The combined effect of policy changes and the covid-19 pandemic on the same day discharge and complications following total hip arthroplasty: a nationwide analysis

Gordon, Adam M.; Magruder, Matthew; Ng, Mitchell; Sheth, Bhavya; Conway, Charles A.; Wong, Che Hang Jason

doi:10.1186/s42836-022-00131-w

Cited by 15 publications

(10 citation statements)

References 33 publications

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“…Contrary to our hypothesis, we found no significant difference in the patient sex, race, BMI, smoking status, or age between the two groups. This is in concurrence with Gordon and colleagues, who analyzed the demographics of THA patients in the post-COVID period on the national scale [ 9 ]. Of note, there are few studies analyzing these particular demographic characteristics in TJA patients in the post-COVID period.…”

Section: Discussionsupporting

confidence: 82%

“…Our analysis of LOS revealed that 2020 TJA patients stayed in the hospital a significantly shorter amount of time when compared to their 2019 counterparts. A decrease in LOS was also observed nationally in the post-COVID period [ 9 ]. This reflects a significant shift to outpatient TJA operations as opposed to the more standard inpatient protocol [ 11 ].…”

Section: Discussionmentioning

confidence: 96%

“…In a separate study analyzing changes in THA procedures post-COVID, the backlog theory seems to be supported. In that study, quarter 2 of 2020 had a 68.8% decline in THA, while quarter 3 rebounded to the pre-pandemic baseline, then quarter 4 settled at 81.5% of baseline [ 9 ]. These results suggest that a bottleneck occurred in the period after COVID elective procedure bans.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Total Joint Arthroplasty Patient Demographics Before and After Coronavirus Disease 2019 Elective Surgery Restrictions

McCoy¹,

Touchet²,

Chapple³

et al. 2023

Arthroplasty Today

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Total Joint Arthroplasty Patient Demographics Before and After Coronavirus Disease 2019 Elective Surgery Restrictions

McCoy¹,

Touchet²,

Chapple³

et al. 2023

Arthroplasty Today

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“…This likely occurred because orthopedic surgeons were concerned about their patients becoming infected in hospital systems and preferred that patients recover at home when possible. These same trends were found for total shoulder arthroplasty and total joint arthroplasty of the lower extremity [ 22 – 24 ]. Despite this increase, we did not see any difference in overall complication rates, or any subcategory of complications.…”

Section: Discussionsupporting

confidence: 73%

The effects of the COVID-19 pandemic on elective unicompartmental knee arthroplasty in the USA: further evidence that outpatient arthroplasty is safe and effective

Magruder

Gordon

Sheth

et al. 2022

Eur J Orthop Surg Traumatol

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Purpose In response to COVID-19, elective surgeries including unicompartmental knee arthroplasties (UKA) decreased. We aimed to quantify and compare temporal trends in utilization and complications in the calendar year 2019 (pre-pandemic) to 2020 in the USA. Methods The 2019 to 2020 ACS-NSQIP database was queried for patients undergoing elective UKA. Patients prior to COVID-19 (2019 and 2020 Q1) were compared to those after (2020 Q2-Q4). Case volumes, patient demographics, complications, and lengths of stay (LOS) were compared between years. Pearson’s chi-square test was used to compare patient demographics. Linear regression was conducted to evaluate the change in case volumes. P values less than 0.05 were significant. Results In total, 3361 patients underwent UKA: 1880 in 2019 and 1481 in 2020. The number of outpatient UKAs increased (56.4% vs. 65.6%; p < 0.001). There was no significant difference in the volume of cases in 2019Q1 through 2020Q1 ( p = 0.424). Case volumes fell by 60% in 2020Q2 compared with the average quarterly volume in 2019. Comparing 2019 to 2020, there was no significant difference in rates of total complications (2.1% vs. 2.2%; p = 0.843), minor complications (1.2% vs. 0.9%; p = 0.529), major complications (1.1% vs. 1.4%; p = 0.447), infection complications (1.0% vs. 0.8%; p = 0.652), wound complications (0.1% vs. 0.1%; p = 1.0), cardiac complications (0.0% vs. 0.1%; p = 0.111), pulmonary complications (0.1% vs. 0.2%; p = 0.473), hematology complications (0.1% vs. 0.1%; p = 1.0), renal complications (0.1% vs. 0.0%; p = 1.0), and Clavien–Dindo IV complications (0.1% vs. 0.4%; p = 0.177). Conclusion UKA case volumes declined during the second quarter of 2020. A significant proportion of surgeries were transitioned outpatient, despite no change in complication rates.

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“…Similar results were reported by several authors [ 37 , 44 ]. In their study, Gordon et al analyzed 77,797 patients who underwent elective THA in 2019 (n = 43,667) and 2020 (n = 34,130) and noticed a 24.5% decline of this procedure [ 45 ]. Another study conducted on 17,039 patients admitted for joint replacement surgery in university and community hospitals in Taiwan revealed an even greater reduction, of about 60%, of these procedures during the COVID-19 pandemic [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

Unexpected Repercussions of the COVID-19 Pandemic on Total Hip Arthroplasty with Cemented Hip Prosthesis versus Cementless Implants

et al. 2023

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(1) Background: Total hip arthroplasty (THA) is one of the most common procedures used for adult hip reconstruction, employing mainly two types of prostheses: cemented (CHP) and cementless (CLHP). This study aims to analyze the impact of the COVID-19 pandemic on THA with CHP and CLHP, in terms of the benefit/cost ratio. (2) Methods: This article represents a retrospective analysis of the differences concerning the benefit/cost ratio between THA with the two types of prostheses in 2950 patients admitted for THA in the two orthopedic clinics of our hospital between 1 January 2015–1 March 2020 in comparison with 1005 THA subjects seen between 1 April 2020–31 December 2022. (3) Results: In the first period, THA with CHP was performed in 45.83% of cases, while CLHP was used in 54.16% of patients. During the COVID-19 period, CHP was inserted in 52% of THA patients, while the other 48% had CLHP inserted, with a hospitalization duration reduced by over 50% for both types of implants (p ˂ 0.001). (4) Conclusions: CHP offered good outcomes, with quicker mobilization, and shorter hospitalization duration, compared to CLHP, but optimization of the patients’ management can be achieved mainly by reducing the length of hospitalization through an appropriate preoperative patient evaluation through a multidisciplinary approach, an aspect that was proven during the COVID-19 pandemic.

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The combined effect of policy changes and the covid-19 pandemic on the same day discharge and complications following total hip arthroplasty: a nationwide analysis

Cited by 15 publications

References 33 publications

Total Joint Arthroplasty Patient Demographics Before and After Coronavirus Disease 2019 Elective Surgery Restrictions

Total Joint Arthroplasty Patient Demographics Before and After Coronavirus Disease 2019 Elective Surgery Restrictions

The effects of the COVID-19 pandemic on elective unicompartmental knee arthroplasty in the USA: further evidence that outpatient arthroplasty is safe and effective

Unexpected Repercussions of the COVID-19 Pandemic on Total Hip Arthroplasty with Cemented Hip Prosthesis versus Cementless Implants

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