Abstract
PurposeTo investigate the impact of COVID-19 in Sweden on rates of knee and hip surgeries.MethodsWe used healthcare data for the population of the southernmost region in Sweden (1.4 million inhabitants). We did an interrupted time-series analysis to estimate changes in rates and trends of joint replacements (JR), arthroscopies, and fracture surgeries for knee or hip in April–December 2020 compared to pre-COVID-19 levels adjusting for seasonal variations.ResultsWe found a drop of 54% (95% CI 42%; 68%) and 42% (95% CI 32%; 52%), respectively, in the rate of JRs and arthroscopies in April 2020 when compared to the counterfactual scenario. This was followed by an increase that brought the rates of JRs and arthroscopies back to their predicted levels also during the beginning of the second wave (November–December 2020). Acute fracture surgeries were largely unaffected, i.e. did not show any decrease as observed for the other surgeries.ConclusionsIn southern Sweden, we observed a marked decrease in elective knee and hip surgeries following the first wave of Covid-19. The rates remained close to normal during the beginning of the second wave suggesting that important elective surgeries for patients with end-stage osteoarthritis can still be offered despite an ongoing pandemic provided adequate routines and hospital resources.
Highlights
IntroductionIn March 2020, many countries imposed lockdowns, in anticipation of the Corona virus disease (COVID)-19 “first wave” and the massive healthcare resources required to meet medical needs, with many hospitals severely curtailing the performance of elective surgeries [7, 16]
The coronavirus disease 2019 (COVID-19) emerged in late 2019 in China causing over a million deaths by the end of the Summer of 2020, and nearly a million more deaths by the end of 2020 when the “second wave” was spreading through the world [8].In March 2020, many countries imposed lockdowns, in anticipation of the Corona virus disease (COVID)-19 “first wave” and the massive healthcare resources required to meet medical needs, with many hospitals severely curtailing the performance of elective surgeries [7, 16]
General population We identified a total of 22,084 joint replacements (JR), 12,806 arthroscopies and 15,774 fracture surgeries of the knee or hip over the study period
Summary
In March 2020, many countries imposed lockdowns, in anticipation of the COVID-19 “first wave” and the massive healthcare resources required to meet medical needs, with many hospitals severely curtailing the performance of elective surgeries [7, 16]. Surgical treatments are often the last resort to alleviate chronic pain, improve function and (or) prevent serious complications [1, 10, 11]. Postponing these surgeries may have unwanted consequences on both patients’ and societal perspectives [5, 6, 10]. No study has yet reported the effect of the first and second wave of COVID-19 on these surgeries, and in particular not in a country where no formal lockdown was implemented despite a relatively high rate of infection
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