Evidence-based Risk Stratification for Sport Medicine Procedures During the COVID-19 Pandemic
Betina B Hinckel1, Charles A Baumann, Leandro Ejnisman
1From the Oakland University, Rochester (Dr. Hinckel, and Dr. Cavinatto); Department of Orthopaedic Surgery, William Beaumont Hospital, Royal Oak (Dr. Hinckel, Dr. Cavinatto), MI; the University of Missouri-School of Medicine, Columbia, MO (Mr. Baumann); the Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, BR (Dr. Ejnisman); the Shoulder and Elbow Surgery, Beaumont Orthopaedic Associates, Beaumont Health (Dr. Martusiewicz); the Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA (Dr. Tanaka); the Department of Orthopedic Surgery, TRIA Orthopedic Center, University of Minnesota, Gillette Children's Specialty Healthcare, MN (Dr. Tompkins); the Department of Orthopedic Surgery, Stanford University, CA (Dr. Sherman); the Rush University Medical Center, Chicago, IL (Dr. Chahla); the Division of Sports Medicine and Shoulder Surgery, Department of Orthopedics, Aurora, CO (Dr. Frank); the Department of Orthopaedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA (Dr. Yamamoto); CEGH-CEL, Instituto de Biociências, Universidade de São Paulo (Dr. Yamamoto); DASA Laboratories, Sao Paulo, Brazil (Dr. Yamamoto); the Michigan Orthopedic Surgeons, Fellowship Director William Beaumont Sports Medicine Fellowship, Assistant Professor Oakland University William Beaumont School of Medicine, MI (Dr. Bicos); the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN (Dr. Arendt); the Southern California Permanente Medical Group and Torrey Pines Orthopaedic Medical Group, San Diego, CA (Dr. Fithian); and the Knee Preservation, Cartilage Regeneration and OrthoBiologics, Department of Orthopedic Surgery, Indiana University School of Medicine, OrthoIndy and OrthoIndy Hospital, Greenwood and Indianapolis, IN (Dr. Farr).
The COVID-19 pandemic impacted orthopaedic surgery scheduling. A new framework helps prioritize sports medicine procedures by assessing patient, institutional, and regional risks for better decision-making.
Area of Science:
- Orthopaedic Surgery
- Sports Medicine
- Public Health
Background:
- The COVID-19 pandemic significantly disrupted orthopaedic practices globally.
- Defining surgical urgency solely by elective status is insufficient during the pandemic.
- COVID-19 presents unique risks that must be integrated into surgical decision-making.
Purpose of the Study:
- To develop a framework for prioritizing orthopaedic sports medicine procedures during the COVID-19 pandemic.
- To aid in the risk-benefit assessment for surgical timing and setting.
- To provide an evidence-based approach to clinical urgency stratification.
Main Methods:
- Utilized an evidence-based risk stratification approach.
- Incorporated disease-dependent, disease-independent, and logistical factors.
- Tailored the framework to individual patients, institutions, and regions.
Main Results:
- A comprehensive framework for prioritizing orthopaedic sports medicine procedures was established.
- The framework facilitates a nuanced assessment of surgical urgency.
- It aids in balancing surgical necessity against pandemic-related risks.
Conclusions:
- The proposed framework supports informed decision-making for orthopaedic sports medicine procedures amidst the pandemic.
- It allows for a personalized risk-benefit analysis considering multiple factors.
- This approach enhances patient safety and optimizes resource allocation during public health crises.
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