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Patient Perspectives on the Cancellation of Elective Primary Hip and Knee Arthroplasty During the COVID-19 Pandemic.
Sequeira, Sean B; Novicoff, Wendy M; McVey, Eric D; Noble, David M; Harb, Matthew A; Taliaferro, John P; Browne, James A.
  • Sequeira SB; From the Department of Orthopedic Surgery, University of Virginia, Charlottesville, VA.
J Am Acad Orthop Surg ; 29(24): e1321-e1327, 2021 Dec 15.
Article in English | MEDLINE | ID: covidwho-1556078
ABSTRACT

INTRODUCTION:

The coronavirus disease 2019 (COVID-19) pandemic resulted in the unprecedented widespread cancellation of scheduled elective primary total joint arthroplasty (TJA) in the United States. The impact of postponing scheduled total hip arthroplasty and total knee arthroplasty procedures on patients has not been well studied and may have physical, emotional, and financial consequences.

METHODS:

All patients whose elective primary TJA procedures at a tertiary academic medical center were postponed because of COVID-19 were surveyed. Seventy-four patients agreed to answer 13 questions concerning the physical, mental, and financial impact of surgery cancellation. Statistical analysis, including Pearson correlation coefficients, cross-tabulation analysis, and chi squares, was performed.

RESULTS:

13.5% of patients strongly disagreed with the use of "elective" to describe their cancelled TJA surgery and 25.7% of patients reported substantial physical and/or mental deterioration due to postponement. Younger individuals experienced greater change in their symptoms (P = 0.034), anxiety about their pain (P = 0.010), and frustration/anger (P = 0.043). Poor quality of life, mood, and lower HOOS/KOOS Jr interval scores were correlated with greater financial strain, disagreement with the postponement, and disagreement with the use of "elective" to describe surgery. Disagreement with the use of "elective" to describe surgery was associated with greater financial strain (P = 0.013) and disagreement with the decision to postpone surgery (P = 0.008). In addition, greater financial strain was associated with disagreement with postponement (P = 0.014).

CONCLUSION:

The cancellation of elective TJA during the COVID-19 pandemic had a variety of consequences for patients. One in four patients reported experiencing substantial physical and/or emotional deterioration. Associations of poor quality of life and mood with greater financial strain and disagreement with the term "elective" were seen. These results help quantify the deleterious effects of cancelling elective surgery and identify at-risk patients should another postponement of surgery occur. LEVEL OF EVIDENCE Level II-Prospective cohort study.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Arthroplasty, Replacement, Hip / Arthroplasty, Replacement, Knee / COVID-19 Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: North America Language: English Journal: J Am Acad Orthop Surg Journal subject: Orthopedics Year: 2021 Document Type: Article Affiliation country: JAAOS-D-20-00765

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Arthroplasty, Replacement, Hip / Arthroplasty, Replacement, Knee / COVID-19 Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: North America Language: English Journal: J Am Acad Orthop Surg Journal subject: Orthopedics Year: 2021 Document Type: Article Affiliation country: JAAOS-D-20-00765