Orthopaedic surgery after COVID-19 – A blueprint for resuming elective surgery after a pandemic

Ding, Benjamin Tze Keong; Tan, Kelvin Guoping; Oh, Jacob Yoong-Leong; Lee, Keng Thiam

doi:10.1016/j.ijsu.2020.07.012

Cited by 27 publications

(31 citation statements)

References 15 publications

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“…Although only two units with digital consultations could be found in our study, modern technologies could be a great relief in the management of elective cases 6 . Even more, Ding et al proposed different ways of improving the effectiveness of electives orthopedic procedures that can be utilized during and after the pandemic 2 . The upcoming weeks and months will show if the current concepts and ideas will help to keep up the care for patients with planned procedures.…”

Section: Discussionmentioning

confidence: 99%

“…With more than 42 million cases worldwide as of October 25 th 2020, it poses a substantial threat on the capacity of numerous global healthcare systems 5 . In order to provide as many critical care beds as possible, elective procedures of all specialties were postponed in spring 2020 in many countries 2 . As the pandemic stretches over more than half a year without a definite end in sight and the number of infected individuals climaxes for a second time, many hospitals that depend on elective procedures are developing strategies to return to regular schedules while maintaining high safety standards for their patients.…”

mentioning

confidence: 99%

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

Bockmann

Venjakob²,

Holschen

et al. 2021

JSES International

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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.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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

Bockmann

Venjakob²,

Holschen

et al. 2021

JSES International

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“…These postponed elective procedures are required to reduce pain, improve function and quality of life and prevent complications or disease progression. The number of suffering patients has reached critical volumes that will need to be managed sensibly once the COVID-19 pandemic improves [19].…”

Section: Elective Orthopaedic Surgerymentioning

confidence: 99%

Impact of COVID-19 on Orthopaedic Care and Practice: A Rapid Review

Chatterji

Patel

Jain

et al. 2021

IJOO

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Introduction The COVID-19 pandemic has led to a large body of literature regarding the impact of COVID-19 on orthopaedic care and practice. This rapid review aims to synthesize this published literature to give the orthopaedic fraternity an overview about the best practices that need to be followed during this period. Methodology A rapid review was conducted following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement for rapid reviews on the impact of COVID-19 on orthopaedic care and practice. A Pubmed search was done to identify all literature related to the impact of COVID-19 on orthopaedic care and practice, published between December 2019 and October 2020 using a predefined search strategy. The final review included 375 peer-reviewed articles addressing the objectives. Results The majority of articles were expert opinions (37.1%) and narrative reviews (13.1%). There were 17.3% retrospective studies and 2.1% prospective studies with only one randomized control trial and ten systematic reviews. 83.8% of articles had levels of evidence IV and V, 79.5% of the articles were published in core-orthopaedic journals. Maximum publications were from the United States of America (31.7%), followed by India (11.5%). European countries together contributed to 32.0% of all publications. Conclusion COVID-19 has had a significant impact on all aspects of orthopaedic care and practice. The pandemic has affected outpatient clinics, emergency and elective surgery, rehabilitation, resident training, personnel management, use of personal protective equipment, telemedicine and all sub-specialities of orthopaedics. Orthopaedic practice will require the incorporation of new technologies, restructuring of health systems and reorganizing of training programs for optimal patient care. There would also be a need for frequent review of emerging literature to provide evidence-based guidelines to the orthopaedic fraternity which will not only help in mitigation of transmission of disease but also ensure continuity of optimum patient care.

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“… 9 For this reason, there has been an extensive push to safely resume elective orthopedic surgery. 10 , 11 …”

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confidence: 99%

Patient Perceptions of COVID-19 Precautions and Their Effects on Experiences With Hand Surgery

Tawfik

Silver

Katt

et al. 2021

Journal of Hand Surgery Global Online

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Purpose The purpose of this study is to evaluate patient perceptions of COVID-19 precautions and how these precautions have affected their hand and upper extremity surgery experience. Methods We sent an 18-item survey to 1,213 patients who underwent elective hand and upper extremity surgery at 1 academic institution from October 2020 to January 2021. The survey consisted of questions related to patient demographics, treatment delays due to COVID-19, and patient perceptions of COVID-19 precautions. Descriptive statistics were performed to analyze the survey responses. Responses for patients aged 18–50 and 51+ were compared using a chi-square analysis for categorical variables and a Student t -test for continuous variables. Results Out of 1,213 invitations, 384 survey respondents completed the survey (31.6%). Of the respondents, 16.8% reported delaying medical treatment for an average of 123.2 days because of COVID-19. The preventative measures were found to be adequate by 95% of patients. Only 2.6% of patients reported experiencing surgical delays due to preoperative COVID-19 testing or other COVID-19-related precautions. COVID-19 testing was seen as necessary by 88% of patients, and 74% did not find COVID-19 testing to be a barrier to their surgery. Patients aged 51+ were more likely to delay seeking medical treatment than younger patients (19.3% vs 9.1%, respectively). Furthermore, those that did delay seeking treatment waited longer on average than their younger counterparts (136.1 vs 72.9 days, respectively). Conclusions In conclusion, patients undergoing hand and upper extremity surgery typically do not find COVID-19 precautions to be a significant barrier to care and understand their importance. Despite this, many patients, particularly older ones, are delaying medical care for extended periods of time. It is important for hand surgeons to acknowledge their patients’ perspectives and work to educate patients on evolving surgical safety guidelines. Clinical relevance Patient perspectives of current COVID-19 precautions can help inform hand surgeons on areas for continued patient education.

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Orthopaedic surgery after COVID-19 – A blueprint for resuming elective surgery after a pandemic

Cited by 27 publications

References 15 publications

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

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

Impact of COVID-19 on Orthopaedic Care and Practice: A Rapid Review

Patient Perceptions of COVID-19 Precautions and Their Effects on Experiences With Hand Surgery

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