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Early outcomes of patients undergoing total hip arthroplasty for trauma during COVID-19
Adam C S Stoneham1, Michael Apostolides1, Philippa M Bennett2
1Queen Alexandra Hospital, Portsmouth, UK.
Insights
Total hip arthroplasty (THA) for trauma during the COVID-19 pandemic showed a low risk of SARS-CoV-2 infection. Patients undergoing THA for trauma experienced no significant COVID-19 related complications or mortality.
Area of Science:
- Orthopedic Surgery
- Infectious Disease Epidemiology
- Public Health
Background:
- The COVID-19 pandemic created uncertainty regarding the safety of surgical procedures, including total hip arthroplasty (THA).
- Limited data exists on the risks associated with trauma-related THA during peak pandemic periods.
Purpose of the Study:
- To assess the incidence of SARS-CoV-2 infection in patients undergoing THA for trauma during the COVID-19 pandemic.
- To evaluate the need for intensive care unit (ICU) treatment and complication rates, including mortality, in this patient cohort.
Main Methods:
- A retrospective analysis of patients undergoing primary THA for trauma was conducted.
- Data was collected from four UK regional hospitals between March 1 and June 1, 2020, coinciding with the pandemic's peak.
Main Results:
- One out of 48 patients (2%) contracted COVID-19 during their hospital admission.
- No patients required ICU treatment for COVID-19; two patients needed ICU for unrelated medical issues.
- Complication rates were comparable to expected levels, with no mortalities observed.
Conclusions:
- Trauma-related THA during the COVID-19 pandemic was associated with a low incidence of SARS-CoV-2 infection.
- These findings suggest that THA for trauma may serve as a potential, albeit imperfect, surrogate for understanding risks associated with elective arthroplasty during pandemics.
- Further evidence is needed to guide the resumption of elective joint arthroplasties post-pandemic.
Aims:
This study aimed to identify patients receiving total hip arthroplasty (THA) for trauma during the peak of the COVID-19 pandemic in the UK and quantify the risks of contracting SARS-CoV-2 virus, the proportion of patients requiring treatment in an intensive care unit (ICU), and rate of complications including mortality.
Methods:
All patients receiving a primary THA for trauma in four regional hospitals were identified for analysis during the period 1 March to 1 June 2020, which covered the current peak of the COVID-19 pandemic in the UK.
Results:
Overall, one of 48 patients (2%) contracted COVID-19 during their admission. Although they required a protracted stay in hospital, they did not require ICU treatment. Two patients did require ICU support for medical problems but not relating to COVID-19. Complications were no greater than expected given the short follow-up. There were no mortalities.
Conclusion:
There is a paucity of evidence to guide restarting elective joint arthroplasties following the COVID-19 pandemic. Although THAs for trauma are by no means a perfect surrogate, the results of this study show a low incidence of contracting COVID-19 virus during admission and no significant sequalae during this period.Cite this article: Bone Joint Open 2020;1-7:438-442.
