From the Department of Orthopedic Surgery, University of Virginia, Charlottesville, VA.
J Am Acad Orthop Surg. 2021 Dec 15;29(24):e1321-e1327. doi: 10.5435/JAAOS-D-20-00765.
The coronavirus disease 2019 (COVID-19) pandemic resulted in the unprecedented widespread cancellation of scheduled elective primary total joint arthroplasty (TJA) in the United States. The impact of postponing scheduled total hip arthroplasty and total knee arthroplasty procedures on patients has not been well studied and may have physical, emotional, and financial consequences.
All patients whose elective primary TJA procedures at a tertiary academic medical center were postponed because of COVID-19 were surveyed. Seventy-four patients agreed to answer 13 questions concerning the physical, mental, and financial impact of surgery cancellation. Statistical analysis, including Pearson correlation coefficients, cross-tabulation analysis, and chi squares, was performed.
13.5% of patients strongly disagreed with the use of "elective" to describe their cancelled TJA surgery and 25.7% of patients reported substantial physical and/or mental deterioration due to postponement. Younger individuals experienced greater change in their symptoms (P = 0.034), anxiety about their pain (P = 0.010), and frustration/anger (P = 0.043). Poor quality of life, mood, and lower HOOS/KOOS Jr interval scores were correlated with greater financial strain, disagreement with the postponement, and disagreement with the use of "elective" to describe surgery. Disagreement with the use of "elective" to describe surgery was associated with greater financial strain (P = 0.013) and disagreement with the decision to postpone surgery (P = 0.008). In addition, greater financial strain was associated with disagreement with postponement (P = 0.014).
The cancellation of elective TJA during the COVID-19 pandemic had a variety of consequences for patients. One in four patients reported experiencing substantial physical and/or emotional deterioration. Associations of poor quality of life and mood with greater financial strain and disagreement with the term "elective" were seen. These results help quantify the deleterious effects of cancelling elective surgery and identify at-risk patients should another postponement of surgery occur.
Level II-Prospective cohort study.
2019 年冠状病毒病（COVID-19）大流行导致美国前所未有地广泛取消了计划中的择期初级全关节置换术（TJA）。推迟全髋关节置换术和全膝关节置换术对患者的影响尚未得到很好的研究，可能会产生身体、情绪和经济方面的后果。
对一家三级学术医疗中心因 COVID-19 而推迟择期初级 TJA 手术的所有患者进行了调查。74 名患者同意回答 13 个有关手术取消对身体、精神和经济影响的问题。进行了统计分析，包括 Pearson 相关系数、交叉表分析和卡方检验。
13.5%的患者强烈不同意将他们取消的 TJA 手术描述为“择期”手术，25.7%的患者报告因推迟而出现身体和/或精神恶化。年轻人的症状变化更大（P=0.034），对疼痛的焦虑感（P=0.010）和挫败感/愤怒感（P=0.043）也更大。生活质量差、情绪低落和较低的 HOOS/KOOS Jr 间隔评分与更大的经济压力、不同意推迟手术以及不同意将手术描述为“择期”有关。不同意将手术描述为“择期”与更大的经济压力（P=0.013）和不同意推迟手术的决定（P=0.008）有关。此外，更大的经济压力与不同意推迟手术有关（P=0.014）。
COVID-19 大流行期间择期 TJA 的取消对患者造成了多种后果。四分之一的患者报告经历了身体和/或情绪的明显恶化。生活质量和情绪较差与更大的经济压力和不同意“择期”一词有关。这些结果有助于量化取消择期手术的有害影响，并确定在再次推迟手术时处于危险之中的患者。
II 级-前瞻性队列研究。
