The COVID-19 pandemic in Singapore: what does it mean for arthroplasty?

Decruz, Joshua; Prabhakar, Sumanth Madhusudan; Ding, Benjamin Tze Keong; Kunnasegaran, Remesh

doi:10.1080/17453674.2020.1774138

Cited by 8 publications

(6 citation statements)

References 5 publications

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“…Nine centers reported the number of elective orthopedic procedures performed both before and during the COVID-19 pandemic. 9 , 10 , 16 , 17 , 20 , 29 , 36 , 38 , 39 Cumulatively, the number of elective surgeries decreased by 80% (2013/17400, 0.20, CI: 0.12 to 0.29) ( Fig. 2 ).…”

Section: Resultsmentioning

confidence: 96%

A look at the global impact of SARS CoV-2 on orthopedic services

Cheong

Chin

et al. 2021

Journal of Clinical Orthopaedics and Trauma

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Background The COVID-19 pandemic profoundly impacted healthcare institutions worldwide. Particularly, orthopedic departments had to adapt their operational models. Purpose This review aimed to quantify the reduction in surgical and outpatient caseloads, identify other significant trends and ascertain the impact of these trends on orthopedic residency training programs. Methods Medline and Embase were searched for articles describing case load for surgeries, outpatient clinic attendance, or emergency department (ED) visits. Statistical analysis of quantitative data was performed after a Freeman-Tukey double arcsine transformation. Results were pooled with random effects by DerSimonian and Laird model. When insufficient data was available, a systematic approach was used to present the results instead. Results A total of 23 studies were included in this study. The number of elective surgeries, trauma procedures and outpatient attendance decreased by 80% (2013/17400, 0.20, CI: 0.12 to 0.29), 47% (3887/17561, 0.53, CI: 0.37 to 0.69) and 63% (84174/123967, 0.37, CI: 0.24 to 0.51) respectively. During the pandemic, domestic injuries and polytrauma increased. Residency training was disrupted due to diminished clinical exposure and changing teaching methodologies. Additionally, residents had more duties which contributed to a lower quality of life. Conclusions The COVID-19 pandemic has made an unprecedented impact on orthopedics departments worldwide. The slow return of orthopedic departments to normalcy and the compromised training of residents due to the pandemic points to an uncertain future for healthcare institutions worldwide, wherein the impact of this pandemic may yet still be felt far in the future.

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Section: Resultsmentioning

confidence: 96%

A look at the global impact of SARS CoV-2 on orthopedic services

Cheong

Chin

et al. 2021

Journal of Clinical Orthopaedics and Trauma

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“…2 The COVID-19 pandemic has produced a significant impact on arthroplasty procedures worldwide. [2][3][4][5] Previously, among the most common surgeries performed, the pandemic had lowered the number of arthroplasties performed worldwide. Studies worldwide have found significant decreases in arthroplasty procedures due to the pandemic.…”

Section: Introductionmentioning

confidence: 99%

“…Studies worldwide have found significant decreases in arthroplasty procedures due to the pandemic. [4][5][6][7][8][9][10][11][12][13][14][15] As an orthopedic surgery requiring substantial contact between the surgeon and the patient, new protocols to reduce the infection have negatively impacted arthroplasty. 15 Postponement or cancellation of elective operations was rampant during the pandemic, alongside stricter procedures and guidelines.…”

Section: Introductionmentioning

confidence: 99%

“…Some hospitals prioritized care for COVID-19-infected patients and reallocated the available resources there. 4 Although several years have passed since the start of the pandemic, literature on the effect of the COVID-19 pandemic on the epidemiology and demography of hip and knee arthroplasty procedures remains scarce in parts of the world, including in Indonesia. This will lead to a poorer understanding of the effect of the pandemic on the surgical procedure.…”

Section: Introductionmentioning

confidence: 99%

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The Impact of COVID-19 Pandemic on the Epidemiology of Hip and Knee Arthroplasty: A Two-Year Look into the Pandemic from A Single Tertiary Referral General Hospital in Indonesia

Hanif,

Wardhani,

Widhiyanto

et al. 2024

JUXTA

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Highlights: Arthroplasty surgeries were reduced significantly during the COVID-19 pandemic. The number of operations gradually increased between the first and second year of the pandemic. Patients’ median age and hospital stays were reduced during the pandemic. Abstract Introduction: The COVID-19 pandemic has had significant effects on arthroplasty surgeries worldwide. Various studies have described decreased arthroplasty procedures among the most common orthopedic surgeries. This study aimed to analyze the effects of the pandemic on the epidemiology and demography of hip and knee arthroplasty in a tertiary referral general hospital in Indonesia. Methods: This was a retrospective study of medical records data conducted on hip and knee arthroplasty cases from the pre-pandemic (April 2019–March 2020), first-year pandemic (April 2020–March 2021), and second-year pandemic (April 2021–March 2022) periods. Each period was compared for epidemiology and demography data, which included the annual number of arthroplasties, female-to-male ratio, age, duration of hospitalization, and in-hospital post-operative rehabilitation participation. Results: This study observed a statistically significant decrease of 232.00% for hip and 371.43% for knee arthroplasty performed during the first-year pandemic and an increase of 41.86% for hip and 74.07% for knee arthroplasty in the second-year pandemic. A decrease in median age and fluctuation of the female-to-male ratio were observed. The median duration of hospitalization was 80.00% shorter between the pre-pandemic and first-year pandemics and 11.11% shorter between the first and second-year pandemics. Participation in rehabilitation fluctuated during each period. There were four positive cases of COVID-19 and two cases of mortality during the first- and second-year pandemics. Conclusion: The COVID-19 pandemic caused a significant reduction in arthroplasties performed during the first year and a slight increase during the second year. A decreased median age and shorter hospital stays were also observed.

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“…The orthopaedic operations were subjected to one of the greatest relative declines in the normal medical activity in both the United Kingdom (UK) National Health Service and the United States (US) [ 1 , 2 ]. Although there are less abundant data for Asian regions, a major Singapore institution reported a 74% reduction in arthroplasties compared to the pre-pandemic levels [ 3 ], while a major orthopaedic department in Japan noted over 80 and 50% reductions in hip and knee arthroplasties respectively [ 4 ]. Similar patterns were observed in mainland China, Malaysia, and South Korea [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Lessons learnt from the impact of COVID-19 on arthroplasty services in Hong Kong: how to prepare for the next pandemic?

et al. 2021

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Background Arthroplasty services worldwide have been significantly disrupted by the pandemic of coronavirus disease 2019 (COVID-19). This retrospective comparative study aimed to characterize its impact on arthroplasty services in Hong Kong. Methods From January 1 to June 30, 2020, the patients of “COVID-19 cohort” underwent elective total hip or knee replacement in Hong Kong public hospitals. The cohort was compared to the “control cohort” during the same period in 2019. Data analysis was performed to compare the two cohorts’ numbers of operations, hospital admission, orthopaedic clinic attendances, and waiting time. Results A total of 33,111 patient episodes were analyzed. During the study period, the elective arthroplasty operations and hospitalizations decreased by 53 and 54%, respectively (P < 0.05). Reductions were most drastic from February to April, with surgical volume declining by 86% (P < 0.05). The primary arthroplasty operations decreased by 91% (P < 0.05), while the revision operations remained similar. Nevertheless, 14 public hospitals continued performing elective arthroplasty for patients with semi-urgent indications, including infection, progressive bone loss, prosthesis loosening, dislocation or mechanical failure of arthroplasty, and tumor. At the institution with the highest arthroplasty surgical volume, infection (28%) was the primary reason for surgery, followed by prosthesis loosening (22%) and progressive bone loss (17%). The orthopaedic clinic attendances also decreased by 20% (P < 0.05). Increases were observed in waiting time and the total number of patients on the waiting list for elective arthroplasty. Conclusions Despite the challenges, public hospitals in Hong Kong managed to continue providing elective arthroplasty services for high-priority patients. Arthroplasty prioritization, infection control measures, and post-pandemic service planning can enhance hospital preparedness to mitigate the impact of current and future pandemics.

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The COVID-19 pandemic in Singapore: what does it mean for arthroplasty?

Cited by 8 publications

References 5 publications

A look at the global impact of SARS CoV-2 on orthopedic services

A look at the global impact of SARS CoV-2 on orthopedic services

The Impact of COVID-19 Pandemic on the Epidemiology of Hip and Knee Arthroplasty: A Two-Year Look into the Pandemic from A Single Tertiary Referral General Hospital in Indonesia

Lessons learnt from the impact of COVID-19 on arthroplasty services in Hong Kong: how to prepare for the next pandemic?

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