Total Joint Arthroplasty during Coronavirus Disease-2019 COVID-19 Pandemic

Abstract

Background: Since the outbreak of the novel coronavirus disease-2019 (COVID-19) pandemics many orthopedic elective surgeries have been postponed all over the world. There are several guidelines for resuming elective surgeries during this crisis. In our center (Imam Khomeini hospital, Tehran, Iran), we resumed total joint arthroplasty (TJAs) surgeries using preoperative history taking and physical examination. Here, we report our experience.
 Methods: From February 2020 to August 2020, we included 165 patients who underwent TJA [70 total hip arthroplasty (THA) and 95 total knee arthroplasty (TKA)] in Imam Khomeini hospital, a referral center for COVID-19. We followed each patient from the day of hospitalization to two weeks after discharge by telephone for clinical symptoms of COVID-19.
 Results: Only one patient became infected with COVID-19 a week after discharge from the hospital, and other patients did not show any sign or symptoms within two weeks after the discharge.
 Conclusion: We recommend resuming the elective surgeries using a careful physical examination and medical history for all patients, and in suspicious cases, referring to a specialized COVID-19 clinic for further investigation.

COVID-19 Infection Risk Following Elective Arthroplasty and Surgical Complications in COVID-19-vaccinated Patients: A Multicenter Comparative Cohort Study

“…Postoperative COVID-19 rates did not differ (3.4% vs. 4.6%, P = 0.34). According to Mortazavi et al's study on 165 arthroplasty patients, only one (0.6%) showed postoperative COVID-19 ( 57 ). The authors suggested the preoperative screening protocol, which includes history taking and physical examination, was effective for screening elective surgical patients in a hospital that provides COVID-19 referral services ( 57 ).…”

“…According to Mortazavi et al's study on 165 arthroplasty patients, only one (0.6%) showed postoperative COVID-19 ( 57 ). The authors suggested the preoperative screening protocol, which includes history taking and physical examination, was effective for screening elective surgical patients in a hospital that provides COVID-19 referral services ( 57 ). However, their study includes the first peak of COVID-19, which is not as severe as subsequent peaks.…”

COVID-19 infection rate after urgent versus elective total hip replacement among unvaccinated individuals: A multicenter prospective cohort amid the COVID-19 pandemic

“…Most previous studies deemed safe resumption of surgeries under safety protocols [ [25] , [26] , [27] , [28] , [29] , [30] , [31] ]. In a study in the UK, Infection with COVID-19 after hip and knee arthroplasty was comparable to the general population (0.5%), and LOS is the only risk factor [ 25 ].…”

Incidence of Symptomatic COVID-19 in Unvaccinated Patients Within One Month After Elective Total Joint Arthroplasty: A Multicenter Study

“…Therefore, they suggested that their preventive protocol, including history taking and physical examination, was effective for preoperative screening of the patients undergoing arthroplasty in a hospital that was a referral center for COVID-19. Eventually, the study recommended resuming the elective orthopedic surgeries while following the disease prevention protocols (26,27). However, our study reported a higher rate of postoperative COVID-19, which J o u r n a l P r e -p r o o f can be because the study by Mortazavi et al was performed from February to August 2020, when the national incidence of COVID-19 was remarkably lower, presented in Figure 1B.…”