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在新冠疫情期间重新开展髋关节和膝关节置换手术:印度一家大型髋关节和膝关节置换中心的经验

Reintroduction of Hip and Knee Arthroplasty Through COVID-19 Pandemic: Experience at a High-Volume Hip and Knee Arthroplasty Centre in India.

作者信息

Sonawane Chandrashekhar S, Kulkarni Mahesh M, Wakankar Hemant M, Rao Srisanat S

机构信息

Department of Joint Replacement and Reconstruction, Deenanath Mangeshkar Hospital and Research Center, Erandwane, Pune, Maharashtra 411004 India.

出版信息

Indian J Orthop. 2023 Jul 21;57(9):1519-1526. doi: 10.1007/s43465-023-00930-6. eCollection 2023 Sep.

Abstract

BACKGROUND

COVID-19 was declared as a pandemic in March 2020. Government of India declared a countrywide lockdown on 24 March 2020. All elective surgeries including Hip and Knee arthroplasty were postponed in view of pandemic. Gradually cases were resumed after stepwise unlock measures. The aim of this study is to assess how hip and knee arthroplasty surgeries were affected during first wave of pandemic, and how situation was tackled by an arthroplasty unit of a tertiary-care hospital in India.

METHODS

This study was a single-centre retrospective observational study. Data pertaining to patient demographic details, surgery, preoperative screening for COVID-19, duration of hospital stay, and post-op 30-day complications were collected from hospital records and analyzed. These data were compared with 2019 data.

RESULTS

There was significant decrease (88.45%) in total number of hip and knee arthroplasty cases between March 2020 and November 2020 as compared to the same duration in 2019. 30-day mortality was only 2 deaths both who died due to COVID-19-related complications. Duration of stay in hospital and post-operative complications were not statistically and significantly affected. There was a statistically significant increase in tourniquet time compared to the previous year. If deaths due to COVID-19 are excluded, there was statistically no significance difference in 30-day mortality rate.

CONCLUSION

Following strict local policy for patient selection and reducing the number of post-operative patient visits to the hospital allowed us to perform hip and knee arthroplasty safely with minimum COVID-19-related mortality and morbidity.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s43465-023-00930-6.

摘要

背景

2020年3月,新型冠状病毒肺炎(COVID-19)被宣布为大流行病。印度政府于2020年3月24日宣布全国封锁。鉴于疫情,包括髋关节和膝关节置换术在内的所有择期手术均被推迟。在逐步解封措施实施后,手术病例逐渐恢复。本研究的目的是评估在疫情第一波期间髋关节和膝关节置换手术受到了怎样的影响,以及印度一家三级护理医院的关节置换科室是如何应对这种情况的。

方法

本研究为单中心回顾性观察研究。从医院记录中收集患者人口统计学细节、手术、COVID-19术前筛查、住院时间和术后30天并发症等相关数据并进行分析。将这些数据与2019年的数据进行比较。

结果

与2019年同期相比,2020年3月至2020年11月期间髋关节和膝关节置换病例总数显著减少(88.45%)。30天死亡率仅为2例死亡,均死于COVID-19相关并发症。住院时间和术后并发症在统计学上没有受到显著影响。与上一年相比,止血带时间有统计学显著增加。如果排除因COVID-19导致的死亡,30天死亡率在统计学上没有显著差异。

结论

遵循严格的患者选择本地政策并减少术后患者到医院的就诊次数,使我们能够以最低的COVID-19相关死亡率和发病率安全地进行髋关节和膝关节置换术。

补充信息

在线版本包含可在10.1007/s43465-023-00930-6获取的补充材料。

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