Abstract

The Coronavirus 2 (COVID-19) pandemic has continued to significantly disrupt hip replacement and knee replacement surgery. This study aimed to determine whether there was any difference in patient characteristics, clinical outcomes in patients who underwent hip or knee replacement surgery after the pandemic onset, and revenue.

Methods:

A team in the Journal of the American Academy of Orthopedic Surgeons reviewed a consecutive series of 26,493 patients who underwent primary hip and knee replacement surgery and clinical review by 48 practicing surgeons. Demographics, comorbidities, and outcomes from March 2020 to February 2021 were compared with a pre-pandemic group operated from March 2019 to February 2020.

Results:

There was a 20% decrease in the size of all cases in the invasive group (11,688 vs 14,664, P < 0.001). The post-epidemic group had a shorter length of stay (1.58 vs 1.70 days, P = 0.007), had higher rates of discharge from home (98% vs 91%, P < 0.001), and were more likely to have their procedure done at an outpatient facility ( 21% vs. 7%, P < 0.001). Even among patients older than 65 years, more pandemic patients underwent a procedure as an outpatient (19% versus 7%, P < 0.001), with no difference in complications or readmissions. Total surgeon charges and payments declined by 17.6% and 16.3% during the pandemic (P = 0.010).

Conclusion:

Although the COVID-19 pandemic has resulted in a significant reduction in surgical volume and loss of revenue, there has been a significant shift of arthritic patients to a day surgery department with increased home discharge rates without compromising patient safety.

The novel coronavirus (COVID-19) and severe acute respiratory syndrome (COVID-19) pandemic have put enormous pressure on the global healthcare system and affected orthopedic services and surgeons worldwide. Health Insurance Services, General Surgery, and the American College of Surgeons to reduce elective procedures to prevent the spread of the virus and to maintain the provision of personal protective equipment and respirators. Since hip and knee arthroplasty comprise a significant proportion of the volume of elective surgery in the United States, discontinuing these procedures has been challenging for patients, healthcare providers, and institutions that perform these procedures. It is believed that elective procedures such as joint replacement experienced the greatest percentage reduction in volumes of all elective orthopedic procedures.

A report on the impact of COVID-19 on arthroplasty practice among Medicare-versus-service patients in the last two weeks of March 2020 by Barnes et al showed a sharp decline in arthroplasty volumes, an increase in home-sabbatical trends, and a significant loss of revenue for hospitals and surgeons. The COVID-19 epidemic began to decline by the summer of 2020; there was a gradual return to elective arthroplasty services. However, restrictions persisted on offering elective procedures a pay list because stringent safety precautions became necessary.

Studies from around the world have reported changes in total joint replacement practices caused by the epidemic.

The purpose of this study was to report and evaluate the impact of the COVID-19 pandemic on joint replacement surgery after one year and to evaluate patient characteristics, surgical trends, and adverse events after surgery for 90 days for those who underwent the procedure during this period. The journal also assessed the financial impact of reduced workload on a large group of surgeons and their affiliated hospitals.

Results:

A consecutive series of 26,493 procedures were included. found a 20.0% reduction in the total volume of initial and revision joint replacement cases after the onset of the pandemic in March 2020 (11,778 vs 14,715, P < 0.001). However, an increase in the case and review volumes was observed from June 2020 to November 2020 compared to the previous year. After this gradual improvement, the second hit occurred by December 2020 due to the increase in COVID-19 cases in the region; However, the effect was less compared to the effect at the beginning of the pandemic.

Conclusions:

The results of this study highlight the profound impact that the COVID-19 pandemic has had on the volume of hip and knee joint surgery, particularly among patients over 65 years of age. These changes are expected to be long-lasting. It caused significant financial losses to the US healthcare system and may have profound effects on patients who have had to postpone or cancel the surgery. To maintain high-quality care.