Decreased Case Volumes for Pediatric Orthopaedic Surgery Fellows during the Early Stages of the Coronavirus-19 Pandemic

Abstract

Background: In the early months of the coronavirus disease 2019 (COVID-19) pandemic, elective procedures were suspended to reallocate resources, notably impacting 1-year surgical fellowship programs. The purpose of this study is to compare the case volume of pediatric orthopaedic surgery fellows during the pandemic's peak year to the years before and after.Materials and Methods: Accreditation Council for Graduate Medical Education (ACGME) case log reports of key procedures in pediatric orthopaedic surgery were compared between the fellowship classes of 2018-2019 (pre-pandemic), 2019-2020 (peak pandemic), and 2020-2021 (post-peak pandemic). Both overall case volume and individual key procedures were analyzed for significant differences between each of the three class years.Results: There was a significant decrease (−43.7 cases, −15.5%) in the overall number of key procedures completed by the fellowship class of 2020 compared to 2019 (p=0.014), with similar significant decreases in various individual key procedures (foot and ankle deformity, limb deformity, and soft tissue: transfer, lengthening, and release). In the subsequent year, there was a significant increase (+98.8 cases, +41.5%) in the average case volume for the class of 2021 (p<0.001), with significant increases in procedures for foot and ankle deformity, clubfoot, limb deformity, hip, and soft tissue: transfer, lengthening, and release. Additionally, the rebound in overall case volume for the class of 2021 surpassed the pre-pandemic caseload completed by the class of 2019 (p=0.008).Conclusion: During the peak of the pandemic when elective cases were suspended, pediatric orthopaedic surgery fellows logged fewer surgical cases compared to the pre-pandemic class of 2019. While the case volume rebounded in the subsequent year, further research is needed to quantify the overall impact of the decreased caseload for the pediatric orthopaedic fellowship class of 2020.Level of Evidence: Level IVKey Concepts•With the onset of the unprecedented COVID-19 pandemic, the ensuing shutdowns' effects on the training and case volumes of pediatric orthopaedic fellows remain unclear.•This study quantified the change in case volume of pediatric orthopaedic fellows during the first year of the COVID-19 pandemic and identified a significant decrease of nearly 44 total cases (15.5%) performed by fellows of the graduating class of 2020 when compared to those who graduated in 2019.•This study quantified the rebound in case volume for the fellows of the 2021 graduating class when compared to the graduates of the 2020 fellowship class.