COVID-19 Disruption Of Knee Arthroscopies

The purpose of this study was to examine the proportion of patients who returned for their previously scheduled knee arthroscopy procedure following state-mandated cancellation of elective procedures during COVID-19 lockdown.

We reviewed a retrospective cohort of patients who had planned knee arthroscopies, excluding ligament reconstruction and irrigation/ debridement, cancelled for a date between March and June 2020. The cohort was evaluated for scheduling outcome, returned versus did not return for surgery, before March 2022. Cancellation and reschedule dates, reason for not returning for surgery, patient demographics, and planned surgical characteristics were collected. Characteristics between patients who returned versus did not return were compared using statistical tests of independence.

The cohort consisted of 66 patients; 53 (80%) rescheduled and 13 (20%) did not return. For those who rescheduled, the average time between cancellation and surgery was 115 days (sd=16 days). There were various reasons for not rescheduling surgery: eight (62%) had symptom alleviation; two (15%) had logistical barriers; three (23%) were lost to follow-up. Obesity status had a trend towards significance with lower proportion of rescheduled procedures for non-obese patients (68%) compared to obese patients (89%, p=0.057).

Our study highlights a natural experiment in forced delay of elective knee arthroscopies, which may be a surrogate for conservative management. The proportion of patients who did not return for a scheduled knee arthroscopy surgery (20%) is higher than what has been reported previously (11%) and 62% of these patients found symptom relief. However, 80% of the cohort did return for knee arthroscopy in within two years, suggesting delaying surgery will not alleviate symptoms for the majority of patients. Level of Evidence: IV.