Impact of the COVID-19 Pandemic on Patient Satisfaction After Total Joint Arthroplasty.

The coronavirus disease 2019 (COVID-19) pandemic impacted the inpatient experience before and after total joint arthroplasty (TJA). This study aimed to examine how these changes affected patient satisfaction following TJA as recorded by Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) postdischarge surveys and comments at 2 large academic institutions. A retrospective review identified patients who completed HCAHPS surveys following primary and revision TJA at 2 academic institutions: 1 in a predominately rural southern state (Institution A) and 1 in a northeastern metropolitan city (Institution B). Patients were grouped by discharge date: pre-COVID-19 (April 1, 2019, to October 31, 2019) or COVID-19 affected (April 1, 2020, to October 31, 2020). Differences in demographics, survey responses, and comment sentiments and themes were collected and evaluated. The number of HCAHPS surveys completed increased between periods at Institution A but decreased at Institution B (Institution A, 61 vs 103; Institution B, 524 vs 296). Rates of top-box survey responses remained the same across the 2 periods. The number of comments decreased at Institution B (1977 vs 1012) but increased at Institution A (55 vs 88). During the COVID-19-affected period, there was a significant increase in the negative comment rate from Institution B (11.6% vs 14.8%, P=.013) and a significant decrease in the positive comment rate from Institution A (70.9% vs 44.3%, P<.001). There was an increase in negative patient sentiments following TJA during the COVID-19 pandemic as seen in qualitative comments but not quantitative responses. This suggests that certain aspects of the TJA patient experience were impacted by COVID-19. [Orthopedics. 2023;46(2):e105-e110.].

Severity of Covid-19 Lockdown Orders Corresponds to Orthopaedic Trauma Volume.

During the Coronavirus Disease 2019 (COVID-19) pandemic, states implemented social distancing guidelines. This study examines the effect of the severity of lockdown orders on orthopaedic trauma volume. Two institutions, one in a state with strict stay home (SH) orders and one in a state with lax social distancing (SD) orders, were examined. Surgical case counts, total orthopaedic case counts, orthopaedic trauma case counts, institution trauma activations, and mechanism of injury data were collected and compared to control periods. For SH versus SD, total surgical cases decreased 48.6% vs. 62%; orthopaedic cases decreased 51.8% vs. 62%, and orthopaedic trauma cases decreased 34% v. 0%. Orthopaedic trauma cases comprised more of both institutions' total cases. Total surgical cases decreased at both SH and SD, but orthopaedic trauma cases did not decrease at SD. More strict social distancing orders correlate with greater reduction in orthopaedic trauma cases. (Journal of Surgical Orthopaedic Advances 31(4):222-225, 2022).

The Effect of the COVID-19 Pandemic on Electively Scheduled Hip and Knee Arthroplasty Patients in the United States.

BACKGROUND: In response to the COVID-19 pandemic, hospitals in the United States were recommended to stop performing elective procedures. This stoppage has led to the cancellation of a large number of hip and knee arthroplasties. The effect of this on patients' physical mental and economic health is unknown. METHODS: A survey was developed by the AAHKS Research Committee to assess pain, anxiety, physical function, and economic ability of patients to undergo a delayed operation. Six institutions conducted the survey to 360 patients who had to have elective hip and knee arthroplasty cancelled between March and July of 2020. RESULTS: Patients were most anxious about the uncertainty of when their operation could be rescheduled. Although 85% of patients understood and agreed with the public health measures to curb infections, almost 90% of patients plan to reschedule as soon as possible. Age and geographic region of the patients affected their anxiety. Younger patients were more likely to have financial concerns and concerns about job security. Patients in the Northeast were more concerned about catching COVID-19 during a future hospitalization. CONCLUSIONS: Patients suffering from the pain of hip and knee arthritis continue to struggle with pain from their end-stage disease. They have anxiety about the COVID-19 pandemic. Few patients feel they will be limited financially and 90% want to have surgery as soon as possible. Age and physical location of the patients affect their causes for anxiety around their future surgery.

The Rapid Response to the COVID-19 Pandemic by the Arthroplasty Divisions at Two Academic Referral Centers.

The COVID-19 pandemic has created widespread changes across all of health care. As a result, the impacts on the delivery of orthopedic services have been challenged. To ensure and provide adequate health care resources in terms of hospital capacity and personnel and personal protective equipment, service lines such as adult reconstruction and lower limb arthroplasty have stopped or substantially limited elective surgeries and have been forced to re-engineer care processes for a high volume of patients. Herein, we summarize the similar approaches by two arthroplasty divisions in high-volume academic referral centers in (1) the cessation of elective surgeries, (2) workforce restructuring, (3) phased delivery of outpatient and inpatient care, and (4) educational restructuring.