Changing Trend in COVID 19 Pandemic, Orthopaedic Care, and Arthroplasty - A Prospective Study Conducted in Indira Gandhi Institute of Medical Sciences, an Apex Tertiary Centre of Bihar

Abstract

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

Orthopaedic practice in Indian secondary care - Exploring the notion of ‘integrated care’ from the perspectives of healthcare professionals and patients, with strategies for implementation

“…Also, how planning and communication play an essential part in the patient journey. 16 This is both to ensure patient and surgeon safety by sticking to protocols, while continually re-evaluating them. Fostering this culture helps to improve systems and learn how to prevent previous shortcomings Furthermore, research conducted by the Department of Public Health for India said that, in Bihar the lack of funding and high population density all affects the ability to deliver trauma care.…”