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BACKGROUND The novel corona virus pandemic has a profound impact on health services throughout the world, which reflected the changing guidelines of different health societies in different time zones. We tried first to ensure the safety of our patients and surgical staff. Patient care priorities based on strict evidence-based management of a particular case and also COVID-19-adjusted governmentimposed restriction during the crisis. We aim to study postoperative complication after arthroplasty and readmission rate and compared the same with the prepandemic era. We also address our strategies, concerns, and regulatory barriers due to government-imposed lockdown, during initial surge of pandemic and also when restrictions were lifted. This study is unique in the way that there is no such study from Bihar, a state of developing country with scarcity of specialized health services. METHODS In this prospective study done in Indira Gandhi Institute Of Medical Sciences, Patna, Bihar between 1st December 2019 to 31st January 2021 (14 months duration). We have selected a subset of those patient who were admitted for primary arthroplasty of hip during the pandemic after lock down, and compared those with patient those underwent similar operative management before the lockdown period. RESULTS There was no significant difference in postoperative complication and readmission rate when compared with the pre-pandemic era. CONCLUSIONS There is no significant increase in risks of patient as well as operating surgeon before the pandemic and during the pandemic when the elective operative procedure (arthroplasty) was allowed. Communication, precautions, and proper preoperative planning remain essential part of management at each step of treatment. By following above mentioned standard operative procedure (SOP) chances of getting infection of COVID-19 is negligible from operative work. KEYWORDS COVID 19, SARS-CoV-2, Arthroplasty, Orthopaedics

Background and objectiveThere is scarce data on demography and different surgical treatment modalities for giant cell tumor of bone (GCTB) from eastern India. In light of this, the present study aimed to examine the demographic characteristics, different surgical treatment modalities, and recurrence rate of GCTB at a tertiary care institute in Bihar. Materials and methodsA retrospective audit of 52 GCTB patients who were treated at the center from January 2016 to December 2020 was conducted. The minimum follow-up period was one year. GCTB patients underwent surgical procedures ranging from extended intralesional curettage with bone graft or bone cement with or without fixation to wide local excision to resection with or without reconstruction or amputation depending on the stage and site of the tumors. ResultsThe mean age of patients was 31.86 years (range: 13-67 years). The distal femur (20 patients, 38.46%) and proximal tibia (11 patients, 21.15%) were the most common sites of the tumor. Sixty-eight confirmed cases (male: 32, female: 36) of GCTB were operated on, with a male-to-female ratio of 1:1.125. Sixteen patients (four males and 12 females) were lost to follow-up. So, the final study consisted of 52 patients with a median age of 28 years (first quartile: 24 years, third quartile: 38 years). The majority of patients (32 patients, 61.53%) were in the third and fourth decades of life. ConclusionBased on this retrospective audit, it is concluded that the knee region is the most common site of GCTB. Surgery is the mainstay of management. Most of the patients came under Campanacci Grade 3 with low compliance with follow-up and adherence to the treatment. Hence, educational programs, the establishment of early detection centers, and timely referral to expert treatment are necessary.

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