The Effect of the COVID-19 Pandemic on Hip and Knee Arthroplasty Patients in the United States: A Multicenter Update to the Previous Survey

Brown, Timothy S.; Bedard, Nicholas A.; Rojas, Edward O; Anthony, Christopher A.; Schwarzkopf, Ran; Stambough, Jeffrey B.; Nandi, Sumon; Prieto, Hernan A.; Parvızı, Javad; Bini, Stefano A.; Piuzzi, Nicholas S; Blankstein, Michael; Wellman, Samuel S.; Dietz, Matthew J.; Dasa, Vinod

doi:10.1016/j.artd.2020.11.025

Cited by 21 publications

(29 citation statements)

References 8 publications

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“…The observed decrease in elective surgeries is in line with previous reports and was partially expected due to the important disruption triggered by the epidemic [ 3 , 4 , 6 , 13 , 17 , 18 ]. However, none of the available studies implemented a counterfactual model taking into account seasonality and historical trends of surgical procedures.…”

Section: Discussionsupporting

confidence: 91%

The impact of first and second wave of COVID-19 on knee and hip surgeries in Sweden

et al. 2021

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Purpose To investigate the impact of COVID-19 in Sweden on rates of knee and hip surgeries. Methods We used healthcare data for the population of the southernmost region in Sweden (1.4 million inhabitants). We did an interrupted time-series analysis to estimate changes in rates and trends of joint replacements (JR), arthroscopies, and fracture surgeries for knee or hip in April–December 2020 compared to pre-COVID-19 levels adjusting for seasonal variations. Results We found a drop of 54% (95% CI 42%; 68%) and 42% (95% CI 32%; 52%), respectively, in the rate of JRs and arthroscopies in April 2020 when compared to the counterfactual scenario. This was followed by an increase that brought the rates of JRs and arthroscopies back to their predicted levels also during the beginning of the second wave (November–December 2020). Acute fracture surgeries were largely unaffected, i.e. did not show any decrease as observed for the other surgeries. Conclusions In southern Sweden, we observed a marked decrease in elective knee and hip surgeries following the first wave of Covid-19. The rates remained close to normal during the beginning of the second wave suggesting that important elective surgeries for patients with end-stage osteoarthritis can still be offered despite an ongoing pandemic provided adequate routines and hospital resources.

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Section: Discussionsupporting

confidence: 91%

The impact of first and second wave of COVID-19 on knee and hip surgeries in Sweden

et al. 2021

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“…Despite these predictions, we did not find any appreciable difference in annual cohorts with respect to age, BMI, and comorbidity burden. Groups have queried patients about their perceptions and feelings about delaying total joint arthroplasties during the pandemic [ 7 , 8 , 10 , 13 ]. Patients have generally felt an increase in anxiety and decline in quality of life [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…The ramifications of cancelling elective joint arthroplasty have been felt by both patients and orthopedic joint replacement surgeons in the United States [ 4 – 13 ]. From a surgeon’s perspective, the projected backlog of cases was estimated to take between 9 to 35 months to recover [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

The combined effect of policy changes and the covid-19 pandemic on the same day discharge and complications following total hip arthroplasty: a nationwide analysis

Gordon

Magruder

et al. 2022

Arthroplasty

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Introduction As a result of the SARS-CoV-2 (COVID-19) pandemic in 2020, elective surgeries, including total joint arthroplasty (TJA), were suspended nationwide. Concurrent removal of total hip arthroplasty (THA) from the Medicare inpatient-only list posed challenges to the delivery of quality patient care with low payor cost. Therefore, the objective of this study was to compare temporal trends in patient demographics, case volumes, length of stay, and complications following elective THA in the years 2019 to 2020 in the United States. Methods The 2019 to 2020 ACS-NSQIP database was queried for elective THA patients. Patients Pre-COVID (2019 and 2020Q1) were compared with post-COVID (2020Q2-Q4). THA utilization, demographics, 30-day complications, and length of stay (LOS) were compared between years. Linear regression evaluated changes in case volumes over time with significance threshold of P < 0.05. Results A total of 77,797 patients underwent elective THA in 2019 (n = 43,667) and 2020 (n = 34,130), resulting in a 24.5% decline. Outpatient THA increased in 2020 (35.6%) vs. 2019 (5.7%) (P < 0.001). There was no significant difference in the volume of cases in 2019Q1 through 2019Q4 (P = 0.984). Elective THA volumes declined by 68.8% in 2020Q2, returned to pre-pandemic baseline in 2020Q3, before leveling off at 81.5% of baseline in Q4. Average LOS was significantly shorter in 2020 (1.55 days) vs. 2019 (1.78 days) (P < 0.001) and the proportion of same day discharge (SDD) increased quarterly from 2019 to 2020. There was no significant difference in the total complication rates in 2019 (6.6%) vs. 2020 (6.6%) (P = 0.831). Discussion Elective THA precipitously declined during the second quarter of 2020. The combined effect of policy changes and the COVID-19 pandemic resulted in a seven-fold increase in the number of surgeries performed in the outpatient setting in 2020. Rates of SDD doubled over the study period, despite no change in complication rates.

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“…Patients suffered from a care delay, and the surgical volume for cancer surgeries and emergency and general surgery procedures, as well as coronary syndrome interventions, dropped substantially during the first wave of the pandemic [ 7 , 8 , 18 , 19 ]. In the study by Brown et al, comparing 15 orthopedic institutions in the USA between May and June 2020, 86% of knee and hip arthroplasty operations were postponed or cancelled [ 20 ]. All those findings match to the 86% (-368 primary TJAs) decline during the first wave of surgical procedures described in this study.…”

Section: Discussionmentioning

confidence: 99%

Impact of the 1st and 2nd Wave of the COVID-19 Pandemic on Primary or Revision Total Hip and Knee Arthroplasty—A Cross-Sectional Single Center Study

Simon

Frank

Aichmair

et al. 2021

JCM

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The aim of this study was to evaluate the number of primary and revision total joint arthroplasties (TJA/rTJA) in 2020 compared to 2019. Specifically, the first and the second waves of the COVID-19 pandemic were evaluated as well as the pre-operative COVID-19 test. A cross-sectional single-center study of our prospectively maintained institutional arthroplasty registry was performed. The first COVID-19 wave and the second COVID-19 wave led to a socioeconomic lockdown in 2020. Performed surgeries, cause of revision, age, gender, and American Society of Anesthesiologists-level were analyzed. Preoperative COVID-19 testing was evaluated and nationwide COVID-19 data were compared to other countries. In 2020, there was a decrease by 16.2% in primary and revision TJAs of the hip and knee compared to 2019. We observed a reduction of 15.8% in primary TJAs and a reduction of 18.6% on rTJAs in 2020 compared to 2019. There is an incline in total hip arthroplasties (THAs) and a decline in total knee arthroplasties (TKAs) comparing 2019 to 2020. During the first wave, there was a reduction in performed primary TJAs of 86%. During the second wave, no changes were observed. This is the first study quantifying the impact of the COVID-19 pandemic on primary and revision TJAs regarding the first and second wave.

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The Effect of the COVID-19 Pandemic on Hip and Knee Arthroplasty Patients in the United States: A Multicenter Update to the Previous Survey

Cited by 21 publications

References 8 publications

The impact of first and second wave of COVID-19 on knee and hip surgeries in Sweden

The impact of first and second wave of COVID-19 on knee and hip surgeries in Sweden

The combined effect of policy changes and the covid-19 pandemic on the same day discharge and complications following total hip arthroplasty: a nationwide analysis

Impact of the 1st and 2nd Wave of the COVID-19 Pandemic on Primary or Revision Total Hip and Knee Arthroplasty—A Cross-Sectional Single Center Study

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