Reintroduction of Hip and Knee Arthroplasty Through COVID-19 Pandemic: Experience at a High-Volume Hip and Knee Arthroplasty Centre in India.

Abstract

COVID-19 was declared as a pandemic in March 2020. Government of India declared a countrywide lockdown on 24 March 2020. All elective surgeries including Hip and Knee arthroplasty were postponed in view of pandemic. Gradually cases were resumed after stepwise unlock measures. The aim of this study is to assess how hip and knee arthroplasty surgeries were affected during first wave of pandemic, and how situation was tackled by an arthroplasty unit of a tertiary-care hospital in India. This study was a single-centre retrospective observational study. Data pertaining to patient demographic details, surgery, preoperative screening for COVID-19, duration of hospital stay, and post-op 30-day complications were collected from hospital records and analyzed. These data were compared with 2019 data. There was significant decrease (88.45%) in total number of hip and knee arthroplasty cases between March 2020 and November 2020 as compared to the same duration in 2019. 30-day mortality was only 2 deaths both who died due to COVID-19-related complications. Duration of stay in hospital and post-operative complications were not statistically and significantly affected. There was a statistically significant increase in tourniquet time compared to the previous year. If deaths due to COVID-19 are excluded, there was statistically no significance difference in 30-day mortality rate. Following strict local policy for patient selection and reducing the number of post-operative patient visits to the hospital allowed us to perform hip and knee arthroplasty safely with minimum COVID-19-related mortality and morbidity. The online version contains supplementary material available at 10.1007/s43465-023-00930-6.