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Effect of COVID-19 pandemic on hip preservation surgery-a prospective surveillance from the UK Non-Arthroplasty Hip Registry.

Published version
Peer-reviewed

Type

Article

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Authors

Bhandari, Farzaan 
Board, Tim 
Andrade, Tony 
McBryde, Callum 

Abstract

A multi-centre, registry-based cohort study was conducted to assess the effect of the coronavirus disease 2019 (COVID-19) pandemic on the provision of non-arthroplasty hip surgery (NAHS) in the UK by (i) comparing the number of NAHS performed during the pandemic to pre-pandemic levels, (ii) prospectively auditing compliance to established guidance and (iii) evaluating post-operative outcomes and their predictors. Patients who underwent NAHS during the pandemic/pre-pandemic were selected from the Non-Arthroplasty Hip Registry, which collects demographic, procedural and pre-operative outcome data. Patients during the pandemic period were emailed separate COVID-19 surveillance questionnaires, which evaluated adherence to guidelines and post-operative outcomes. Fisher's exact tests and logistic regression were used to identify predictors for developing COVID-19 and being re-admitted into hospital, post-surgery. There was a 64% reduction of NAHS performed during the pandemic compared to the pre-pandemic period. Ninety-nine percent of participants self-isolated, and 96.8% received screening, pre-operatively. No participant was COVID-19-positive peri-operatively. Post-operatively, participants had an intensive care unit admission rate of 2%, median hospital stay of 1 day, hospital readmission rate of 4.2%, COVID-19 development rate of 2.3% and a thromboembolic complication rate of 0.32%. No COVID-19-positive patient developed adverse post-operative outcomes. Participants who developed COVID-19 post-operatively had greater odds of having undergone osteotomy in comparison to arthroscopic surgery (P = 0.036, odds ratio = 5.36). NAHS was performed with good compliance to established guidance, and adverse operative outcomes remained low. If guidance is followed, the risk of COVID-19 post-op development is low. Although bigger operations have a slightly higher risk, this does not impact their prognosis.

Description

Keywords

32 Biomedical and Clinical Sciences, 3202 Clinical Sciences, Patient Safety, Infectious Diseases, Coronaviruses, Emerging Infectious Diseases, Clinical Research, Coronaviruses Disparities and At-Risk Populations, Musculoskeletal

Journal Title

J Hip Preserv Surg

Conference Name

Journal ISSN

2054-8397
2054-8397

Volume Title

8

Publisher

Oxford University Press (OUP)