COVID-19 Collateral Damage: Management of Periprosthetic Joint Infection in Malaysia.

Mohammed Harris Anwarali Khan,Jade Pei Yuik Ho,Jeffrey Jaya Raj,Kunalan Ganthel@Annamalai,Chooi Leng Low,Sasidaran Ramalingam,Ren Yi Kow

doi:10.7759/cureus.18820

Abstract

Background and objectivePeriprosthetic joint infection (PJI) is one of the dreaded complications in patients after arthroplasty surgeries, owing to the risk of morbidity and arduous investigations and management associated with it. Nevertheless, as Malaysia is currently battling against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced coronavirus disease 2019 (COVID-19) pandemic head-on, the treatment for other non-life-threatening diseases including PJI has taken a backseat. In this study, we present a case series of 11 patients with PJI who were managed surgically at the largest tertiary hospital in Malaysia and we hope to shed some light on the difficulties we have encountered during this trying period.Patients and methodsPatients with PJIs who underwent surgical intervention during the ongoing COVID-19 pandemic (March 1, 2020, to June 30, 2021) were reviewed and included in this study. The demographic profile of the patients, presenting complaints, prosthesis topography, biochemical investigative findings, surgical interventions, and short-term outcomes were summarized.ResultsA total of 11 patients were treated surgically at Hospital Kuala Lumpur for PJI. Among them, five patients are still awaiting their second-stage surgeries despite the completion of their antibiotic regimes, and they are fit for the procedure.ConclusionThe COVID-19 pandemic has wreaked havoc on the treatment of patients with PJI. In a setting with scarce resources, surgeons should strongly consider single-stage revision surgeries for the treatment of patients with PJI.

Highlights

As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced coronavirus disease 2019 (COVID-19) pandemic sweeps through the whole world like a wildfire, crumbling most of the healthcare and other crucial sectors along the way, many countries are scrambling to manage and contain this debilitating disease [1,2,3]
While the administrators are justified in focusing on COVID-19 infections and associated mortality rates, the collateral damage of COVID-19 infection in the healthcare sector remains obscured to the public
We present a case series of 11 patients with periprosthetic joint infection (PJI) who were managed surgically during the ongoing pandemic at the largest tertiary hospital in Malaysia and we hope to highlight the difficulties we have encountered during this trying period

Summary

Introduction

As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced coronavirus disease 2019 (COVID-19) pandemic sweeps through the whole world like a wildfire, crumbling most of the healthcare and other crucial sectors along the way, many countries are scrambling to manage and contain this debilitating disease [1,2,3]. In Malaysia, elective surgeries such as joint replacement surgeries have been postponed throughout this pandemic period in many tertiary centers. Periprosthetic joint infection (PJI) is one of the dreaded complications in patients after arthroplasty surgeries, owing to the risk of morbidity and arduous investigations and management associated with it. As Malaysia is currently battling against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced coronavirus disease 2019 (COVID-19) pandemic head-on, the treatment for other non-life-threatening diseases including PJI has taken a backseat. We present a case series of 11 patients with PJI who were managed surgically at the largest tertiary hospital in Malaysia and we hope to shed some light on the difficulties we have encountered during this trying period

Methods

Discussion

Conclusion