Aims It is imperative to understand the risks of operating on urgent cases during the COVID-19 (SARS-Cov-2 virus) pandemic for clinical decision-making and medical resource planning. The primary aim was to determine the mortality risk and associated variables when operating on urgent cases during the COVID-19 pandemic. The secondary objective was to assess differences in the outcome of patients treated between sites treating COVID-19 and a separate surgical site. Methods The primary outcome measure was 30-day mortality. Secondary measures included complications of surgery, COVID-19 infection, and length of stay. Multiple variables were assessed for their contribution to the 30-day mortality. In total, 433 patients were included with a mean age of 65 years; 45% were male, and 90% were Caucasian. Results Overall mortality was 7.6% for all patients and 15.9% for femoral neck fractures. The mortality rate increased from 7.5% to 44.2% in patients with fracture neck of femur and a COVID-19 infection. The COVID-19 rate in the 30-day postoperative period was 11%. COVID-19 infection, age, and Charlson Comorbidity Index were independent risk factor for mortality. Conclusion There was a significant risk of contracting COVID-19 due to being admitted to hospital. Using a site which was not treating COVID-19 respiratory patients for surgery did not identify a difference with respect to mortality, nosocomial COVID-19 infection, or length of stay. The COVID-19 pandemic significantly increases perioperative mortality risk in patients with fractured neck of femora but patients with other injuries were not at increased risk. Cite this article: Bone Jt Open 2021;2(5):330–336.

Introduction: Osteochondritis dissecans of the femoral condyles is a subchondral bone necrosis, rare, more or less extended. The osteochondral fragmentation that results from it is responsible for very invalid pain and joint dysfunction.The aim of this work is to evaluate the clinical, radiological and evolutionary aspects of patients operated for osteochondritis dissecans of the femoral condyles by the technique of mosaicplasty at Order of Malta's Hospital Center in Dakar CHOM.Patients and Method: This is a retrospective, single-center study over a period of 67 months, involving 8 patients (6 men and 2 women). The average age was 25 years and the average BMI 22.93. Standard radiography has been performed in all our patients. 2 patients had MRI and 1 patient did a CT. The collected data were the time of care, the IKDC score, the ICRS score and the Hughston / SFA score. The following characteristics of the lesion -the surface and the location -were also studied. Intraoperatively, the number and diameter of the pads, the location of the donor site and the associated operative procedures were recorded. At last follow-up, patients were assessed according to the Hughston functional and radiological scores, and IKDC. All the patients were immobilized for 6 weeks and benefited from the re-education sessions.Results: At an average follow-up of 36.5 months, the subjective results of the patients were very satisfactory in 62.5% of the cases and the clinical results according to the IKDC were excellent. Healing of osteochondral lesions was achieved in all our patients and 75% were in stage IV according to the radiological Hughston score.