Impact and Strategies on Joint Surgery Centers without Lockdowns during the Peak of the COVID-19 Pandemic: A Multicenter Cross-Sectional Study.

The real psychological impact of COVID-19 remains difficult to quantify and may differ between hospital sizes and levels. Taiwan's response to COVID-19 differed in that it successfully prevented its spread, without implementing any lockdowns before May 2021. Patients' fear would be the major reason for the reduction of surgeries. The daily data for patients who underwent total knee arthroplasty (TKA), total hip arthroplasty, and hemiarthroplasty were collected from two major joint surgery centers of a university hospital and a community hospital in Taiwan. Compared with the previous year, the initial impact of the pandemic evidently reduced the total number of patients (outpatient: 20-29%; admission: 22-37%; surgery: 18-35%) in both hospitals. During the study period, the total number of TKAs decreased by 56-61% in both hospitals. The reduction in arthroplasty surgeries was attributable to patients' fear. Even with confirmed COVID-19 cases, the university hospital experienced less impact than the community hospital. The TKA was the most affected of all surgery types. Even without local epidemics and restrictions in Taiwan, the worldwide pandemic inevitably led to a reduction of approximately 60% of the total TKA operation volume, especially for community hospitals. The surgery scheduling strategies helped maintain the routine arthroplasty services.