The Impact of the COVID-19 Pandemic on Orthopaedic Knee Procedures: A National Multicentered Analysis

Abstract

Introduction: The coronavirus disease 2019 (COVID-19) pandemic strained the United States healthcare system, and associated policies resulted in the postponement or cancellation of many elective surgeries. While most orthopaedic surgeons are aware of how the pandemic affected their patients’ care, broader national trends in the operative treatment of orthopaedic knee pathology are poorly characterized. Therefore, the purpose of this study was to identify trends in orthopaedic knee procedures during the COVID-19 pandemic. Methods: The TriNetX database was queried for orthopaedic knee procedures performed from March 2018 to May 2021. Procedures were classified as arthroplasty (total knee arthroplasty (TKA), revision total knee arthroplasty) or non-arthroplasty (tendon or ligament repair, fracture fixation). Procedural volume per healthcare organization was determined over five seasons from March 2020 to May 2021 and compared to overlapping pre-pandemic periods from March 2018 to May 2019. Descriptive analysis was performed, and comparisons were made using a Student’s T-test. Results: Compared to the pre-pandemic period, there were significant decreases in primary TKA (p=0.016), femoral or entire tibial component revision TKA (p=0.005), and open treatment of femoral shaft fractures (p=0.007) in spring 2020. Procedural volume returned to baseline in summer 2020 through winter 2021. In spring 2021, primary TKA (p=0.017) and one component revision TKA (p=0.003) increased compared to the pre-pandemic period. Conclusion: The greatest decrease in knee procedures occurred early in the pandemic. Rates of these procedures have since rebounded, with some exceeding pre-pandemic levels. Hospitals are now better able to accommodate orthopaedic surgical volume while continuing to care for patients with COVID-19.

Trends of Opioid Usage in Surgical Patients in a Small Community Hospital: Analysis of Patient Data Between 2017 and 2021

“…The advent of the COVID-19 pandemic meant a significant reduction in the number of elective surgical procedures across the country with the understandable diversion of medical resources toward tackling the surge of SARS-Cov-2 infections. In the recent past, several studies have quantified this reduction in the number of surgical procedures undertaken for total joint arthroplasty, 37 orthopedic knee procedures, 38 elective hernia repair, 39 and bariatric surgery. 40 Owing to the pandemic-related disruptions, we observed a sharp drop in the number of surgical admissions which required opioid use over the calendar year 2020.…”