Harvard Medical School, Boston, Massachusetts; Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts.
Harvard Medical School, Boston, Massachusetts; Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, Massachusetts.
J Arthroplasty. 2024 Aug;39(8):1959-1966.e1. doi: 10.1016/j.arth.2024.03.028. Epub 2024 Mar 19.
The Coronavirus Disease 2019 (COVID-19) pandemic decreased surgical volumes, but prior studies have not investigated recovery through 2022, or analyzed specific procedures or cases of urgency within orthopedic surgery. The aims of this study were to (1) quantify the declines in orthopedic surgery volume during and after the pandemic peak, (2) characterize surgical volume recovery during the postvaccination period, and (3) characterize recovery in the 1-year postvaccine release period.
We conducted a retrospective cohort study of 27,476 orthopedic surgeries from January 2019 to December 2022 at one urban academic quaternary referral center. We reported trends over the following periods: baseline pre-COVID-19 period (1/6/2019 to 1/4/2020), COVID-19 peak (3/15/2020 to 5/16/2020), post-COVID-19 peak (5/17/2020 to 1/2/2021), postvaccine release (1/3/2021 to 1/1/2022), and 1-year postvaccine release (1/2/2022 to 12/30/2022). Comparisons were performed with 2 sample t-tests.
Pre-COVID-19 surgical volume fell by 72% at the COVID-19 peak, especially impacting elective procedures (P < .001) and both hip and knee joint arthroplasty (P < .001) procedures. Nonurgent (P = .024) and urgent or emergency (P = .002) cases also significantly decreased. Postpeak recovery before the vaccine saw volumes rise to 92% of baseline, which further rose to 96% and 94% in 2021 and 2022, respectively. While elective procedures surpassed the baseline in 2022, nonurgent and urgent or emergency surgeries remained low.
The COVID-19 pandemic substantially reduced orthopedic surgical volumes, which have still not fully recovered through 2022, particularly nonelective procedures. The differential recovery within an orthopedic surgery program may result in increased morbidity and can serve to inform department-level operational recovery.
2019 年冠状病毒病（COVID-19）大流行减少了手术量，但之前的研究并未调查 2022 年之前的恢复情况，也未分析过骨科手术内的具体手术或紧急情况。本研究的目的是：（1）量化大流行高峰期和之后骨科手术量的下降；（2）描述疫苗接种后期间的手术量恢复情况；（3）描述疫苗接种发布后 1 年的恢复情况。
我们对一家城市学术四级转诊中心 2019 年 1 月至 2022 年 12 月的 27476 例骨科手术进行了回顾性队列研究。我们报告了以下时间段的趋势：基线 COVID-19 前时期（2019 年 1 月 6 日至 2020 年 4 月 4 日）、COVID-19 高峰期（2020 年 3 月 15 日至 2020 年 5 月 16 日）、COVID-19 高峰期后（2020 年 5 月 17 日至 2021 年 1 月 2 日）、疫苗发布后（2021 年 1 月 3 日至 2022 年 1 月 1 日）和疫苗发布后 1 年（2022 年 1 月 2 日至 2022 年 12 月 30 日）。使用 2 样本 t 检验进行比较。
COVID-19 高峰期前的手术量下降了 72%，特别是择期手术（P<.001）和髋关节和膝关节置换术（P<.001）。非紧急（P=.024）和紧急或紧急（P=.002）病例也显著减少。疫苗接种前的高峰期后恢复使手术量恢复到基线的 92%，2021 年和 2022 年分别进一步上升到 96%和 94%。虽然择期手术在 2022 年超过了基线，但非紧急和紧急或紧急手术仍然很低。
COVID-19 大流行大大减少了骨科手术量，截至 2022 年尚未完全恢复，特别是非选择性手术。骨科手术项目内的差异恢复可能会导致发病率增加，并有助于为部门级运营恢复提供信息。
