Changes in the mean incidence and variance of orthopedic diseases before and during the COVID-19 pandemic in Korea: a retrospective study

Abstract

Background During the coronavirus disease (COVID-19) pandemic, the amount of moderate- to high-intensity physical activity significantly decreased. Therefore, the epidemiology of musculoskeletal diseases could possibly have changed. We assessed changes in the incidence of and variance in non-traumatic orthopedic diseases before and after the COVID-19 pandemic in Korea. Methods This study included data from the Korea National Health Insurance Service, which covers the entire Korean population (approximately 50 million), from January 2018 to June 2021. Using International Classification of Diseases, Tenth Revision codes, 12 common orthopedic diseases were evaluated, including cervical disc disorders, lumbar disc disorders, forward head posture, myofascial pain syndrome, carpal tunnel syndrome, tennis elbow, frozen shoulder, rheumatoid arthritis, gout, hip fracture, distal radius fracture, and spine fracture diseases. “Pre-COVID-19” was the period until February 2020, and “COVID-19 pandemic period” was the period starting March 2020. Differences in the mean incidence and variance of diseases before and during the COVID-19 pandemic were compared. Results In most cases, the incidence of orthopedic diseases decreased at the beginning of the pandemic and then increased thereafter. Among the 12 diseases, the incidence of three diseases showed a statistically significant change. The incidence of myofascial pain syndrome (P < 0.001) was lower during the COVID-19 pandemic than during the pre-COVID-19 period. The incidences of frozen shoulder (P < 0.001) and gout (P = 0.043) were higher during the COVID-19 pandemic than during the pre-COVID-19 period. However, no statistical difference in disease variations was observed between the two periods. Conclusions The incidence of orthopedic diseases varied during the COVID-19 pandemic among the Korean population. Although the incidence of myofascial pain syndrome was lower, that of frozen shoulder and gout was higher during the COVID-19 pandemic than during the pre-COVID-19 period. No disease variations during the COVID-19 pandemic were found.

Factors associated with frozen shoulder in adults: a retrospective study

“…Recent studies have shown that diabetes may be an independent risk factor for frozen shoulder[ 28 ]. Diabetes is a metabolic disease that has been confirmed to be associated with a variety of systemic diseases and pain symptoms \* MERGEFORMAT [ 29 ].…”

The Effect of the COVID-19 Pandemic on Early Adolescent Fractures in the Republic of Korea

“…Although the pandemic has imposed delays on elective surgeries, emergency surgeries were performed as needed. It has been shown that the number of elective surgeries has significantly decreased during the pandemic, while trauma and emergency surgeries have not decreased [ 16 ]. Since surgical treatments for fractures are more often required in younger patients, the number of surgeries has decreased less in children [ 41 , 42 ].…”

“…The other is the time range of the data collected. The reduced volume of orthopedic surgeries due to the COVID-19 pandemic has gradually recovered over time [ 16 ]. As the data collected in the earlier studies reflect shorter periods at the beginning of the pandemic, the decrease in the number of surgical treatments might have been exaggerated when compared to later studies, which include the “recovery” period of operations.…”

“…As it seems natural that restrictions on physical activities would affect the musculoskeletal system, a number of studies have investigated the impact of the COVID-19 pandemic in the orthopedic field. It has been shown that the incidence of orthopedic diseases, including fractures of various sites, decreased during the pandemic, especially at the beginning of the outbreak, although the extent of change differed [ 14 , 15 , 16 , 17 ]. Many studies have also shown that the volume of surgical treatment has decreased during this period, as elective surgeries were delayed [ 17 , 18 ].…”