Johnson Charles A, Reid Jared J, Eichinger Josef K, Friedman Richard J
Medical University of South Carolina, Charleston, SC, USA.
Semin Arthroplasty. 2023 Jun;33(2):416-421. doi: 10.1053/j.sart.2023.02.002. Epub 2023 Mar 8.
The coronavirus (COVID-19) pandemic has introduced patient stressors and changes to perioperative protocols in total shoulder arthroplasty (TSA). The purpose of this study is to evaluate the short-term effects of the COVID-19 pandemic on various patient outcomes and satisfaction following elective TSA.
A retrospective review was performed on 147 patients who underwent primary TSA at a single institution between June 2019 and December 2020. Patients were divided into 2 cohorts: pre-COVID (June 2019-March 2020; n = 74) and post-COVID (April 2020-December 2020; n = 73). No elective TSA were performed between 10 March 2020 and 23 April 2020 at our institution. Data were collected prospectively both pre- and postoperatively. Range of motion (ROM) testing included active abduction, internal rotation, and external rotation. Patient reported outcome measures (PROMs) included global shoulder function, Simple Shoulder Test, American Shoulder and Elbow Surgeons, Visual Analog Scale pain scoring systems, and patient satisfaction. ROM and PROMs were compared at preoperative, 3-month follow-up, and 12-month follow-up intervals. Operative time, length of stay (LOS), 90-day readmission, and 90-day reoperation were also compared.
There were no differences in baseline patient characteristics. The operative time, LOS, home discharge rate, readmission, and reoperation did not differ between groups. For both cohorts, the PROMs and ROM improved at each follow-up visit postoperatively. While preoperative abduction, internal rotation, and external rotation were significantly greater in the post-COVID group, all ROM measures were similar at 3-month and 12-month follow-up visits. There was no difference in pain, global function, Simple Shoulder Test, American Shoulder and Elbow Surgeons, or patient satisfaction between groups at all time intervals.
Patients undergoing elective TSA amidst the COVID-19 pandemic demonstrate excellent PROMs, ROM, and high satisfaction up to 12-months postoperatively that are comparable to pre-pandemic standards. Operative time, LOS, discharge destination, as well as 90-day readmission and reoperation rates were not impacted by the pandemic. Patients can expect similar outcomes for TSA when comparing pre-COVID to post-COVID as the pandemic continues.
冠状病毒（COVID-19）大流行给全肩关节置换术（TSA）带来了患者压力源，并改变了围手术期方案。本研究的目的是评估COVID-19大流行对择期TSA后各种患者结局和满意度的短期影响。
对2019年6月至2020年12月期间在单一机构接受初次TSA的147例患者进行回顾性研究。患者分为2组：COVID前组（2019年6月至2020年3月；n = 74）和COVID后组（2020年4月至2020年12月；n = 73）。2020年3月10日至2020年4月23日期间，我们机构未进行择期TSA。术前和术后均前瞻性收集数据。活动范围（ROM）测试包括主动外展、内旋和外旋。患者报告的结局指标（PROMs）包括整体肩部功能、简单肩部测试、美国肩肘外科医师协会、视觉模拟量表疼痛评分系统以及患者满意度。在术前、3个月随访和12个月随访时比较ROM和PROMs。还比较了手术时间、住院时间（LOS）、90天再入院率和90天再次手术率。
两组患者的基线特征无差异。两组间手术时间、LOS、出院回家率、再入院率和再次手术率无差异。对于两组患者，术后每次随访时PROMs和ROM均有所改善。虽然COVID后组术前的外展、内旋和外旋明显更大，但在3个月和12个月随访时，所有ROM测量值均相似。在所有时间点，两组间的疼痛、整体功能、简单肩部测试、美国肩肘外科医师协会评分或患者满意度均无差异。
在COVID-19大流行期间接受择期TSA的患者在术后12个月内表现出优异的PROMs、ROM和高满意度，与大流行前的标准相当。手术时间、LOS、出院目的地以及90天再入院率和再次手术率均未受到大流行的影响。随着大流行的持续，比较COVID前和COVID后，患者可以预期TSA会有相似的结局。
