The negative impact of the COVID-19 lockdown on pain and physical function in patients with end-stage hip or knee osteoarthritis

Abstract

Purpose The purpose of this study was to evaluate pain, functional impairment, mental health, and daily activity in patients with end-stage hip and knee osteoarthritis (OA) during the COVID-19 lockdown. Methods The study included 63 patients, with hip or knee OA, who had been scheduled for arthroplasty that was postponed because of COVID-19. Patients were evaluated by telephone interviews during the first week after lockdown, in the fourth week, and again at the end of the lockdown. Patients rated their pain level on the basis of a visual analog scale (VAS) and completed WOMAC, SF-12 and Tegner activity scale (TAS) questionnaires. Results VAS and WOMAC scores increased significantly during lockdown, while physical activity significantly decreased. At the final evaluation, VAS and WOMAC showed a significant negative correlation with TAS. The SF-12 subscale scores showed a significant decrease of the physical component during the lockdown, while the mental component remained largely unchanged. Patients with knee OA showed a faster progress of pain compared to those with hip OA. 50 patients (79%) stated they wished to have arthroplasty as soon as possible. Conclusion The COVID-19 lockdown had a significant impact on pain, joint function, physical function, and physical activity in patients with end-stage hip and knee OA. Level of evidence II (Prospective cohort study).

Assessing the Attitudes, Awareness, and Behavioral Alterations of Patients Awaiting Total Hip Arthroplasty During the COVID-19 Crisis

“…Similarly, Endstrasser et al observed a time dependent decrease in SF-12 physical component scores as the COVID-19 pandemic progressed. 8 Similarly, our patients reported lower mHHS scores than would be expected in a pre-operative cohort. 16 …”

“…In comparison, our cohort of patients had a mean PCS-12 score of 30.9 (SD ± 7.4), which is lower than a similar study conducted on an Austrian cohort. 8 Similarly, the mean MCS-12 score in our patients was 49.95 (SD ± 13.07), with the national average in patients >50 being 53.0 (SD ± 8.30). 17 …”

“…Similar results have been found in both European and American cohorts. 7 , 8 Endstrasser and colleagues noted that 79% of patients awaiting hip and knee arthroplasty would be keen to undergo surgery during the COVID-19 pandemic. 8 Brown et al noted that 90% of patients who had arthroplasty surgery cancelled were keen to undergo arthroplasty surgery as soon as possible, with only 6% of patients wishing to postpone their operation for fear of COVID-19 infection.…”

“… 7 , 8 Endstrasser and colleagues noted that 79% of patients awaiting hip and knee arthroplasty would be keen to undergo surgery during the COVID-19 pandemic. 8 Brown et al noted that 90% of patients who had arthroplasty surgery cancelled were keen to undergo arthroplasty surgery as soon as possible, with only 6% of patients wishing to postpone their operation for fear of COVID-19 infection. 7 The perceived threat of COVID-19 infection in our cohort was low, with over 85% of patients reporting that they were at little or no risk of contracting COVID-19.…”

“…Research in both the European and American context has shown that in spite of the ongoing pandemic the majority of patients are keen to undergo arthroplasty surgery as soon as possible. 7 , 8 Naturally, some patients will have been daunted by the shocking images published in print media and reported in the news depicting extremely ill patients in overrun hospitals. We hypothesized that this may lessen their desire to undergo a hip replacement in the current climate.…”