Resuming elective orthopaedic services during the COVID-19 pandemic: our experience

Aims: The aim of this study was to surveil whether the standard operating procedure created for the NHS Golden Jubilee sufficiently managed COVID-19 risk to allow safe resumption of elective orthopaedic surgery. Methods: This was a prospective study of all elective orthopaedic patients within an ele...

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Autores principales:	Rongkagorn Chuntamongkol, Rebekah Meen, Sophie Nash, Nicholas E. Ohly, Jon Clarke, Nicholas Holloway
Formato:	article
Lenguaje:	EN
Publicado:	The British Editorial Society of Bone & Joint Surgery 2021
Materias:	covid-19 resumption arthroplasty elective orthopaedics covid-19 infections knee arthroplasty procedures elective orthopaedic surgery anesthesiologists hip and knee arthroplasties infections prospective study joint arthroplasty orthopaedic procedures osteoarthritis Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/9757a4d6644f4c6ca01cd38e88f02144
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spelling	oai:doaj.org-article:9757a4d6644f4c6ca01cd38e88f021442021-12-01T18:44:47ZResuming elective orthopaedic services during the COVID-19 pandemic: our experience2633-146210.1302/2633-1462.211.BJO-2021-0080.R1https://doaj.org/article/9757a4d6644f4c6ca01cd38e88f021442021-11-01T00:00:00Zhttps://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.211.BJO-2021-0080.R1https://doaj.org/toc/2633-1462Aims: The aim of this study was to surveil whether the standard operating procedure created for the NHS Golden Jubilee sufficiently managed COVID-19 risk to allow safe resumption of elective orthopaedic surgery. Methods: This was a prospective study of all elective orthopaedic patients within an elective unit running a green pathway at a COVID-19 light site. Rates of preoperative and 30-day postoperative COVID-19 symptoms or infection were examined for a period of 40 weeks. The unit resumed elective orthopaedic services on 29 June 2020 at a reduced capacity for a limited number of day-case procedures with strict patient selection criteria, increasing to full service on 29 August 2020 with no patient selection criteria. Results: A total of 2,373 cases were planned in the 40-week study period. Surgery was cancelled in 59 cases, six (10.2%) of which were due to having a positive preoperative COVID-19 screening test result. Of the remaining 2,314, 996 (43%) were male and 1,318 (57%) were female. The median age was 67 years (interquartile range 59.2 to 74.6). The median American Society of Anesthesiologists grade was 2. Hip and knee arthroplasties accounted for the majority of the operations (76%). Six patients tested positive for COVID-19 preoperatively (0.25%) and 39 patients were tested for COVID-19 within 30 days after discharge, with only five patients testing positive (0.22%). Conclusion: Through strict application of a COVID-19 green pathway, elective orthopaedic surgery could be safely delivered to a large number of patients with no selection criteria. Cite this article: Bone Jt Open 2021;2(11):951–957.Rongkagorn ChuntamongkolRebekah MeenSophie NashNicholas E. OhlyJon ClarkeNicholas HollowayThe British Editorial Society of Bone & Joint Surgeryarticlecovid-19resumptionarthroplastyelectiveorthopaedicscovid-19 infectionsknee arthroplasty procedureselective orthopaedic surgeryanesthesiologistship and knee arthroplastiesinfectionsprospective studyjoint arthroplastyorthopaedic proceduresosteoarthritisOrthopedic surgeryRD701-811ENBone & Joint Open, Vol 2, Iss 11, Pp 951-957 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	covid-19 resumption arthroplasty elective orthopaedics covid-19 infections knee arthroplasty procedures elective orthopaedic surgery anesthesiologists hip and knee arthroplasties infections prospective study joint arthroplasty orthopaedic procedures osteoarthritis Orthopedic surgery RD701-811
spellingShingle	covid-19 resumption arthroplasty elective orthopaedics covid-19 infections knee arthroplasty procedures elective orthopaedic surgery anesthesiologists hip and knee arthroplasties infections prospective study joint arthroplasty orthopaedic procedures osteoarthritis Orthopedic surgery RD701-811 Rongkagorn Chuntamongkol Rebekah Meen Sophie Nash Nicholas E. Ohly Jon Clarke Nicholas Holloway Resuming elective orthopaedic services during the COVID-19 pandemic: our experience
description	Aims: The aim of this study was to surveil whether the standard operating procedure created for the NHS Golden Jubilee sufficiently managed COVID-19 risk to allow safe resumption of elective orthopaedic surgery. Methods: This was a prospective study of all elective orthopaedic patients within an elective unit running a green pathway at a COVID-19 light site. Rates of preoperative and 30-day postoperative COVID-19 symptoms or infection were examined for a period of 40 weeks. The unit resumed elective orthopaedic services on 29 June 2020 at a reduced capacity for a limited number of day-case procedures with strict patient selection criteria, increasing to full service on 29 August 2020 with no patient selection criteria. Results: A total of 2,373 cases were planned in the 40-week study period. Surgery was cancelled in 59 cases, six (10.2%) of which were due to having a positive preoperative COVID-19 screening test result. Of the remaining 2,314, 996 (43%) were male and 1,318 (57%) were female. The median age was 67 years (interquartile range 59.2 to 74.6). The median American Society of Anesthesiologists grade was 2. Hip and knee arthroplasties accounted for the majority of the operations (76%). Six patients tested positive for COVID-19 preoperatively (0.25%) and 39 patients were tested for COVID-19 within 30 days after discharge, with only five patients testing positive (0.22%). Conclusion: Through strict application of a COVID-19 green pathway, elective orthopaedic surgery could be safely delivered to a large number of patients with no selection criteria. Cite this article: Bone Jt Open 2021;2(11):951–957.
format	article
author	Rongkagorn Chuntamongkol Rebekah Meen Sophie Nash Nicholas E. Ohly Jon Clarke Nicholas Holloway
author_facet	Rongkagorn Chuntamongkol Rebekah Meen Sophie Nash Nicholas E. Ohly Jon Clarke Nicholas Holloway
author_sort	Rongkagorn Chuntamongkol
title	Resuming elective orthopaedic services during the COVID-19 pandemic: our experience
title_short	Resuming elective orthopaedic services during the COVID-19 pandemic: our experience
title_full	Resuming elective orthopaedic services during the COVID-19 pandemic: our experience
title_fullStr	Resuming elective orthopaedic services during the COVID-19 pandemic: our experience
title_full_unstemmed	Resuming elective orthopaedic services during the COVID-19 pandemic: our experience
title_sort	resuming elective orthopaedic services during the covid-19 pandemic: our experience
publisher	The British Editorial Society of Bone & Joint Surgery
publishDate	2021
url	https://doaj.org/article/9757a4d6644f4c6ca01cd38e88f02144
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Resuming elective orthopaedic services during the COVID-19 pandemic: our experience

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