Martin Thaler1, Nanne Kort2, Luigi Zagra3, Michael T Hirschmann4, Ismail Khosravi5, Michael Liebensteiner1, Theofilos Karachalios6, Reha N Tandogan7. 1. Department for Orthopaedic Surgery and Traumatology, Medical University Innsbruck, Innsbruck, Austria. 2. CortoClinics, Schijndel, The Netherlands. 3. Hip Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. 4. Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland, (Bruderholz, Liestal, Laufen), University of Basel, 4101, Bruderholz, Basel, Switzerland. 5. Department for Orthopaedic Surgery and Traumatology, Medical University Innsbruck, Innsbruck, Austria. ismail.khosravi@tirol-kliniken.at. 6. Orthopaedic Department, Faculty of Medicine, School of Health Sciences, University General Hospital of Larissa, University of Thessalia, Thessalia, Greece. 7. Ortoklinik and Cankaya Orthopaedics, Ankara, Turkey.
Abstract
PURPOSE: During the COVID-19 pandemic there has been a massive reduction of arthroplasty services due to reallocation of hospital resources. The unique challenge for clinicians has been to define which arthroplasty patients most urgently require surgery. The present study aimed to investigate priority arthroplasty procedures during the pandemic and in the reinstatement period from the surgeon's perspective. MATERIAL AND METHODS: An online survey was conducted among members of the European Hip Society (EHS), European Knee Associates (EKA) and other invited orthopaedic arthroplasty surgeons (experts) from across the world. The survey consisted of 17 different arthroplasty procedures/indications of which participants were asked to choose and rank the most important 10. RESULTS: Four hundred and thirty-nine arthroplasty surgeons from 44 countries responded. The EHS and EKA had a 43% response rate of members. In weighted average points, the majority of respondents (67.5 points) ranked 'acute fractures requiring arthroplasty (Periprosthetic fractures, THA/hemi-arthroplasty for femoral neck fractures)' as priority indication number one, followed by 'first-stage explantations for acute PJI (periprosthetic joint infection)' in second place and priority indication (45.9 points) three as 'one-stage revision for acute PJI' (39.7 points). CONCLUSIONS: There was agreement that femoral neck fractures, periprosthetic fractures, and acute infections should be prioritised and cannot be postponed in the setting of the COVID-19 pandemic. As arthroplasty procedures are being resumed in most countries now, there has also been a relaxation of lockdown rules in most countries, which might cause a so-called second wave of the pandemic. Therefore, the results of the current study present a proposal by experts as to which operations should be prioritised in the setting of a second wave of the pandemic.
PURPOSE: During the COVID-19 pandemic there has been a massive reduction of arthroplasty services due to reallocation of hospital resources. The unique challenge for clinicians has been to define which arthroplasty patients most urgently require surgery. The present study aimed to investigate priority arthroplasty procedures during the pandemic and in the reinstatement period from the surgeon's perspective. MATERIAL AND METHODS: An online survey was conducted among members of the European Hip Society (EHS), European Knee Associates (EKA) and other invited orthopaedic arthroplasty surgeons (experts) from across the world. The survey consisted of 17 different arthroplasty procedures/indications of which participants were asked to choose and rank the most important 10. RESULTS: Four hundred and thirty-nine arthroplasty surgeons from 44 countries responded. The EHS and EKA had a 43% response rate of members. In weighted average points, the majority of respondents (67.5 points) ranked 'acute fractures requiring arthroplasty (Periprosthetic fractures, THA/hemi-arthroplasty for femoral neck fractures)' as priority indication number one, followed by 'first-stage explantations for acute PJI (periprosthetic joint infection)' in second place and priority indication (45.9 points) three as 'one-stage revision for acute PJI' (39.7 points). CONCLUSIONS: There was agreement that femoral neck fractures, periprosthetic fractures, and acute infections should be prioritised and cannot be postponed in the setting of the COVID-19 pandemic. As arthroplasty procedures are being resumed in most countries now, there has also been a relaxation of lockdown rules in most countries, which might cause a so-called second wave of the pandemic. Therefore, the results of the current study present a proposal by experts as to which operations should be prioritised in the setting of a second wave of the pandemic.
Entities:
Keywords:
Arthroplasty; Fracture; Infection; Prioritisation of procedures; SARS-CoV-2; Survey
Authors: Assema Zh Bekniyazova; Assiya Kadralinova; Maiya E Konkayeva; Aigerim A Yeltayeva; Aidos K Konkayev Journal: Front Med (Lausanne) Date: 2022-06-07
Authors: Luigi Zagra; Martina Faraldi; Mauro Andreata; Immacolata Ottaiano; Giuseppe Basile; Giovanni Lombardi Journal: Int Orthop Date: 2021-05-13 Impact factor: 3.075