Impact of COVID-19 on Spinal Diagnosis and Procedural Volume in the United States.

STUDY DESIGN: Retrospective analysis of a national database. OBJECTIVES: COVID-19 resulted in the widespread shifting of hospital resources to handle surging COVID-19 cases resulting in the postponement of surgeries, including numerous spine procedures. This study aimed to quantify the impact that COVID-19 had on the number of treated spinal conditions and diagnoses during the pandemic. METHODS: Using CPT and ICD-10 codes, TriNetX, a national database, was utilized to quantify spine procedures and diagnoses in patients >18 years of age. The period of March 2020-May 2021 was compared to a reference pre-pandemic period of March 2018-May 2019. Each time period was then stratified into four seasons of the year, and the mean average number of procedures per healthcare organization was compared. RESULTS: In total, 524,394 patient encounters from 53 healthcare organizations were included in the analysis. There were significant decreases in spine procedures and diagnoses during March-May 2020 compared to pre-pandemic levels. Measurable differences were noted for spine procedures during the winter of 2020-2021, including a decrease in lumbar laminectomy and anterior cervical arthrodesis. Comparing the pandemic period to the pre-pandemic period showed significant reductions in most spine procedures and treated diagnoses; however, there was an increase in open repair of thoracic fractures during this period. CONCLUSIONS: COVID-19 resulted in a widespread decrease in spinal diagnosis and treated conditions. An inverse relationship was observed between new COVID-19 cases and spine procedural volume. Recent increases in procedural volume from pre-pandemic levels are promising signs that the spine surgery community has narrowed the gap in unmet care produced by the pandemic.

The Impact of the COVID-19 Pandemic on Orthopaedic Knee Procedures: A National Multicentered Analysis.

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic strained the United States healthcare system, and associated policies resulted in the postponement or cancellation of many elective surgeries. While most orthopaedic surgeons are aware of how the pandemic affected their patients' care, broader national trends in the operative treatment of orthopaedic knee pathology are poorly characterized. Therefore, the purpose of this study was to identify trends in orthopaedic knee procedures during the COVID-19 pandemic. METHODS: The TriNetX database was queried for orthopaedic knee procedures performed from March 2018 to May 2021. Procedures were classified as arthroplasty (total knee arthroplasty (TKA), revision total knee arthroplasty) or non-arthroplasty (tendon or ligament repair, fracture fixation). Procedural volume per healthcare organization was determined over five seasons from March 2020 to May 2021 and compared to overlapping pre-pandemic periods from March 2018 to May 2019. Descriptive analysis was performed, and comparisons were made using a Student's T-test. RESULTS: Compared to the pre-pandemic period, there were significant decreases in primary TKA (p=0.016), femoral or entire tibial component revision TKA (p=0.005), and open treatment of femoral shaft fractures (p=0.007) in spring 2020. Procedural volume returned to baseline in summer 2020 through winter 2021. In spring 2021, primary TKA (p=0.017) and one component revision TKA (p=0.003) increased compared to the pre-pandemic period. CONCLUSION: The greatest decrease in knee procedures occurred early in the pandemic. Rates of these procedures have since rebounded, with some exceeding pre-pandemic levels. Hospitals are now better able to accommodate orthopaedic surgical volume while continuing to care for patients with COVID-19.

The Evolving Role of Social Media in Pediatric Orthopaedics.

BACKGROUND: Social media has grown significantly and its application in health care has been dramatically accentuated by the COVID-19 pandemic. It is often considered as a "new dimension" of health care, particularly in its ability to provide health information. In 2017, the top social media sites utilized by pediatric orthopaedic surgeons included Facebook, LinkedIn, and Twitter. In our study, we analyze the current social media usage, trends in Instagram and TikTok content, and the perceptions on social media usage among pediatric orthopaedic surgeons. METHODS: The Pediatric Orthopaedic Society of North America (POSNA) membership directory was searched for the presence of social media. A review of all Instagram and TikTok posts made by the POSNA members were reviewed. A survey regarding the perception of social media networks and content was distributed to all POSNA members. RESULTS: A total of 1231 POSNA members actively practicing in the United States were included in our study. In all, 327 (26.6%) had a LinkedIn profile, 34 (2.8%) had a professional Facebook profile, 15 (1.2%) had a public Instagram account, 0 (0%) had TikTok, and 72 (5.8%) had a professional Twitter account. Fifteen POSNA members with public Instagram accounts had 10,878 followers. A total of 907 Instagram posts were made, 134 (14.8%) of which were education and 462 (50.9%) of which were personal or political. The perception of various social media networks such as Instagram (3.02), Facebook (3.16), and LinkedIn (3.51) were positive on a 5-point Likert scale, while perceptions of TikTok (2.36) and Twitter (2.99) were negative. Educational posts on Instagram (3.19) and Facebook (3.37) were positive. CONCLUSIONS: We provide an update to the utilization of social media by pediatric orthopaedists. Use of Instagram and TikTok accounts remain rare. Educational posts, when hosted on an appropriate social media platform, are perceived positively among pediatric orthopaedists. LEVEL OF EVIDENCE: Level IV.

Utility of Social Media for Recruitment by Orthopaedic Surgery Residency Programs.

BACKGROUND: As the use of social media continues to rise, the presence of social media accounts among orthopaedic surgery residency programs can foster connections with other specialties, highlight departmental achievements, and be a resource for applicants to learn more about the program. This study evaluated the current utility and landscape of social media, with an emphasis on the use of Instagram, in orthopaedic surgery residency programs in the United States. METHODS: A cross-sectional study of orthopaedic surgery residency Instagram accounts was performed. The Instagram accounts were evaluated for the number of followers, number of accounts following, and number of posts. Instagram posts were further categorized into academic, departmental, education, and COVID-19-related content. In addition, a search was performed to identify the presence of Twitter and Facebook accounts among orthopaedic surgery residency programs. Bivariate and multivariable logistic regression models were used to analyze the data in this study. RESULTS: Of the 192 orthopaedic surgery residency programs evaluated, 108 programs (56%) had an Instagram account, 65 programs (34%) had a Twitter account, and 58 programs (30%) had a Facebook account. Of the 108 programs with an Instagram account, 92 accounts (85%) were created in 2020. A higher Doximity ranking of a program was positively associated with the presence of an Instagram account (p < 0.001). A significant correlation was found between the number of posts and the Instagram engagement score (p = 0.018). The majority of Instagram posts contained departmental content (54%) followed by social (13%) and COVID-19-related (10%) content. CONCLUSIONS: The presence of orthopaedic surgery residency programs on social media has grown significantly in the year 2020. With the presence of more than 50% of residency programs on Instagram, this can be a useful resource for prospective applicants and other healthcare professionals to gain insight into the activities of orthopaedic surgery residency programs across the United States.

Orthopedic Surgery Residency Program Website Content and Accessibility During the COVID-19 Pandemic: Observational Study.

BACKGROUND: The exceptional competitiveness of the orthopedic surgery specialty, combined with the unclear impact of the COVID-19 pandemic on residency recruitment, has presented significant challenges to applicants and residency program directors. With limited in-person opportunities in the 2020-2021 application cycle, applicants have been pressed to gauge chances and best fit by browsing program websites. OBJECTIVE: The aim of the study was to assess the accessibility and content of accredited orthopedic surgery residency program websites during the COVID-19 pandemic. METHODS: Using the online database of the Electronic Residency Application Service (ERAS), we compiled a list of accredited orthopedic surgery residency programs in the United States. Program websites were evaluated across four domains: program overview, education, research opportunities, and application details. Each website was assessed twice in July 2020, during a period of adjustment to the COVID-19 pandemic, and twice in November 2020, following the October ERAS application deadline. RESULTS: A total of 189 accredited orthopedic surgery residency programs were identified through ERAS. Of these programs, 3 (1.6%) did not have functional website links on ERAS. Data analysis of content in each domain revealed that most websites included program details, a description of the didactic curriculum, and sample rotation schedules. Between the two evaluation periods in July and November 2020, the percentage of program websites containing informative videos and virtual tours rose from 12.2% (23/189) to 48.1% (91/189; P<.001) and from 0.5% (1/189) to 13.2% (25/189; P<.001), respectively. However, the number of programs that included information about a virtual subinternship or virtual interview on their websites did not change. Over the 4-month period, larger residency programs with 5 or more residents were significantly more likely to add a program video (P<.001) or virtual tour (P<.001) to their websites. CONCLUSIONS: Most residency program websites offered program details and an overview of educational and research opportunities; however, few addressed the virtual transition of interviews and subinternships during the COVID-19 pandemic.