Impact of the COVID-19 Outbreak on Orthopedic Surgery: A Nationwide Analysis of the First Pandemic Year.

Maximiliano Barahona,Cristian Barrientos,Alvaro Martinez,Macarena A Barahona,Miguel J Palet,Carlos A Infante

doi:10.7759/cureus.17252

Abstract

PurposeTo analyze the impact of the coronavirus disease 2019 (COVID-19) outbreak during the first pandemic year in a single country.MethodsA cross-sectional study was designed. The free access database of the Chilean Department of Statistics and Health Information (DEIS) was used to compare the number of orthopedic procedures between 2019 and 2020. Country mobility was exported from the Institute of Complex Engineering Systems (ISCI) free-access database; this corresponds to a direct measurement of the degree of confinement of the country. Spearman correlation (rho) was used to analyze the total monthly COVID infection trend and mobility to orthopedics procedures.ResultsThe number of orthopedic surgeries fell by 22.8% during the first year of the pandemic. All surgical procedures were adversely affected, with the fracture/trauma surgeries being the least affected. The maximum adverse impact was seen in knee arthroplasty (-64%), followed by hip arthroplasty (-41%) and knee ligament reconstruction (-44%). The number of orthopedic procedures had a mild correlation to the monthly number of COVID-19 cases (rho=-0.53, p=0.08) and a strong correlation with the country's mobility (rho=0.94, p=0.0001).ConclusionsThe COVID-19 outbreak diminished the number of orthopedic procedures during 2020, and the impact was directly correlated to the country's mobility. The public health network did have a more significant adverse impact in elective surgeries due to a slower recovery than private institutions. An increase in the waiting list should be expected, which will widen the difference in access to orthopedic surgery in Chile.

Highlights

The first case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported in China; after which the novel coronavirus spread out to the rest of the world, creating a global health emergency that led to the World Health Organization (WHO) declaring it a pandemic on March 11, 2020 [1].The pandemic has caused more than three million deaths and led governments to promote social distancing and dictate lockdown measures to stop the spread and reduce mortality
The number of orthopedic surgeries fell by 22.8% during the first year of the pandemic
The number of orthopedic procedures had a mild correlation to the monthly number of COVID-19 cases and a strong correlation with the country's mobility

Summary

Introduction

The first case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported in China; after which the novel coronavirus spread out to the rest of the world, creating a global health emergency that led to the World Health Organization (WHO) declaring it a pandemic on March 11, 2020 [1]. The pandemic has caused more than three million deaths and led governments to promote social distancing and dictate lockdown measures to stop the spread and reduce mortality. Conversion of hospital beds and suspension of elective surgeries were decreed to increase the availability of intensive care units [5]. This had a direct impact on the number of orthopedic procedures performed in our country

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