Elective shoulder surgery during the coronavirus disease 2019 pandemic in Germany: the patients' perspective

Abstract

Introduction The coronavirus disease 2019 (COVID19)- pandemic impeded the treatment of elective shoulder patients all over the world. Due to the constraints in personnel and operation theatre capacities, many patients who should undergo planned surgeries could not receive medical care. In our study, we examined the status quo of elective shoulder arthroscopy during the pandemic in Germany. Methods Using a non-profit database, the 40 shoulder units that performed the most arthroscopic rotator cuff repairs in Germany in 2018 were identified. Following a standardized protocol, the webpages of these units were screened and their strategy for elective procedures during the COVID19- pandemic was analyzed. Special emphasis was put on the use of new digital technologies. Results At the time of the study, no unit had stopped scheduling appointments for elective shoulder patients due to the pandemic. Almost all units (97.5%) offered explicit information about COVID19 and their strategies towards it. The possibilities of visiting patients in shoulder units varied due to local restrictions. Two units (5%) offered digital consultations. Conclusion At the time of the study, elective shoulder procedures could be planned and carried out at the largest centers in Germany. Local restrictions had a great influence on the organization of the procedure and hospital stay during the COVID19-pandemic. Digital consultations were not available in every unit.

Impacto da COVID-19 no momento de reparo do manguito rotador e método de acompanhamento pós-operatório

“…Elective surgery during the COVID-19 pandemic was strongly influenced by several factors, including ethical considerations, resource limitations, and patient willingness to undergo surgery during a pandemic. 6 11 14 In a report on oncological orthopedic patients, the delays in surgical management caused by COVID-19 demonstrated major morbidity. 5 There have been no reports to date on the impact in delays in surgical management on orthopedic sports medicine patients.…”

“…This was offered at several institutions worldwide, including our own. 14 The goal of these visits was to reduce the number of potential exposures and infections in our community while encouraging appropriate stewardship of healthcare resources. Early reports demonstrated no significant impact on patient-reported outcomes for shoulder surgery patients who underwent telemedicine follow-up postoperatively.…”

“…Esta opção foi oferecida por diversas instituições de todo o mundo, inclusive a nossa. 14 O objetivo destas consultas era reduzir o número de exposições e possíveis infecções na nossa comunidade, ao mesmo tempo em que incentivava a administração adequada dos recursos de saúde. Os primeiros trabalhos não demonstraram impacto significativo nos desfechos relatados pelos pacientes que foram submetidos a acompanhamento por telemedicina após a cirurgia de ombro.…”

“…Fu et al 8 demonstraram uma maior taxa de novas lacerações no grupo submetido à reconstrução tardia (> 12 meses) em comparação com os grupos submetidos a reparo precoce (< 6 semanas) e de rotina ( A realização de cirurgias eletivas durante a pandemia de COVID-19 foi bastante influenciada por vários fatores, inclusive considerações éticas, limitações de recursos e disposição do paciente de se submeter ao procedimento neste período. 6,11,14 Em um relato sobre pacientes ortopédicos oncológicos, os atrasos no manejo cirúrgico causados pela COVID-19 aumentaram a morbidade. 5 Ainda não há relatos sobre o impacto nos atrasos no manejo cirúrgico em pacientes de medicina esportiva ortopédica.…”