Management of Orthopaedic Patients During COVID-19 Pandemic in India: A Guide

Neradi, Deepak; Hooda, Aman; Shetty, Akshay; Kumar, Deepak; Salaria, Amit Kumar; Goni, Vijay

doi:10.1007/s43465-020-00122-6

Cited by 20 publications

(18 citation statements)

References 5 publications

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“…There are many guidelines for TKA and postoperative managements [ 12 ]. However, there is a lack of specific guidelines for rehabilitation protocol during the COVID-19 lockdown [ 3 , 5 ]. The lack of instruction by trained physiotherapists adds more challenges to the patients after discharge [ 5 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

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Physiotherapeutic assistance verse home care assistance in the early rehabilitation of total knee arthroplasty during COVID-19 lockdown

2021

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Background The aim of this retrospective comparison study was to assess early functional recovery of total knee arthroplasty with home care assistance during COVID-19 lockdown. Methods A total of 16 patients (27 knees involved) were divided into a pre-lockdown group (10 patients; 17 knees) and a post-lockdown group (6 patients, 10 knees) in terms of the time of surgeries performed before and after lockdown, respectively, due to COVID-19 pandemic. Patients of pre-lockdown group underwent rehabilitation under the guidance of trained physiotherapists for at-home sessions and under assisted physiotherapy. Patients of post-lockdown group followed the rehabilitation protocol of at-home sessions and under home-care assistance during COVID-19 lockdown. Functional recovery of the knee was assessed against the Knee Injury and Osteoarthritis Outcome Score, Junior. A p < 0.05 was considered statistically significant. Results The pre- and postoperative mean KOOS Junior of pre-lockdown group were 48.73 ± 2.64 and 64.91 ± 2.74, respectively (p < 0.001). The pre- and postoperative scores of post-lockdown group were 48.83 ± 2.83 and 67.84 ± 4.31 (p < 0.001), respectively. Intergroup comparison between pre- and postoperative KOOS Jr. revealed no significant differences (p > 0.05). Conclusion Although the COVID-19 lockdown affected the routine postoperative rehabilitation after total knee arthroplasty, the coordination among the surgeon, therapists, and home caregivers can provide sustained assistance in rehabilitation. The guidelines for practitioners and physiotherapists can benefit functional recovery of the knee.

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Section: Discussionmentioning

confidence: 99%

“…The governments around the world are all in the crisis-management mode. The Prime Minister of India announced a nationwide lockdown effective as of 25th March 2020 to prevent community transmission [ 3 , 4 ]. This unmatched event of this magnitude affected both the surgeons and patients who underwent TKA.…”

Section: Introductionmentioning

confidence: 99%

Physiotherapeutic assistance verse home care assistance in the early rehabilitation of total knee arthroplasty during COVID-19 lockdown

2021

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“…These methods devised to reuse N-95 and goggles are very helpful in the judicious use of limited resources without increasing the risk of infection. The proper and meticulous technique of donning and doffing should be practiced each time to prevent infection [23].…”

Section: Discussionmentioning

confidence: 99%

Adapting Policy Guidelines for Spine Surgeries During COVID-19 Pandemic in View of Evolving Evidences: An Early Experience From a Tertiary Care Teaching Hospital

Verma¹,

Nagar²,

Jain³

et al. 2020

Cureus

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Eight patients (61.5%) presented with spinal cord injury (SCI) due to vertebral fracture with fall from height (87.5%) as the most common etiology. Among the traumatic SCI patients, six (75%) were managed surgically with posterior decompression and instrumented fusion with pedicle screws while two patients (25%) were managed conservatively. There were four patients (30.8%) of tuberculosis of the spine of whom two (50%) were managed with posterior decompression, debridement, and stabilization with pedicle screws, samples for culture, biopsy, and cartridge-based nucleic acid amplification test (CBNAAT) were collected during the procedure; for the remaining two patients (50%), a trans-pedicular biopsy was performed to confirm the diagnosis for initiation of anti-tubercular therapy. Prolapsed intervertebral disc causing cauda equina syndrome was the reason for emergency surgery in one patient (7.7%). COVID-19 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) test was performed in four patients (30.8%), in whom the most common symptom was fever (two patients (50%)). These patients were residents of high prevalence area for COVID-19 infection. Sore throat (25%), fatigue (25%), and low oxygen saturation (25%) were present in one patient which prompted us to get the COVID-19 test. All patients were reported negative for COVID-19. Conclusion The structural organization and the management protocol we describe allowed us to reduce infection risk and ultimately hospital stay, thereby maximizing the already stretched available medical resources. These precautions helped us to reduce transmission and exposure to COVID-19 in health care workers (HCW) and patients in our institute. The aim of this article is that our early experience can be of value to the medical communities that will soon be in a similar situation.

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“…Three main stages of screening for SARS‐CoV‐2 infection were described in literature. Epidemiological history and symptoms were investigated at the point of admission as a method of quickly identifying suspected COVID-19 patients ( Neradi et al 2020 ). These patients were sometimes isolated in buffer wards for further testing ( Meng et al 2020 , Wu et al 2020 ).…”

Section: Patient Screening For Covid-19mentioning

confidence: 99%

“…The redeployment of staff to the ‘front line’ also necessitated this reduction. To further reduce infection risk, efforts were made to reduce the duration of surgeries ( Neradi et al 2020 ). However, the additional COVID-19 precautions (discussed below) have also led to an increase in theatre utilisation per case in some practices ( Mathai et al 2020 ).…”

Section: Surgical Protocol Changesmentioning

confidence: 99%

The orthopaedic experience of COVID-19: A literature review

Al-Kulabi

Mansour

Thahir

2021

Journal of Perioperative Practice

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This literature review aims to provide an account of the changes to orthopaedics in the era of COVID-19. Herein, the authors explored the use of telemedicine in orthopaedics as well as changes in surgical protocols, screening methods, work priorities and orthopaedic education. There was increased utilisation of telemedicine in orthopaedic training and outpatient cases as a means to provide continuity in education and care. The need to implement social distancing measures, coupled with the reduced availability of staff, has dictated that the practice of orthopaedics shifts to focus on acute care whilst redistributing resources to front-line specialities. This was facilitated by the cancellation of electives and the reduction of outpatient clinics. Thus, it is demonstrated that major changes have been implemented in many aspects of orthopaedic practice in order to address the challenges of the COVID-19 pandemic.

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Management of Orthopaedic Patients During COVID-19 Pandemic in India: A Guide

Cited by 20 publications

References 5 publications

Physiotherapeutic assistance verse home care assistance in the early rehabilitation of total knee arthroplasty during COVID-19 lockdown

Physiotherapeutic assistance verse home care assistance in the early rehabilitation of total knee arthroplasty during COVID-19 lockdown

Adapting Policy Guidelines for Spine Surgeries During COVID-19 Pandemic in View of Evolving Evidences: An Early Experience From a Tertiary Care Teaching Hospital

The orthopaedic experience of COVID-19: A literature review

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