Jonathan Grauer

• Yale University

Background Single-institution studies demonstrate reduced cost and similar outcomes for wide-awake fasciectomy compared with those with standard anesthesia. This retrospective cohort study examines these findings on a national level, comparing adverse events and cost for partial fasciectomies performed wide-awake and with standard anesthesia. Meth...

Introduction Knee osteoarthritis and hip osteoarthritis (OA) are orthopaedic conditions for which total joint arthroplasty (TJA) is the definitive treatment. The correlation of social determinants of health (SDOH) disparities with access to specialized health care such as TJA is of increasing interest. At our institution, SDOH screening was impleme...

Background The purpose of the present study was to assess whether an association exists between cannabis use and nonunion among patients with acute scaphoid fractures initially treated nonoperatively. Methods Using the PearlDiver national data set (2010-2020), adult patients with a scaphoid fracture were identified. Patients initially treated with...

Background Surgical timing after distal radius fracture may impact patient outcome. This retrospective study assessed the timing of surgery after distal radius fracture and predictors of delayed surgery. Materials and Methods Patients who had distal radius fractures were identified from the PearlDiver M161Ortho dataset. Those who went on to have s...

Background The development of posttraumatic osteoarthritis (PTOA) of the knee after anterior cruciate ligament (ACL) reconstruction (ACLR) leads to additional morbidity in adults. Purpose To determine the 5-year incidence of and risk factors for PTOA diagnoses after primary ACLR in pediatric patients. Study Design Case control study, Level of evi...

Background While diagnosis of ganglion cysts of the wrist in the pediatric population is common, data on management are limited. This study describes a nationwide analysis of the incidence and treatment of pediatric ganglion cysts. Methods Patients who were diagnosed with a wrist ganglion cyst were identified from the PearlDiver database. Exclusio...

Background Prosthetic joint infection is a serious complication of total knee arthroplasty (TKA) and total hip arthroplasty (THA). While cefazolin is the standard prophylactic antibiotic, some groups have considered adding aminoglycosides (gentamycin or tobramycin) to this regimen. Methods Adult primary THA and TKA patients were identified from 20...

Introduction Venous thromboembolism (VTE) following injury and subsequent fixation of a distal femur fracture (DFFx) is associated with considerable morbidity. However, the incidence of VTE, associated factors, and the relative risk compared with hip fracture (HFx) fixation remains poorly characterized. Methods Retrospective cohort study using the...

Introduction Anterior cruciate ligament reconstructions (ACLrs) unfortunately can require revision ACLr, or contralateral ACLr may be indicated (together subsequent ACLr). This study aimed to examine the rate of and factors associated with returning to the same surgeon. Methods Patients who underwent ACLr and subsequent ACLr within 3 years were ab...

Category Ankle; Trauma Introduction/Purpose Orthopaedists are increasingly pursuing subspecialization after residency. However, few studies have compared ankle fracture surgery outcomes between orthopaedists from different subspecialty backgrounds. This study aims to investigate the effect of subspecialization on patient outcomes following surgica...

Background Lumbar diskectomy is a common procedure, following which a brief course of narcotics is often prescribed. Nonetheless, increasing attention has been given to such prescribing patterns to limit adverse effects and the potential for abuse. This study investigated prescribing patterns of opioid within 90 days following lumbar diskectomy. M...

Background Anterior cruciate ligament reconstruction (ACLR) is a commonly performed orthopaedic procedure. As the number of ACLRs continues to increase in incidence, understanding the variability and drivers of cost to the health care system may help target cost-saving measures. Purposes To examine the variability in overall 90-day reimbursements...

Background This study sought to characterize the incidence of, timing of, predictive factors for, and reasons for emergency department (ED) visits within 90 days of single-level posterior cervical foraminotomy (PCF). These visits, after PCF, have received limited attention. Materials and Methods The 2010–2022 M161 PearlDiver database was queried f...

Introduction Academic scholarship is often valued by clinicians, peers, and intuitions. Quantifying the effect of research publications is challenging. Various metrics have been used to assess this. This study aimed to examine the relatively new research metric, relative citation ratio (RCR), introduced by the National Institutes of Health, for ped...

Background Autism spectrum disorder (ASD) is a neurodevelopmental disorder associated with osteoarthritis for which total knee arthroplasty (TKA) may be considered. The safety and efficacy of TKA in patients with ASD had been poorly characterized. Methods Total knee arthroplasty patients were identified using the M157 PearlDiver database. Patients...

Background A large proportion of total knee arthroplasty (TKA) patients are on antidepressant medications at the time of surgery. Postoperative outcomes of this patient demographic have not been characterized. This study compared the risk of 90-day adverse events and 5-year survival to revision surgery between patients on antidepressants and those...

Background Total hip arthroplasty (THA) was removed from the Centers for Medicare and Medicaid Services inpatient-only (IPO) list on January 1, 2020. The impact of this policy changes on length of stay (LOS) and coding status (inpatient/outpatient) beyond 2020 remains to be fully defined. Methods Data were obtained from the 2018 to 2021 National S...

A mandible fracture is a common traumatic craniofacial injury for which surgery is sometimes indicated. Post-fracture and postoperative pain are often controlled through prescribed narcotics, which have received increased attention for potential abuse. The current work identified 90-day opioid prescribing patterns following surgically treated mandi...

Introduction Diabetes mellitus (DM) is a common comorbidity in total knee arthroplasty (TKA) patients, which has been associated with multiple complications. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are one class of medications recently approved to better manage DM. This study investigates the correlation of SGLT2i use on postoperative co...

Introduction Pediatric supracondylar humerus fractures are common and the most frequent pediatric fracture to require surgical intervention. After initial management, emergency department (ED) visits subsequent to this injury/surgery are not well characterized, but are of clinical interest. Methods Pediatric patients (age >1 y old and <13 y old) w...

Introduction Core decompression is a minimally invasive procedure considered in the treatment of early-stage femoral head osteonecrosis. This procedure is theorized to relieve vascular pressure and promote angiogenesis. Although a less invasive procedure, there are considerations related to learning curve, technique variations, etc. that may affect...

Study Design Cross-sectional study of presenter disclosures from the 2022 North American Spine Society (NASS), Scoliosis Research Society (SRS), and Cervical Spine Research Society (CSRS) annual research conferences. Objective The current study aimed to evaluate the consistency of financial disclosures for authors presenting at multiple 2022 spine...

Aim To compare the efficacy of a postoperative continuous adductor canal block (cACB) with and without a steroid adjuvant to that of epidural analgesia (EA). Methods Patients who underwent primary total TKA at a single institution between July 2011-November 2017 were included for retrospective analysis. TKA patients were stratified into one of the...

Background Posterior lumbar fusion (PLF) is a common spine surgery that may be considered in patients with underlying comorbidities, such as inflammatory bowel disease (IBD). Prior literature examining the association of this disease and PLF outcomes was done in the National Inpatient Sample (NIS), which only assessed in-hospital data and did not r...

Background Following carpal tunnel release (CTR), patients may be indicated for subsequent hand surgery (contralateral CTR and/or trigger finger release [TFR]). While surgeons typically take pride in patient loyalty, the rate of returning to the same hand surgeons has not been previously characterized. Methods Patients undergoing CTR were isolated...

Background Atopic dermatitis (AD), also known as eczema, is a highly prevalent, chronic inflammatory skin condition. The perioperative outcomes of patients with AD after total knee arthroplasty (TKA) have not been characterized. Methods Adult patients who underwent TKA were identified in the PearlDiver administrative database. After matching based...

Background Total shoulder arthroplasty (TSA) is commonly done for degenerative conditions. Patients may need additional contralateral TSA or ipsilateral revision TSA. As a marker of patient satisfaction and practice integrity, factors associated with return to the same or different surgeon are of interest. Methods Patients undergoing TSA were abst...

Study Design/Setting Retrospective cohort study Objective To characterize the incidence and odds of neurologic adverse events following interlaminar (IL) and transforaminal (TF) cervicothoracic epidural spinal injections (CESI). Summary of Background Data CESI may be considered in the management of various cervical pathology. Adverse events, alth...

Introduction With the rising prevalence of mental health disorders, it is important to consider their correlation with surgical outcomes. Anxiety has been associated with adverse events after many surgical procedures, but its relationship relative to anterior cervical diskectomy and fusion (ACDF) regarding medical complications has not previously b...

Background Behcet syndrome (BS), a multisystem autoimmune disorder, has unclear effects on outcomes after total hip arthroplasty (THA) and total knee arthroplasty (TKA). This study assessed the relative risk of perioperative adverse events in patients with BS. Methods This retrospective cohort study used the PearlDiver M157Ortho data set, a large...

Background After anterior cruciate ligament (ACL) reconstruction (ACLR), ipsilateral ACL graft reinjury or contralateral ACL injury has been reported. The rate and predictors of such subsequent ACL injuries have not been reported in recent years and in large patient cohorts. Purpose The current study utilized a large, national, multi-insurance, ad...

Background Geriatric hip fractures are common and important sentinel events regarding bone health. Although dual x-ray absorptiometry (DEXA) scans are a standard method for determining bone density, differences in use among various race/ethnic groups around the time of hip fracture may reveal disparities within the healthcare system. Methods The 2...

Introduction Geriatric patients with hip fracture are at risk of having COVID-19 while needing fracture treatment. Understanding the associated risks of variable timing of COVID-19 before surgery may help direct care algorithms. Methods Geriatric patients with documented hip fracture surgery were identified within the PearlDiver M157 database. Pat...

Goldenhar syndrome is a rare congenital disease that presents with a spectrum of clinical sequelae related to the vertebrae and other organs. The spinal manifestations of the syndrome are associated with scoliosis for which fusion may be considered. The current study aimed to evaluate the risks of adverse events and reoperations following posterior...

Background: Patients with hemophilia A can develop joint hemarthroses, degenerative changes, and eventually undergo total shoulder arthroplasty (TSA). Few data exist concerning complications and prosthesis survival after TSA in this population. Questions/purposes: (1) Is hemophilia A associated with more bleeding and thromboembolic adverse events...

Background Context Odontoid fractures are relatively common. However, the literature is unclear how these fractures are best managed in many scenarios. As such, care is varied and poorly characterized. Purpose To investigate the trends and predictive factors of surgical versus nonsurgical treatment and anterior versus posterior stabilization of od...

Study Design Retrospective cohort study Objective To evaluate postoperative adverse events, readmissions, and five-year survival to reoperation for two-level cervical disc arthroplasty (CDA) relative to two-level anterior cervical discectomy and fusion (ACDF). Background CDA and ACDF are both treatment options for degenerative cervical spine path...

Study Design Retrospective cohort study Objective To assess relative odds of perioperative complications, readmissions, and five-year survival to reoperation for three-level lumbar decompression patients who undergo three-level fusion relative to one-level fusion. Background Patients undergoing multilevel lumbar decompression may be indicated for...

Background Posterior lumbar fusion (PLF) is frequently considered for various spinal pathologies. While many outcome metrics have been assessed, to our knowledge, there has yet to be literature specifically investigating inpatient falls (IPFs) and its risk factors. Methods Adult patients who underwent single-level PLF were abstracted from the 2010...

Study Design Retrospective cohort analysis. Objective CCS is the most common type of incomplete spinal cord injury and can occur without or with bony injury. Surgical intervention and its timing for patients diagnosed with CCS has been controversial. The current study assessed utilization of and factors associated with operative intervention and i...

Background Nerve injury following total hip arthroplasty (THA) is a rare but serious adverse event. While prior studies have reported risk factors for nerve injury related to THA, they are limited to institutional data or small sample sizes. The current study aimed to leverage a large, national database to assess independent risk factors for sustai...

Introduction Some papers suggest that wide-awake flexor tendon repair (FTR) may reduce rates of postoperative tendon gapping and rupture due to improved intraoperative testing of the repair. The current study is a nationwide cohort study comparing FTRs performed wide-awake and with traditional anesthesia. Methods Patients undergoing zone II FTR be...

Introduction Wide-awake and office-based hand surgeries are increasingly common. The association of these techniques with postoperative pain and pain control has garnered recent attention. A prior study demonstrated that office-based trigger finger release (TFR) were associated with decreased perioperative opioid prescriptions compared to those per...

Background Spinal surgeries are a common procedure, but there is significant risk of adverse events following these operations. While the rate of adverse events ranges from 8% to 18%, surgical site infections (SSIs) alone occur in between 1% and 4% of spinal surgeries. Methods We completed a systematic review addressing factors that contribute to...

Background This study compared trends in use, predictive factors, and reimbursement of endoscopic carpal tunnel release (ECTR) withthose of open carpal tunnel release (OCTR) from 2010 to 2021 using a national administrative database. Methods ECTR and OCTR patients were identified in the PearlDiver M151Ortho data set. Numeric and proportional utili...

Aim To examine patients with cerebral palsy (CP) undergoing open reduction and internal fixation (ORIF) for ankle fractures. Method This was a retrospective study of adult patients undergoing ankle fracture ORIF for closed, isolated ankle fractures identified in between 2010 and 2021 in the Q1 PearlDiver M151 database. Patients with CP were identi...

Introduction Anatomic and reverse total shoulder arthroplasties (TSAs) are effective treatment options for end-stage glenohumeral osteoarthritis. Those undergoing TSA may also have fibromyalgia, a musculoskeletal condition. However, the association of fibromyalgia with shorter and longer term outcomes after TSA has not been well characterized. Met...

Study Design Retrospective cohort study Objective Compare perioperative adverse events and reoperations between navigation-assisted and robotic-assisted posterior lumbar fusion. Summary of Background data Navigation has become increasingly utilized for posterior lumbar fusion (PLF). More recently, robotic assistance systems have been gaining trac...

Background Prior studies have compared perioperative opioid prescriptions between carpal tunnel release (CTR) performed wide-awake and with traditional anesthetic techniques, but the association of opioid prescriptions with surgical setting has not been fully explored. The current study assessed the association of opioid prescriptions with surgical...

Background Total hip arthroplasty (THA) is a common procedure following which postoperative visits are important to optimize outcomes. The associated global billing period includes the 90 postoperative days (or approximately 13 weeks), during which professional billing is included with the surgery itself. The current study assessed clinical practic...

Introduction Total knee arthroplasty (TKA) is a common procedure for which patient factors are known to affect perioperative outcomes. Asthma has not been specifically considered in this regard, although it is the most common inflammatory airway disease and predisposes to osteoarthritis. Methods Adult patients undergoing TKA were identified from 2...

Purpose: Posterior scoliosis fusion (PSF) for adolescent idiopathic scoliosis (AIS) is considered a highly successful surgery with excellent outcomes. However, especially as many patients "graduate" from their pediatric surgeons, there is the need to quantify the long-term outcomes of such surgeries. Methods: The 2010-2022 Pearldiver M161 dataset...

Background Elbow arthroscopy has defined indications for which technical pearls and outcomes have been described. However, other aspects of the postoperative course, such as postprocedural emergency department (ED) visits, have received less attention. The current study defined the incidence and factors associated with ED visits in the 90 days foll...

This quality improvement study investigates usage patterns of codes for inflammatory arthritides under International Statistical Classification of Diseases and Related Health Problems, Tenth Revision vs International Classification of Diseases, Ninth Revision.

Objective: Geriatric vertebral compression fractures are the most common fracture associated with osteoporosis. Using a large national database, the current study aimed to examine and characterize bracing trends for geriatric thoracic/lumbar compression fracture management. Methods: The current study utilized the PearlDiver database from 2015-2021...

Background Following decompression in anterior cervical discectomy and fusion (ACDF), reconstruction is typically done with structural allograft or a synthetic cage. Relative trends and factors associated with utilizing these implants have not been well characterized. Methods The PearlDiver 2011 to 2021 M157 database was used to identify adult pat...

Background Core decompression is a minimally invasive joint-preserving approach for early-stage osteonecrosis. The rate at which core decompression patients require total hip arthroplasty (THA) and rates of perioperative adverse outcomes have not been well-characterized. Methods Adult patients undergoing core decompression and/or THA with osteonec...

Study Design Retrospective cohort study. Objective Characterize physical therapy (PT) utilization following single-level posterior lumbar fusion (PLF). Summary of Background Data PLF is a common procedure that is increasing in frequency. Following such surgeries, PT may be considered to facilitate mobilization and return to activities. However, t...

Study Design Retrospective cohort study. Objectives Gabapentinoids have been increasingly studied as a non-narcotic option for neuropathic and postoperative pain. However, there is evidence suggesting that off-label use of these medications for the treatment of isolated LBP is not effective. The purpose of the current study was to evaluate prescri...

OBJECTIVES Over the years, medical schools have evolved their curricula in response to the medical field, faculty, and students. The current study aims to examine how medical students study, what resources they most commonly use, and how it relates to United States Medical Licensing Examination (USMLE) Step 1 scores. METHODS A cross-sectional surv...

Introduction The effect of orthopaedic fellowship subspecialization on surgical complications for patients with supracondylar fracture is unknown. This study seeks to compare the effect of subspecialty training on supracondylar fracture complications. Methods The American Board of Orthopaedic Surgery Part II Examination Case List database was revi...

Background Optimal management after posterior cruciate ligament (PCL) injury remains an active area of research, as reconstruction is technically challenging and poses unique risks in the posterior knee. Studies have reported variable rates of complications. Purpose To describe the rates of readmission, emergency department (ED) visits, and postop...

Introduction Sponsorship trends have not been specifically evaluated for shoulder and elbow clinical trials, nor have trial characteristics been compared among shoulder and elbow trials sponsored by institutions, industries, and federal agencies. Methods ClinicalTrials.gov was queried for clinical trials using the terms ‘shoulder’ and ‘elbow.’ Tri...

Introduction Patients with cystic fibrosis (CF) are living longer and may be considered for total hip arthroplasty (THA) or total knee arthroplasty (TKA). Perioperative outcomes and implant survival after these procedures performed for those with CF have not been previously described. Methods Using the M151 PearlDiver database, a large, national,...

Introduction Clavicle fractures are common and have historically been managed nonsurgically. Over time, there are increasing surgical considerations for such injuries. Nonetheless, trends over the past decade are not well characterized. Methods Adult patients presenting for first diagnosis of clavicle fractures were identified from the 2010 to 202...

Category Ankle Arthritis Introduction/Purpose Total ankle replacement (TAR) surgery has steadily increased in recent decades. The aim of the current study was to investigate the evolving burden of revision surgery and risk factors and timing of revision or implant removal. We hypothesized that there has been an increase in revision TAR and explant...

Introduction Lumbar laminotomy/diskectomy is a common procedure performed to address radiculopathy that persists despite conservative treatment. Understanding cost/reimbursement variability and its drivers has the potential to help optimize related healthcare delivery. The goal of this study was to assess variability and factors associated with rei...

Background Patients with Down syndrome (DS) are being considered for total joint arthroplasty. There is limited literature regarding outcomes of patients with DS after total hip arthroplasty (THA) and total knee arthroplasty (TKA). Methods Data were abstracted from the 2010 to 2021 Q1 PearlDiver M151 database. THA and TKA osteoarthritis adult pati...

Objectives The purpose of this study was to compare the rates of secondary knee surgery for patients undergoing meniscus repair with or without concurrent anterior cruciate ligament reconstruction (ACLr). Methods Utilizing a large national database, patients with meniscal repair with or without concurrent arthroscopic ACLr were identified. The two...

Study design /setting Retrospective study. Objective To understand what patients utilize emergency departments (EDs) versus urgent care centers for low back pain (LBP). Summary of Background Data LBP is a common reason for ED visits. In the setting of trauma, or recent surgery, the resources of EDs may be needed. However, urgent care centers, may...

Background Readmissions are a typical postoperative metric; however, postoperative emergency department (ED) utilization also negatively affects patient care. Few studies have explored this metric after patellofemoral arthroplasty (PFA); thus, we investigated the incidence, timing, predictive factors, and reasons for ED utilization within 90 days a...

Study Design Descriptive epidemiologic study. Objective To analyze trends and patient characteristics of those undergoing cervicothoracic transforaminal, interlaminar, and facet injections over time. Background Cervicothoracic transforaminal, interlaminar, and facet injections are considered for varied spinal pathologies. Evolving literature, cha...