PMCID: PMC10750518, DOI: 10.1177/2473011423s00199.Peer-Reviewed Original ResearchExplant surgeryRisk factorsYounger ageComorbidity burdenIndependent predictorsFemale sexRevision surgeryMultivariate logistic regression analysisHigher comorbidity burdenPatient comorbidity burdenRevision total ankle replacementTotal ankle replacement surgeryRetrospective cohort studyIndependent risk factorImplant survival rateElixhauser Comorbidity IndexRisk of revisionTiming of revisionLogistic regression analysisSite of careTotal ankle replacementLarge national databaseAnkle replacement surgeryOccurrence of revisionExplant patientsThe Burden of Revision Total Ankle Replacement Has Increased From 2010 to 2020
Ratnasamy P, Maloy G, Oghenesume O, Peden S, Grauer J, Oh I. The Burden of Revision Total Ankle Replacement Has Increased From 2010 to 2020. Foot & Ankle Orthopaedics 2023, 8: 24730114231198234. PMID: 37767009, PMCID: PMC10521287, DOI: 10.1177/24730114231198234.Peer-Reviewed Original ResearchElixhauser Comorbidity IndexHigher Elixhauser comorbidity indexRetrospective cohort studyCohort studyIndependent predictorsAnnual incidenceRevision surgeryRisk factorsYounger ageMultivariate logistic regression analysisRevision total ankle replacementTotal ankle replacement surgeryIndependent risk factorImplant survival rateTiming of revisionLogistic regression analysisSite of careTotal ankle replacementAnkle replacement surgeryExplant patientsExplant surgeryComorbidity indexPatient factorsIndex procedureFemale sexSingle-level Anterior Cervical Discectomy and Fusion Results in Lower Five-year Revisions than Posterior Cervical Foraminotomy in a Large National Cohort
Jayaram R, Joo P, Gouzoulis M, Ratnasamy P, Caruana D, Grauer J. Single-level Anterior Cervical Discectomy and Fusion Results in Lower Five-year Revisions than Posterior Cervical Foraminotomy in a Large National Cohort. Spine 2023, 48: 1266-1271. PMID: 37339256, DOI: 10.1097/brs.0000000000004754.Peer-Reviewed Original ResearchConceptsPosterior cervical foraminotomySingle-level ACDFSingle-level anterior cervical discectomyPerioperative adverse eventsAnterior cervical discectomyAdverse eventsCervical foraminotomyCervical discectomyRevision rateOdds ratioShort-term adverse eventsSimilar short-term outcomesKaplan-Meier survival analysisRetrospective cohort studySerious adverse eventsCervical disc diseaseFive-year ratesSurgical site infectionShort-term outcomesMultivariable logistic regressionLarge national cohortCumulative revision rateCervical reoperationPCF cohortCohort studyFactors Associated With Increased Opioid Prescriptions Following Anterior Cruciate Ligament Reconstruction in Opioid-Naïve Patients
Yalcin S, Joo P, McLaughlin W, Moran J, Caruana D, Flores M, Grauer J, Medvecky M. Factors Associated With Increased Opioid Prescriptions Following Anterior Cruciate Ligament Reconstruction in Opioid-Naïve Patients. Arthroscopy Sports Medicine And Rehabilitation 2023, 5: 100740. PMID: 37645399, PMCID: PMC10461142, DOI: 10.1016/j.asmr.2023.04.023.Peer-Reviewed Original ResearchAnterior cruciate ligament reconstructionOpioid-naïve patientsOpioid prescriptionsCruciate ligament reconstructionOrthopaedic surgeonsMean MMEOpioid useLigament reconstructionPreoperative diagnosisArthroscopic anterior cruciate ligament reconstructionMedical providersFollowing Anterior Cruciate Ligament ReconstructionOlder ageRetrospective cohort studyCollateral ligament repairSubstance use disordersMean morphineNaïve patientsOpioid dosesPrescriber specialtyCohort studyPatient factorsChronic painAverage MMEPhysician specialtyPrevious Isolated Medial Bucket-Handle Meniscus Repair Significantly Increases Risk of Subsequent Ipsilateral Anterior Cruciate Ligament Reconstruction
McLaughlin W, Gillinov S, Joo P, Moran J, Jimenez A, Grauer J, Gardner E. Previous Isolated Medial Bucket-Handle Meniscus Repair Significantly Increases Risk of Subsequent Ipsilateral Anterior Cruciate Ligament Reconstruction. Arthroscopy Sports Medicine And Rehabilitation 2023, 5: e671-e678. PMID: 37388885, PMCID: PMC10300536, DOI: 10.1016/j.asmr.2023.03.008.Peer-Reviewed Original ResearchAnterior cruciate ligament reconstructionBucket-handle meniscus tearsSubsequent anterior cruciate ligament reconstructionCruciate ligament reconstructionBucket-handle meniscus repairControl groupLigament reconstructionMeniscal injuryMeniscus surgeryGreater oddsMeniscus repairRetrospective cohort studyAge-matched patientsKaplan-Meier analysisCohort studyPrior surgeryRetrospective reviewInclusion criteriaMeniscus tearsHigh riskGeneral populationMeniscal tearsOperative methodPatientsLevel IIIUrgent Care Versus Emergency Department Utilization for Foot and Ankle Fractures
Dhodapkar M, Gouzoulis M, Halperin S, Modrak M, Yoo B, Grauer J. Urgent Care Versus Emergency Department Utilization for Foot and Ankle Fractures. Journal Of The American Academy Of Orthopaedic Surgeons 2023, 31: 984-989. PMID: 37253245, DOI: 10.5435/jaaos-d-22-01097.Peer-Reviewed Original ResearchConceptsUrgent care facilityAnkle fracturesEmergency departmentED utilizationCare facilitiesUrgent careOdds ratioICD-10 diagnosis codesCertain injury typesUrgent care utilizationRetrospective cohort studyUrgent care visitsYears old presentingMinority of patientsEmergency department utilizationOld presentingCare visitsAdult patientsCare algorithmCohort studyIndependent predictorsCare utilizationMultivariable analysisCommon injuriesDiagnosis codesRheumatoid arthritis patients are at increased risk for adverse events following lumbar discectomy
Ratnasamy P, Rudisill K, Gouzoulis M, Kammien A, Grauer J. Rheumatoid arthritis patients are at increased risk for adverse events following lumbar discectomy. The Spine Journal 2023, 23: 990-996. PMID: 36990283, DOI: 10.1016/j.spinee.2023.03.012.Peer-Reviewed Original ResearchConceptsLumbar discectomy patientsAdverse eventsRheumatoid arthritisLumbar discectomyPatient ageDiscectomy patientsMinor adverse eventsRetrospective cohort studyLumbar spinal surgeryPatient's medication regimenElixhauser Comorbidity IndexExclusion of patientsRA medicationsComorbidity indexCohort studyMedication regimenPrior diagnosisPredictive factorsAdverse outcomesSubgroup analysisSpinal surgeryInfection diagnosisAutoinflammatory diseasesHigher oddsDiscectomyIs There Utility to Requiring Spine MRI Pre-authorizations? Pre-authorizations
Kebaish K, Galivanche A, Mercier M, Varthi A, Rubin L, Grauer J. Is There Utility to Requiring Spine MRI Pre-authorizations? Pre-authorizations. Clinical Spine Surgery A Spine Publication 2023, 36: 186-189. PMID: 36728293, DOI: 10.1097/bsd.0000000000001422.Peer-Reviewed Original ResearchConceptsSpine magnetic resonance imagingMagnetic resonance imagingSpine centerAcademic spine centerRetrospective cohort studySignificant increased oddsMultivariate logistic regressionPatient undergoing treatmentEventual dispositionInsurance carriersCohort studyIncreased oddsCommercial insurance carriersMRI requestsMRI ordersUndergoing treatmentBACKGROUND DATAGreater oddsPreauthorization processCommercial insuranceResonance imagingSpine scansLogistic regressionPreauthorizationScans
2022
Emergency Department Visits Within 90 Days of Total Ankle Replacement
Ratnasamy PP, Kammien AJ, Gouzoulis MJ, Oh I, Grauer JN. Emergency Department Visits Within 90 Days of Total Ankle Replacement. Foot & Ankle Orthopaedics 2022, 7: 24730114221134255. PMID: 36324696, PMCID: PMC9619275, DOI: 10.1177/24730114221134255.Peer-Reviewed Original ResearchElixhauser Comorbidity IndexSurgical site painRetrospective cohort studyED visitsSite painCohort studyHealth care utilization/costsHigher Elixhauser comorbidity indexPain management pathwayPostoperative ED visitsPostoperative hospital lengthEmergency department visitsDay of surgeryLogistic regression analysisSite of careTotal ankle replacementHealth care costsComorbidity indexHospital lengthED utilizationDepartment visitsPatient factorsPostoperative weekEmergency departmentFemale sexEmergency Department Visits Within 90 Days of Total Ankle Arthroplasty
Ratnasamy P, Kammien A, Gouzoulis M, Grauer J. Emergency Department Visits Within 90 Days of Total Ankle Arthroplasty. Foot & Ankle Orthopaedics 2022, 7: 2473011421s00895. PMCID: PMC9679845, DOI: 10.1177/2473011421s00895.Peer-Reviewed Original ResearchTotal ankle arthroplastyElixhauser Comorbidity IndexSurgical site painED visitsSite painTAA patientsAnkle arthroplastyRisk factorsCommon reasonHealth care utilization/costsHigher Elixhauser comorbidity indexPostoperative ED visitsRetrospective cohort studyEmergency department visitsDay of surgeryLogistic regression analysisComorbidity indexCohort studyED utilizationDepartment visitsPatient factorsPostoperative weekEmergency departmentPatient populationFemale sexPhysical Therapy Utilization Within 90 Days of Total Ankle Arthroplasty
Ratnasamy P, Gouzoulis M, Kammien A, Grauer J. Physical Therapy Utilization Within 90 Days of Total Ankle Arthroplasty. Foot & Ankle Orthopaedics 2022, 7: 2473011421s00896. PMCID: PMC9679831, DOI: 10.1177/2473011421s00896.Peer-Reviewed Original ResearchTotal ankle arthroplastyElixhauser Comorbidity IndexPhysical therapyPatient factorsTAA patientsAnkle arthroplastyHigher Elixhauser comorbidity indexPhysical therapy utilizationRetrospective cohort studyDay of surgeryMedicaid insurance coverageLogistic regression analysisComorbidity indexCohort studyPatients surgeryPredictive factorsTherapy utilizationOutpatient settingSurgeryGreater incidenceMultivariate analysisOlder ageFirst weekSeventh weekInsurance coverageHome and Outpatient Physical Therapy Utilization Following Total Ankle Replacement
Ratnasamy P, Gouzoulis M, Kammien A, Oh I, Grauer J. Home and Outpatient Physical Therapy Utilization Following Total Ankle Replacement. Foot & Ankle Orthopaedics 2022, 7: 24730114221146175. PMID: 36582653, PMCID: PMC9793015, DOI: 10.1177/24730114221146175.Peer-Reviewed Original ResearchTotal ankle replacementRetrospective cohort studyElixhauser Comorbidity IndexPhysical therapyCohort studyPatient factorsTAR patientsAnkle replacementPhysical therapy utilizationDay of surgeryInpatient physical therapyLogistic regression analysisFrequency of homeComorbidity indexIndependent predictorsMedicaid insurancePatients surgeryPredictive factorsTherapy utilizationCare pathwayAdministrative codingSurgeryLevel IIIPatientsFirst weekUnderweight 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 infection
2021
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
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
Characteristics and Predictors of HCAHPS Nonresponse After Spine Surgery.
Malpani R, Adrados M, Mercier MR, McLynn RP, Galivanche AR, Pathak N, Grauer JN. Characteristics and Predictors of HCAHPS Nonresponse After Spine Surgery. Spine 2020, 45: e448-e456. PMID: 31609883, PMCID: PMC7113123, DOI: 10.1097/brs.0000000000003287.Peer-Reviewed Original ResearchConceptsSpine surgery patientsSpine surgeryHCAHPS surveyPerioperative outcomesAdverse eventsPatient characteristicsSurgery patientsSingle institutionMultivariate analysisLonger hospital lengthHigher American SocietyMajor adverse eventsMinor adverse eventsRetrospective cohort studyMinority of patientsPatient satisfaction surveyHospital Consumer AssessmentSatisfaction surveyNonresponder biasHospital lengthPatient demographicsCohort studyHospital readmissionRetrospective analysisBACKGROUND DATAHigh, As Well As Low, Preoperative Platelet Counts Correlate With Adverse Outcomes After Elective Posterior Lumbar Surgery.
Malpani R, Gala RJ, Adrados M, Galivanche AR, Clark MG, Mercier MR, Pathak N, Mets EJ, Grauer JN. High, As Well As Low, Preoperative Platelet Counts Correlate With Adverse Outcomes After Elective Posterior Lumbar Surgery. Spine 2020, 45: 349-356. PMID: 32045405, DOI: 10.1097/brs.0000000000003248.Peer-Reviewed Original ResearchConceptsPosterior lumbar surgeryPreoperative platelet countLow platelet countPlatelet countLumbar surgeryAdverse outcomesAdverse eventsHospital lengthNational Surgical Quality Improvement Program databaseLow preoperative platelet countPreoperative low platelet countQuality Improvement Program databaseHigh platelet groupLonger hospital lengthLumbar surgery patientsPerioperative adverse outcomesMinor adverse eventsPostoperative adverse eventsImprovement Program databaseRetrospective cohort studyHigher platelet countsLarger patient populationPostoperative complicationsCohort studyPlatelet group
2019
Pediatric obesity is associated with short-term risks after pelvic osteotomy
Basques BA, Meadows MC, Grauer JN, Kogan M. Pediatric obesity is associated with short-term risks after pelvic osteotomy. Journal Of Pediatric Orthopaedics B 2019, 28: 95-99. PMID: 30234701, DOI: 10.1097/bpb.0000000000000552.Peer-Reviewed Original ResearchConceptsPelvic osteotomyRisk factorsNational Surgical Quality Improvement Program Pediatric databasePediatric pelvic osteotomiesRetrospective cohort studyIndependent risk factorLength of stayShort-term riskNonobese patientsPerioperative morbidityAdverse eventsCohort studyBlood transfusionOperative timePediatric obesityPatient counselingFemoral osteotomySurgical correctionPediatric databaseHip dysplasiaOsteotomyReadmissionObesityPatientsTransfusion
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 studySystematic Changes in the National Surgical Quality Improvement Program Database Over the Years Can Affect Comorbidity Indices Such as the Modified Frailty Index and Modified Charlson Comorbidity Index for Lumbar Fusion Studies
Shultz BN, Ottesen TD, Ondeck NT, Bovonratwet P, McLynn RP, Cui JJ, Grauer JN. Systematic Changes in the National Surgical Quality Improvement Program Database Over the Years Can Affect Comorbidity Indices Such as the Modified Frailty Index and Modified Charlson Comorbidity Index for Lumbar Fusion Studies. Spine 2018, 43: 798-804. PMID: 28922281, DOI: 10.1097/brs.0000000000002418.Peer-Reviewed Original ResearchConceptsNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseCharlson Comorbidity IndexImprovement Program databaseComorbidity indexFrailty indexNSQIP databaseProgram databaseSurgeons National Surgical Quality Improvement Program databaseElective posterior lumbar fusionModified Charlson Comorbidity IndexModified Frailty IndexAdverse postoperative outcomesRetrospective cohort studyMean American SocietyMean ASA scorePosterior lumbar fusionAnesthesiologists (ASA) scoreASA scoreCohort studyPostoperative outcomesLumbar fusionBACKGROUND DATAAmerican CollegePatientsEvaluating the effect of growing patient numbers and changing data elements in the National Surgical Quality Improvement Program (NSQIP) database over the years: a study of posterior lumbar fusion outcomes
Shultz BN, Bovonratwet P, Ondeck NT, Ottesen TD, McLynn RP, Grauer JN. Evaluating the effect of growing patient numbers and changing data elements in the National Surgical Quality Improvement Program (NSQIP) database over the years: a study of posterior lumbar fusion outcomes. The Spine Journal 2018, 18: 1982-1988. PMID: 29649610, DOI: 10.1016/j.spinee.2018.03.016.Peer-Reviewed Original ResearchConceptsNational Surgical Quality Improvement ProgramNSQIP databaseERA groupPreoperative characteristicsPostoperative outcomesBlood transfusionSeptic shockOutcome studiesNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement ProgramQuality Improvement Program databaseSurgical Quality Improvement ProgramPosterior lumbar fusion surgeryLumbar fusion outcomesRetrospective cohort studyImprovement Program databaseYear of surgeryDeep vein thrombosisUrinary tract infectionLumbar fusion surgeryPostoperative day 30Number of patientsMultivariate Poisson regressionQuality Improvement ProgramPerioperative outcomes