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Unexpected Repercussions of the COVID-19 Pandemic on Total Hip Arthroplasty with Cemented Hip Prosthesis versus
Ahmed Abu-Awwad1,2, Cristina Tudoran2,3,4,5, Jenel Marian Patrascu1,2
1Department XV-Discipline of Orthopedics-Traumatology, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania.
Insights
The COVID-19 pandemic influenced total hip arthroplasty (THA) choices, with cemented hip prostheses (CHP) showing quicker mobilization and shorter hospital stays than cementless hip prostheses (CLHP). Multidisciplinary preoperative evaluation optimizes patient management.
Area of Science:
- Orthopedic Surgery
- Health Economics
- Epidemiology
Background:
- Total hip arthroplasty (THA) is a common procedure for adult hip reconstruction.
- Two main prosthesis types are used: cemented (CHP) and cementless (CLHP).
- The COVID-19 pandemic significantly impacted healthcare delivery and resource allocation.
Purpose of the Study:
- To analyze the impact of the COVID-19 pandemic on the benefit/cost ratio of THA using CHP versus CLHP.
- To compare prosthesis selection and patient outcomes before and during the pandemic.
Main Methods:
- Retrospective analysis of 3955 THA patients (2950 pre-pandemic, 1005 during pandemic).
- Comparison of benefit/cost ratios and clinical outcomes between cemented (CHP) and cementless (CLHP) hip prostheses.
- Data collected from two orthopedic clinics between January 2015 and December 2022.
Main Results:
- Pre-pandemic: CLHP use (54.16%) slightly higher than CHP (45.83%).
- During pandemic: CHP use increased to 52%, CLHP decreased to 48%.
- Hospitalization duration reduced by over 50% for both implant types during the pandemic (p < 0.001).
Conclusions:
- Cemented hip prostheses (CHP) demonstrated quicker mobilization and shorter hospitalization compared to cementless (CLHP).
- The pandemic highlighted the importance of multidisciplinary preoperative evaluation for optimizing patient management and reducing hospital stays.
- Effective patient management strategies, including reduced hospitalization, were successfully implemented during the COVID-19 pandemic.
Abstract:
(1) Background: Total hip arthroplasty (THA) is one of the most common procedures used for adult hip reconstruction, employing mainly two types of prostheses: cemented (CHP) and cementless (CLHP). This study aims to analyze the impact of the COVID-19 pandemic on THA with CHP and CLHP, in terms of the benefit/cost ratio. (2) Methods: This article represents a retrospective analysis of the differences concerning the benefit/cost ratio between THA with the two types of prostheses in 2950 patients admitted for THA in the two orthopedic clinics of our hospital between 1 January 2015-1 March 2020 in comparison with 1005 THA subjects seen between 1 April 2020-31 December 2022. (3) Results: In the first period, THA with CHP was performed in 45.83% of cases, while CLHP was used in 54.16% of patients. During the COVID-19 period, CHP was inserted in 52% of THA patients, while the other 48% had CLHP inserted, with a hospitalization duration reduced by over 50% for both types of implants (p ˂ 0.001). (4) Conclusions: CHP offered good outcomes, with quicker mobilization, and shorter hospitalization duration, compared to CLHP, but optimization of the patients' management can be achieved mainly by reducing the length of hospitalization through an appropriate preoperative patient evaluation through a multidisciplinary approach, an aspect that was proven during the COVID-19 pandemic.
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