Impact of the COVID-19 Outbreak on Orthopedic Surgery: A Nationwide Analysis of the First Pandemic Year

Abstract

To analyze the impact of the coronavirus disease 2019 (COVID-19) outbreak during the first pandemic year in a single country. MethodsA cross-sectional study was designed. The free access database of the Chilean Department of Statistics and Health Information (DEIS) was used to compare the number of orthopedic procedures between 2019 and 2020. Country mobility was exported from the Institute of Complex Engineering Systems (ISCI) free-access database; this corresponds to a direct measurement of the degree of confinement of the country. Spearman correlation (rho) was used to analyze the total monthly COVID infection trend and mobility to orthopedics procedures. ResultsThe number of orthopedic surgeries fell by 22.8% during the first year of the pandemic. All surgical procedures were adversely affected, with the fracture/trauma surgeries being the least affected. The maximum adverse impact was seen in knee arthroplasty (-64%), followed by hip arthroplasty (-41%) and knee ligament reconstruction (-44%). The number of orthopedic procedures had a mild correlation to the monthly number of COVID-19 cases (rho=-0.53, p=0.08) and a strong correlation with the country's mobility (rho=0.94, p=0.0001). ConclusionsThe COVID-19 outbreak diminished the number of orthopedic procedures during 2020, and the impact was directly correlated to the country's mobility. The public health network did have a more significant adverse impact in elective surgeries due to a slower recovery than private institutions. An increase in the waiting list should be expected, which will widen the difference in access to orthopedic surgery in Chile.

Global Impact of the COVID-19 Pandemic on Orthopedics and the Implications of Telemedicine: A Systematic Review of the Literature

“…Two studies [ 33 , 40 ] reported the impact on orthopedic performance in America ( Table 6 ). A study in the United States included 2830 cases for multi-subspecialty percentages analysis (pre-COVID-19 vs. post-COVID-19: 1917 vs. 913).…”

“…All types of surgical performance were affected, with knee arthroplasty having the greatest impact (−64%), followed by knee ligament reconstruction (−44%) and hip replacement (−41%). Trauma surgery/fracture was least affected [ 33 ].…”

Perspective Chapter: Impact of the COVID-19 Pandemic on the Field of Orthopedics

“…However, the data may not be available from some countries. The reduction percentage of the volume of all surgeries was 49.4% in Germany [14], 44.2% in Hong Kong [30], 35% in Taiwan [55], 33% and 26% in the United Kingdom [19,21], 22.8% in Chile [32], and 15.6% in Australia (Figure 1, [49]). Surprisingly, even though there were few COVID-19 cases in the first wave and no serious lockdowns or restrictions in Hong Kong and Taiwan, they still experienced a substantial impact on the number of surgeries.…”

“…Knee replacement (−64%) had the greatest adverse impact, followed by hip replacement (−41%) and knee ligament reconstruction (−44%). The number of orthopedic surgeries was slightly correlated with the number of COVID-19 cases per month (p = 0.08) and strongly correlated with the country's mobility (p = 0.0001) [32].…”

“…The maximal reduction percentage of the elective surgery was 100% in the United Kingdom [42], 84% in Hong Kong [30], 83% in Portugal [53], 64% in Chile [32], and 43.5% in Taiwan (Figure 2, [55]). The relatively smaller reduction percentage in Taiwan may be attributable to the lack of restrictions or lockdowns [59].…”