2024
Disparities in Dual-energy X-ray Absorptiometry Scan Utilization Across Race/Ethnic Groups Before and After Hip Fractures
Rudisill K, Ratnasamy P, Sanchez J, Grauer J. Disparities in Dual-energy X-ray Absorptiometry Scan Utilization Across Race/Ethnic Groups Before and After Hip Fractures. JAAOS Global Research And Reviews 2024, 8: e24.00052. PMID: 39303221, PMCID: PMC11419421, DOI: 10.5435/jaaosglobal-d-24-00052.Peer-Reviewed Original ResearchConceptsHip fracture populationHip fractureDEXA scanRace/ethnic groupsElixhauser Comorbidity IndexLesser oddsPatient ageFracture populationScan utilizationComorbidity indexTime of hip fractureBefore hip fractureStudy revealed disparitiesImprove medication accessDual x-ray absorptiometryHip fracture patientsGeriatric hip fracturesX-ray absorptiometryHip fragility fracturesMedication accessNon-white categorySentinel eventsHealthcare systemFragility fracturesFracture patientsTrends in Open Versus Endoscopic Carpal Tunnel Release From 2010 to 2021
Ratnasamy P, Rudisill K, Joo P, Lattanza L, Grauer J. Trends in Open Versus Endoscopic Carpal Tunnel Release From 2010 to 2021. JAAOS Global Research And Reviews 2024, 8: e24.00077. PMID: 38885416, PMCID: PMC11191037, DOI: 10.5435/jaaosglobal-d-24-00077.Peer-Reviewed Original Research
2023
Emergency department visits within 90 days of lumbar discectomy
Ratnasamy P, Rudisill K, Caruana D, Kammien A, Grauer J. Emergency department visits within 90 days of lumbar discectomy. The Spine Journal 2023, 23: 1522-1530. PMID: 37356460, DOI: 10.1016/j.spinee.2023.06.384.Peer-Reviewed Original ResearchConceptsElixhauser Comorbidity IndexSurgical site painED visitsED utilizationLumbar discectomySite painUnderwent reoperationPatient factorsPostoperative weekPatient satisfactionPrimary diagnosisRisk factorsCSF leakHealth care resource utilizationHigher Elixhauser comorbidity indexExcess health care expendituresCommon primary diagnosisType of reoperationNerve root decompressionDay of surgeryEmergency department visitsPatient-level predictorsPosterior segmental instrumentationRisk of reoperationSpecific patient characteristicsDecline in Separate Incision Autograft for Spine Surgery Over the Past Decade: A Fading “gold standard”
Rudisill K, Ratnasamy P, Maloy G, Grauer J. Decline in Separate Incision Autograft for Spine Surgery Over the Past Decade: A Fading “gold standard”. Journal Of The American Academy Of Orthopaedic Surgeons 2023, 31: 938-944. PMID: 37332184, DOI: 10.5435/jaaos-d-22-01029.Peer-Reviewed Original ResearchConceptsElixhauser Comorbidity IndexSurgeon specialtySpinal fusionComorbidity indexSmoking statusGold standardIliac crest autograftPatient ageIndependent predictorsPatient factorsNonsurgical factorsCrest autograftSpine surgeryBone graftingSpine fusionIliac crestBone graftAutograftYounger ageSurgeryInsurance factorsSpinal boneCommon procedureInsurance plansAgeTotal 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 medicineUrgent 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 codesComparing 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 ResearchConceptsProximal 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 dataSurgeryRacial/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
Cervical Disc Arthroplasty Usage Has Leveled Out From 2010 to 2021
Ratnasamy P, Rudisill K, Maloy G, Grauer J. Cervical Disc Arthroplasty Usage Has Leveled Out From 2010 to 2021. Spine 2022, 48: e342-e348. PMID: 36728785, PMCID: PMC10300227, DOI: 10.1097/brs.0000000000004560.Peer-Reviewed Original ResearchConceptsSingle-level cervical disc arthroplastyCervical disc arthroplastyKaplan-Meyer survival analysisPredictive patient factorsCervical spine pathologySingle-level ACDFAnterior cervical discectomyAnterior cervical surgeryCervical spine surgerySpine reoperationCervical surgeryCervical discectomyPatient factorsPredictive factorsSpine surgeryACDFDisc arthroplastySpine pathologyEpidemiologic studiesOrthopaedic surgeonsCommercial insuranceSurvival analysisMultivariate analysisSurgeryYounger ageChanges in the Utilization of Lumbosacral Epidural Injections Between 2010 and 2019
Ratnasamy PP, Gouzoulis MJ, Kammien AJ, Holder EK, Grauer JN. Changes in the Utilization of Lumbosacral Epidural Injections Between 2010 and 2019. Spine 2022, 47: 1669-1674. PMID: 36281568, PMCID: PMC9643603, DOI: 10.1097/brs.0000000000004467.Peer-Reviewed Original ResearchMeSH KeywordsAgedAnesthesia, EpiduralHumansInjections, EpiduralLumbosacral RegionMedicareUnited StatesConceptsElixhauser Comorbidity IndexEpidural injectionTransforaminal injectionsSpinal epidural injectionDescriptive epidemiologic studyLumbosacral epidural injectionNumber of injectionsCurrent Procedural Terminology codingCaudal injectionComorbidity indexPatient agePatient characteristicsPearlDiver databaseLumbar pathologyTerms of specialtyInsurance authorizationPractice patternsService utilizationAverage patientEpidemiologic studiesMedicaid coveragePatientsTransforaminalMedicare coverageUtilization trendsPatient Demographic and Socioeconomic Factors Associated With Physical Therapy Utilization After Uncomplicated Meniscectomy
Mercier MR, Galivanche AR, Wiggins AJ, Kahan JB, McLaughlin W, Radford ZJ, Grauer JN, Gardner EC. Patient Demographic and Socioeconomic Factors Associated With Physical Therapy Utilization After Uncomplicated Meniscectomy. JAAOS Global Research And Reviews 2022, 6: e22.00135. PMID: 35816646, PMCID: PMC9276169, DOI: 10.5435/jaaosglobal-d-22-00135.Peer-Reviewed Original ResearchConceptsMore PT visitsPT visitsPhysical therapyUse of PTPhysical therapy utilizationPatient demographicsPatient agePearlDiver databaseMale sexTherapy utilizationInsurance statusInsurance typeInclusion criteriaLower oddsPatientsMeniscectomyOlder ageLogistic regressionVisitsSocioeconomic factorsDemographic factorsAgeSexPT useTherapyJump 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
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 LOSSpine Surgery HCAHPS Patient Satisfaction Survey Results Inversely Correlate with Survey Response Time
Kebaish KJ, Mercier MR, Duy PQ, Malpani R, Galivanche AR, Grauer JN. Spine Surgery HCAHPS Patient Satisfaction Survey Results Inversely Correlate with Survey Response Time. Spine 2021, 46: 1264-1270. PMID: 34435990, DOI: 10.1097/brs.0000000000003974.Peer-Reviewed Original ResearchConceptsHCAHPS surveySurgery patientsSpinal surgery patientsSpine surgery patientsPatient satisfaction surveyHospital Consumer AssessmentPatient satisfaction metricsAcademic medical centerMultivariate regression analysisLower scoresSurvey response timeAnesthesiologists classPatient demographicsPostoperative outcomesRetrospective reviewFunctional statusSpine surgeryBACKGROUND DATAMedical CenterPatient experienceDay 22Day 43Healthcare providersDay 0Reported satisfaction
2019
Patient-related Factors and Perioperative Outcomes Are Associated with Self-Reported Hospital Rating after Spine Surgery.
Mets EJ, Mercier MR, Hilibrand AS, Scott MC, Varthi AG, Grauer JN. Patient-related Factors and Perioperative Outcomes Are Associated with Self-Reported Hospital Rating after Spine Surgery. Clinical Orthopaedics And Related Research® 2019, 478: 643-652. PMID: 31389897, PMCID: PMC7145058, DOI: 10.1097/corr.0000000000000892.Peer-Reviewed Original ResearchConceptsOverall hospital experienceMultivariate logistic regression analysisPatient-related factorsAdverse eventsHospital ratingSpine surgeryLogistic regression analysisPerioperative outcomesPatient factorsQuality of careSurgical variablesHospital experienceHCAHPS scoresHCAHPS surveyPatient demographicsAnnual reimbursementAnesthesiologists class IIMinor adverse eventsNumerous patient factorsOnly surgical factorMajor adverse eventsSpine surgery populationSingle academic institutionHospital Consumer AssessmentPotential confounding variablesChanges 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
2016
Variation in Resource Utilization for Patients With Hip and Pelvic Fractures Despite Equal Medicare Reimbursement
Samuel AM, Webb ML, Lukasiewicz AM, Basques BA, Bohl DD, Varthi AG, Lane JM, Grauer JN. Variation in Resource Utilization for Patients With Hip and Pelvic Fractures Despite Equal Medicare Reimbursement. Clinical Orthopaedics And Related Research® 2016, 474: 1486-1494. PMID: 26913512, PMCID: PMC4868172, DOI: 10.1007/s11999-016-4765-8.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overDiagnosis-Related GroupsFee-for-Service PlansFemaleFracture FixationHealth ResourcesHip FracturesHospital CostsHumansIntensive Care UnitsLength of StayMaleMedicarePatient Care BundlesPelvic BonesProcess Assessment, Health CareRegistriesRespiration, ArtificialRetrospective StudiesTime FactorsTrauma CentersTreatment OutcomeUnited StatesConceptsIntensive care unitDiagnosis-related groupsPelvic fracturesHip fractureInpatient lengthAcetabulum fracturesVentilator timeICU lengthHospital factorsVentilation timePelvis fracturesIntensive care unit stayNational Trauma Data BankTotal inpatient lengthTrue hospital costsMechanical ventilation timeInpatient resource utilizationHigh-energy traumaTrauma Data BankIncidence of fracturesNonoperative fracturesUnit stayTrauma patientsCare unitPelvic trauma