Safety evaluation of a strategy to restart elective orthopaedic surgery during the de-escalation phase of the COVID-19 pandemic.

AIMS: To evaluate safety outcomes and patient satisfaction of the re-introduction of elective orthopaedic surgery on 'green' (non-COVID-19) sites during the COVID-19 pandemic. METHODS: A strategy consisting of phased relaxation of clinical comorbidity criteria was developed. Patients from the orthopaedic waiting list were selected according to these criteria and observed recommended preoperative isolation protocols. Surgery was performed at green sites (two local private hospitals) under the COVID-19 NHS contract. The first 100 consecutive patients that met the Phase 1 criteria and underwent surgery were included. In hospital and postoperative complications with specific enquiry as to development of COVID-19 symptoms or need and outcome for COVID-19 testing at 14 days and six weeks was recorded. Patient satisfaction was surveyed at 14 days postoperatively. RESULTS: There were 54 females and 46 males (mean age 44 years, mean body mass index (BMI) 25.6 kg/m2). In all, 56 patients underwent major orthopaedic procedures. There were no exclusions. One patient had a postoperative positive SARS-CoV-2 RT-PCR test but had no typical symptoms of COVID-19 infection and no clinical sequelae. 99% of patients were satisfied with the process and 98% would recommend undergoing elective orthopaedic surgery in the study period. CONCLUSION: In an environment with appropriate infrastructure, patient selection, isolation, screening, and testing, elective orthopaedic surgery is safe during the COVID-19 pandemic, and associated with high patient satisfaction. Further follow-up is required to establish that safety is maintained as the clinical restrictions are eased with the phased approach described.Cite this article: Bone Joint Open 2020;1-8:450-456.

Changes in saccadic latencies over the human menstrual cycle.

The study assessed differences in sensorimotor processing as reflected in measurements of saccadic latencies at 3 different stages in the menstrual cycle (menstruation, early luteal, and premenstruation) in naturally cycling women (n = 13), and at the same time intervals in women taking an oral contraceptive (n = 6), and male controls (n = 8). Subjects (M age = 22.0 yr., SD = 2.2 yr.) were recruited by questionnaire from the student population of the University of Cambridge. Latencies were measured using a portable infrared scleral oculometer. Changes in latency across the menstrual cycle occurred only in the naturally cycling women (F(2.11) = 5.95, p < .05). Premenstrual latencies were greater (199.3 +/- 12.7 msec., M +/- SD) compared to those during menstruation (191.9 +/- 11.1 msec.) or midcycle (196.9 +/- 12.7 msec.). These findings could account for the loss of musculoskeletal coordination reported by some women prior to menstruation and suggests that administration of an oral contraceptive may alleviate this effect.