Barnes Matthew R, Zagaria Alexandra B, Werth Paul M, Jevsevar David S
Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
Department of Orthopaedics, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Arthroplast Today. 2024 Apr 23;27:101348. doi: 10.1016/j.artd.2024.101348. eCollection 2024 Jun.
The coronoavirus disease 2019 (COVID-19) pandemic had profound impact on elective procedures in the United States. We characterized the longer-term decline and recovery of hip and knee arthroplasty procedures following the onset of the COVID-19 pandemic in the United States.
We conducted a retrospective analysis of patients undergoing primary and revision total knee and hip arthroplasty (TKA and THA) in the United States between 2014 and 2020 using claims from a large national commercial payer data set contaivning deidentified information from patients with commercial health coverage. We calculated the percentage of cases lost by month using a forecast model to predict TKA and THA volumes in the absence of COVID-19. We then calculated the association between COVID-19 positivity rates and THA/TKA procedures by state and month.
There was a large initial decline in procedures, with primary TKA and THA volumes declining by 93.2% and 87.1% in April 2020, respectively, with revisions seeing more modest declines. Cases quickly recovered with volumes exceeding expected levels in summer months. However, cumulative 2020 volumes remained below expected with 9.7% and 7.5% of expected primary TKA and THA cases lost, respectively. Higher state COVID-19 positivity rates were associated with lower primary TKA, THA, and revision knee procedure rates.
After the initial decline in March and April, knee and hip arthroplasty cases resumed quickly; however, by the end of 2020, the annual procedure volume had still not recovered fully. The loss in case volume within states was worse in months with higher COVID-19 positivity rates.
2019年冠状病毒病（COVID-19）大流行对美国的择期手术产生了深远影响。我们描述了美国COVID-19大流行开始后髋关节和膝关节置换手术的长期下降和恢复情况。
我们使用一个大型全国商业支付者数据集的索赔数据，对2014年至2020年在美国接受初次和翻修全膝关节和髋关节置换术（TKA和THA）的患者进行了回顾性分析，该数据集包含来自有商业健康保险患者的去识别信息。我们使用预测模型计算了在没有COVID-19的情况下按月份流失的病例百分比，以预测TKA和THA的手术量。然后我们计算了各州各月COVID-19阳性率与THA/TKA手术之间的关联。
手术量最初大幅下降，2020年4月初次TKA和THA手术量分别下降了93.2%和87.1%，翻修手术量下降幅度较小。病例数在夏季迅速恢复，手术量超过预期水平。然而，2020年的累计手术量仍低于预期，分别有9.7%和7.5%的预期初次TKA和THA病例流失。各州较高的COVID-19阳性率与较低的初次TKA、THA和翻修膝关节手术率相关。
在3月和4月最初下降之后，膝关节和髋关节置换病例迅速恢复；然而，到2020年底，年度手术量仍未完全恢复。在COVID-19阳性率较高的月份，各州病例数的损失更严重。
