The Initial Impact of COVID-19 on Total Hip and Knee Arthroplasty

Barnes, C. Lowry; Zhang, Xiaoran; Stronach, Benjamin M.; Haas, Derek A.

doi:10.1016/j.arth.2021.01.010

Cited by 47 publications

(54 citation statements)

References 10 publications

(10 reference statements)

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“…An even bigger decrease of arthroplasty volume was observed at the beginning of the epidemic in the United States of America. Barnes et al reported a significant decline in TKA and THA surgical volumes in mid-March 2020, of 94% and 92%, respectively [20]. According to Chia-Lung Shih et al, even though the epidemiological situation in Taiwan differed from that observed in the US or Scotland, with a very small number of COVID-19 cases and no restrictions concerning the elective surgical procedures, the volume of orthopaedic surgeries decreased by 20-30%.…”

Section: Discussionmentioning

confidence: 99%

The Effect of the COVID-19 Pandemic on Total Hip and Knee Arthroplasty Surgical Volume in 2020 in Poland

Czubak-Wrzosek

Czubak²,

Grzelecki³

et al. 2021

IJERPH

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The aim of this study was to analyse the effect of the first year of the COVID-19 pandemic on total hip arthroplasty (THA) and total knee arthroplasty (TKA) surgical volume in Poland. A retrospective analysis of data concerning THA and TKA collected by the National Health Fund in Poland in 2019 and in 2020 has been conducted. The number of primary hip or knee arthroplasties in 2020 was around 71% and 67% of the number registered in 2019, respectively. There was also a decline in the volume of revision arthroplasties observed, with 65% and 63% of THA and TKA revisions performed in 2019. The most significant decrease was observed in April and May, and during the second wave of the pandemic in November 2020, with a decline of 87%, 55% and 56%, respectively. The results of this study show the significant impacts that the COVID-19 pandemic had on the volume of elective hip and knee arthroplasties in Poland in 2020. In comparison with 2019, a decrease of around 30% for primary and of 40% for revision arthroplasties was observed. The most significant decline was observed in April and May 2020, and during the second wave of the COVID-19 pandemic in Poland in November 2020.

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Section: Discussionmentioning

confidence: 99%

The Effect of the COVID-19 Pandemic on Total Hip and Knee Arthroplasty Surgical Volume in 2020 in Poland

Czubak-Wrzosek

Czubak²,

Grzelecki³

et al. 2021

IJERPH

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“…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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“…Cancellation of elective surgical operations led to a significant financial loss for the orthopaedic physicians, an increased backlog of numerus orthopaedic operations and substantial waiting list for the patients, and a significant reduction of the number of procedures for residents and trainees. Reassignment of trainees to high-volume institutions in the future may be a plausible approach to mitigate significant training deficits in the trainees worst impacted by the reduction in operative case volume [ 1 – 4 , 7 – 13 ].…”

Section: Orthopedic Practice In Covid-19 Pandemicmentioning

confidence: 99%