Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA.
J Arthroplasty. 2020 Jul;35(7S):S45-S48. doi: 10.1016/j.arth.2020.04.060. Epub 2020 Apr 24.
In an effort to help combat the COVID-19 pandemic and preserve essential health care resources, starting in mid-March 2020, surgeons have been instructed to only perform essential surgical procedures. The vast majority of hip and knee arthroplasty surgery does not meet the definition of essential surgery. This study estimated the number of arthroplasty procedures that would be canceled because of these important restrictions.
The US hip and knee arthroplasty procedure volume projections for 2020 were estimated from four recently published studies. Data from the American Joint Replacement Registry were utilized to determine what percentage of these cases would be considered nonessential surgery. Monthly and weekly estimates of nonessential hip and knee arthroplasty procedures that would have occurred had there not been any restrictions due to COVID-19 were calculated.
After excluding essential procedures, it was estimated that approximately 30,000 primary and 3000 revision hip and knee arthroplasty procedures will be canceled each week while COVID-19 restrictions regarding nonessential surgery are in place. If only 50% of nonessential cases were actually canceled across the United States, that would still result in the cancellation of 15,001 primary and 1435 revision hip and knee arthroplasty procedures per week while restrictions are in place.
This study highlights the profound impact COVID-19 is having on our current hip and knee arthroplasty volume. The large number of cases canceled because of COVID-19 translates into major financial losses for health care institutions and may have a profound impact on our patients.
为了帮助应对 COVID-19 大流行并保护基本医疗资源,自 2020 年 3 月中旬以来,外科医生被指示仅进行基本的外科手术。绝大多数髋关节和膝关节置换手术不符合基本手术的定义。本研究估计了由于这些重要限制而取消的关节置换手术数量。
从最近发表的四项研究中估计了 2020 年美国髋关节和膝关节置换手术的程序量预测。利用美国关节置换登记处的数据确定了这些病例中有多少百分比被认为是非必要手术。计算了如果没有 COVID-19 导致的任何限制,每月和每周非必要髋关节和膝关节置换手术的估计次数。
在排除基本手术后,估计每周将取消约 30,000 例初次髋关节和膝关节置换术和 3000 例翻修术,而关于非必要手术的 COVID-19 限制仍在实施。如果仅在美国取消 50%的非必要病例,那么在限制实施期间,每周仍将取消 15,001 例初次髋关节和膝关节置换术和 1435 例翻修术。
本研究强调了 COVID-19 对当前髋关节和膝关节置换量的巨大影响。由于 COVID-19 取消的大量病例导致医疗机构遭受重大财务损失,并可能对我们的患者产生深远影响。