Resuming hip and knee arthroplasty after COVID-19: ethical implications for wellbeing, safety and the economy

Kort, Nanne P.; Zagra, Luigi; Gómez‐Barrena, Enrique; Tandoğan, Reha N.; Thaler, Martin; Berstock, James R; Karachalios, Theofilos

doi:10.1177/1120700020941232

Cited by 29 publications

(62 citation statements)

References 28 publications

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“…This is evident that an unexpected interruption in the activity of a subspecialty leads to an uncontrolled congestion of the patients 11 . A recent publication of the COVIDSurg Collaborative estimated that more than 12 million operations have been cancelled or postponed globally, during the 12 weeks of disruption in the healthcare delivery 4 .…”

Section: Discussionmentioning

confidence: 99%

“…O’Connor et al, recognize these worrisome projections comparable to the Great Depression of the United States in 1929, while emphasizing the entangled system of health economics 15 . Kort et al, have further evaluated this concern taking into account the excessive demand that may exceed the available resources following the resumption of the elective surgeries 11 . However, only 37,93% of our respondents were concerned about the overwhelming industry who may struggle to meet demand.…”

Section: Discussionmentioning

confidence: 99%

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How the Covid-19 pandemic affected shoulder and elbow practice in Turkey?

2020

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Background The Covid19 pandemic drastically affected the healthcare delivery worldwide. Elective surgical interventions were cancelled or postponed avoiding disease transmission and excessive consumption of critical hospital resources. The main objective for composing this survey was to document the preventive attitude and its variations against Covid19 pandemic in a specific group: Shoulder and elbow surgeons; to evaluate their perception of emergency and to envisage the ‘new normal’ with the altered order of priority in the upcoming post-coronavirus era. Methods An anonymous survey composed of 25 questions was sent to all the members of the Turkish Society of Shoulder and Elbow Surgery (TSSES) in April 22-29, while governmental preventive measures were maximale. A secure, web-based application (SurveyMonkey Inc, SanMateo, CA, USA) was used for the composition of the survey and the analysis of the responses. Results Eighty-eight responses collected from 129 members of TSSES (68%), with a mean 13.9 years of practice in shoulder and elbow surgery. More than 75% decrease in surgical and outpatient clinical activity was documented. Half of respondents used telemedicine and the rate of obtaining informed consent remained low. The preventive attitude showed significant variation. Discussion the perception of emergency and the protective measures showed a wide discrepancy among our respondents. Almost 80% of our respondents indicated the necessity of task forces for composing protocols to maintain subspecialty practice under adequate protective measures, and the subspecialty societies as the most eligible institutions to compose these criteria. Level of evidence Survey Study; Experts

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

How the Covid-19 pandemic affected shoulder and elbow practice in Turkey?

2020

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“…The need for additional inpatient and long-term care is of particular concern during the COVID-19 pandemic. [18] There are concerns that acute care hospitals and long-term care facilities lack the beds, equipment, and person-power necessary to care for additional patients. Also, there are increased risks of utilizing additional acute care stays or extended long-term care for THA patients due to the increased A c c e p t e d M a n u s c r i p t risk of contracting COVID-19 [19] and the patients' inherent increased risks for severe outcomes with infection.…”

Section: Discussionmentioning

confidence: 99%

“…Also, there are increased risks of utilizing additional acute care stays or extended long-term care for THA patients due to the increased A c c e p t e d M a n u s c r i p t risk of contracting COVID-19 [19] and the patients' inherent increased risks for severe outcomes with infection. [18] Future advances aimed at decreasing the rate of THA dislocation could help alleviate these concerns and burdens. [9] A strength of the current study design is the use of direct matching for the year of THA, surgeon, and the hospital for THA.…”

Section: Discussionmentioning

confidence: 99%

Healthcare resource utilization and costs for hip dislocation following primary total hip arthroplasty in the medicare population

Mantel¹,

Chitnis

Ruppenkamp

et al. 2020

Journal of Medical Economics

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“… Failure of the population to acquire herd immunity. In most countries, the infection rate is less than 4% [ 13 , 22 ]. …”

Section: Introductionmentioning

confidence: 99%

Preparation for the next COVID-19 wave: The European Hip Society and European Knee Associates recommendations

Donell

Thaler

Budhiparama³

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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Purpose To plan for the continuance of elective hip and knee arthroplasty during a resurgence or new wave of COVID-19 infections. Method A systematic review was conducted using the terms "COVID-19" or "SARS-Cov-2" and "second wave". No relevant citations were found to inform on recommendations the plan. Therefore, an expert panel of the European Hip Society and the European Knee Associates was formed to provide the recommendations. Results Overall, the recommendations consider three phases; review of the first wave, preparation for the next wave, and during the next wave. International and national policies will drive most of the management. The recommendations focus on the preparation phase and, in particular, the actions that the individual surgeon needs to undertake to continue with, and practice, elective arthroplasty during the next wave, as well as planning their personal and their family's lives. The recommendations expect rigorous data collection during the next wave, so that a cycle of continuous improvement is created to take account of any future waves. Conclusions The recommendations for planning to continue elective hip and knee arthroplasty during a new phase of the SARS-Cov-2 pandemic provide a framework to reduce the risk of a complete shutdown of elective surgery. This involves engaging with hospital managers and other specialities in the planning process. Individuals have responsibilities to themselves, their colleagues, and their families, beyond the actual delivery of elective arthroplasty.

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Resuming hip and knee arthroplasty after COVID-19: ethical implications for wellbeing, safety and the economy

Cited by 29 publications

References 28 publications

How the Covid-19 pandemic affected shoulder and elbow practice in Turkey?

How the Covid-19 pandemic affected shoulder and elbow practice in Turkey?

Healthcare resource utilization and costs for hip dislocation following primary total hip arthroplasty in the medicare population

Preparation for the next COVID-19 wave: The European Hip Society and European Knee Associates recommendations

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