The impact of first and second wave of COVID-19 on knee and hip surgeries in Sweden

Andrea Dell’Isola; Ali Kiadaliri; Aleksandra Turkiewicz; Velocity Hughes; Karin Magnusson; Jos Runhaar; Sita Bierma-Zeinstra; Martin Englund

doi:10.1186/s40634-021-00382-7

The impact of first and second wave of COVID-19 on knee and hip surgeries in Sweden

Andrea Dell’Isola^*, Ali Kiadaliri, Aleksandra Turkiewicz, Velocity Hughes, Karin Magnusson, Jos Runhaar, Sita Bierma-Zeinstra, Martin Englund

^*Corresponding author for this work

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Abstract

Purpose: To investigate the impact of COVID-19 in Sweden on rates of knee and hip surgeries. Methods: We used healthcare data for the population of the southernmost region in Sweden (1.4 million inhabitants). We did an interrupted time-series analysis to estimate changes in rates and trends of joint replacements (JR), arthroscopies, and fracture surgeries for knee or hip in April–December 2020 compared to pre-COVID-19 levels adjusting for seasonal variations. Results: We found a drop of 54% (95% CI 42%; 68%) and 42% (95% CI 32%; 52%), respectively, in the rate of JRs and arthroscopies in April 2020 when compared to the counterfactual scenario. This was followed by an increase that brought the rates of JRs and arthroscopies back to their predicted levels also during the beginning of the second wave (November–December 2020). Acute fracture surgeries were largely unaffected, i.e. did not show any decrease as observed for the other surgeries. Conclusions: In southern Sweden, we observed a marked decrease in elective knee and hip surgeries following the first wave of Covid-19. The rates remained close to normal during the beginning of the second wave suggesting that important elective surgeries for patients with end-stage osteoarthritis can still be offered despite an ongoing pandemic provided adequate routines and hospital resources.

Original language	English
Article number	60
Journal	Journal of Experimental Orthopaedics
Volume	8
Issue number	1
DOIs	https://doi.org/10.1186/s40634-021-00382-7
Publication status	Published - Dec 2021

Bibliographical note

Funding Information:
We would like to acknowledge the funding support from the Swedish Research Council, the Foundation for Research in Rheumatology (FOREUM), the Österlund Foundation, Governmental Funding of Clinical Research within National Health Service (ALF), the Greta and Johan Kock Foundation, The Royal Physiographic Society in Lund and the Swedish Rheumatism Association, during the conduct of the study. The funding sources had no role in the design of the study and interpretation of the results.

Publisher Copyright:
© 2021, The Author(s).

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10.1186/s40634-021-00382-7

s40634-021-00382-7Final published version, 1.02 MBLicence: CC BY

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title = "The impact of first and second wave of COVID-19 on knee and hip surgeries in Sweden",

abstract = "Purpose: To investigate the impact of COVID-19 in Sweden on rates of knee and hip surgeries. Methods: We used healthcare data for the population of the southernmost region in Sweden (1.4 million inhabitants). We did an interrupted time-series analysis to estimate changes in rates and trends of joint replacements (JR), arthroscopies, and fracture surgeries for knee or hip in April–December 2020 compared to pre-COVID-19 levels adjusting for seasonal variations. Results: We found a drop of 54% (95% CI 42%; 68%) and 42% (95% CI 32%; 52%), respectively, in the rate of JRs and arthroscopies in April 2020 when compared to the counterfactual scenario. This was followed by an increase that brought the rates of JRs and arthroscopies back to their predicted levels also during the beginning of the second wave (November–December 2020). Acute fracture surgeries were largely unaffected, i.e. did not show any decrease as observed for the other surgeries. Conclusions: In southern Sweden, we observed a marked decrease in elective knee and hip surgeries following the first wave of Covid-19. The rates remained close to normal during the beginning of the second wave suggesting that important elective surgeries for patients with end-stage osteoarthritis can still be offered despite an ongoing pandemic provided adequate routines and hospital resources.",

author = "Andrea Dell{\textquoteright}Isola and Ali Kiadaliri and Aleksandra Turkiewicz and Velocity Hughes and Karin Magnusson and Jos Runhaar and Sita Bierma-Zeinstra and Martin Englund",

note = "Funding Information: We would like to acknowledge the funding support from the Swedish Research Council, the Foundation for Research in Rheumatology (FOREUM), the {\"O}sterlund Foundation, Governmental Funding of Clinical Research within National Health Service (ALF), the Greta and Johan Kock Foundation, The Royal Physiographic Society in Lund and the Swedish Rheumatism Association, during the conduct of the study. The funding sources had no role in the design of the study and interpretation of the results. Publisher Copyright: {\textcopyright} 2021, The Author(s).",

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AU - Dell’Isola, Andrea

AU - Kiadaliri, Ali

AU - Turkiewicz, Aleksandra

AU - Hughes, Velocity

AU - Magnusson, Karin

AU - Runhaar, Jos

AU - Bierma-Zeinstra, Sita

AU - Englund, Martin

N1 - Funding Information: We would like to acknowledge the funding support from the Swedish Research Council, the Foundation for Research in Rheumatology (FOREUM), the Österlund Foundation, Governmental Funding of Clinical Research within National Health Service (ALF), the Greta and Johan Kock Foundation, The Royal Physiographic Society in Lund and the Swedish Rheumatism Association, during the conduct of the study. The funding sources had no role in the design of the study and interpretation of the results. Publisher Copyright: © 2021, The Author(s).

PY - 2021/12

Y1 - 2021/12

N2 - Purpose: To investigate the impact of COVID-19 in Sweden on rates of knee and hip surgeries. Methods: We used healthcare data for the population of the southernmost region in Sweden (1.4 million inhabitants). We did an interrupted time-series analysis to estimate changes in rates and trends of joint replacements (JR), arthroscopies, and fracture surgeries for knee or hip in April–December 2020 compared to pre-COVID-19 levels adjusting for seasonal variations. Results: We found a drop of 54% (95% CI 42%; 68%) and 42% (95% CI 32%; 52%), respectively, in the rate of JRs and arthroscopies in April 2020 when compared to the counterfactual scenario. This was followed by an increase that brought the rates of JRs and arthroscopies back to their predicted levels also during the beginning of the second wave (November–December 2020). Acute fracture surgeries were largely unaffected, i.e. did not show any decrease as observed for the other surgeries. Conclusions: In southern Sweden, we observed a marked decrease in elective knee and hip surgeries following the first wave of Covid-19. The rates remained close to normal during the beginning of the second wave suggesting that important elective surgeries for patients with end-stage osteoarthritis can still be offered despite an ongoing pandemic provided adequate routines and hospital resources.

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The impact of first and second wave of COVID-19 on knee and hip surgeries in Sweden

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