How COVID-19 Changed Orthopaedic Surgery

The COVID-19 pandemic has left no corner of our lives untouched, and the world of healthcare has been particularly affected. When the World Health Organization declared the pandemic in March 2020, hospitals around the globe had to adapt quickly. The focus shifted to tackling the virus, which meant that many regular healthcare services, including surgeries, took a backseat. Hospitals had to shuffle their resources like a game of musical chairs, leading to a significant impact on surgical services, especially orthopaedic care.

#What Happened to Surgeries?

During the pandemic, many Elective Surgeries—which are procedures that can be scheduled in advance—were delayed or even canceled. The aim was to keep hospital beds available for COVID-19 patients. Emergency surgeries, on the other hand, continued but faced their own set of challenges. Limited operating rooms and revised patient care protocols meant that doctors and nurses had to think on their feet. If you’ve ever tried to cook a three-course meal in a cramped kitchen, you might know a bit about what these medical professionals were up against!

#Elective Surgeries: The Casualties of COVID

Elective surgeries make up a significant portion of orthopaedic procedures, accounting for as much as two-thirds of all surgeries in many hospitals. This was particularly true in hospitals that aren’t specialized trauma centers. Because of the pandemic, many of these elective surgeries were put on hold, leading to a stunning decrease in the number of operations performed. In some high-income countries, elective surgeries saw a drop of around 50% to 70%. That’s a lot of patients left waiting with painful joints or other issues, twiddling their thumbs—perhaps even learning new hobbies to pass the time!

Emergency surgeries were a mixed bag. For some, the number of trauma cases went down due to lockdowns that prevented accidents, while for others, the moment restrictions eased, there was a surge in cases as people returned to their normal routines. It’s as if the universe had a secret plan to ensure there would be more injuries once everyone was allowed out again. Who knew that staying home could lead to such a dramatic rise in backyard trampoline accidents?

#The Lesser-Known Stories from Low and Middle-Income Countries

While many studies focused on high-income nations, not much was said about how the pandemic affected orthopaedic surgeries in low and middle-income countries (LMICs). These regions often face unique challenges, and understanding how they adapted during this crisis is important for future planning. Despite being less affected in terms of illness rates, many regions in sub-Saharan Africa saw socio-economic disruptions, impacting healthcare access and surgical volumes.

For instance, hospitals in Kenya developed guidelines to help manage surgical care during the pandemic, aiming to keep patients safe while optimizing resources. It was like trying to juggle four balls while riding a unicycle—exciting, but not without a few near-misses!

#Researching the Impact

To really understand how the pandemic shaped orthopaedic surgery, a study was conducted at a major hospital in Nairobi, Kenya. Researchers aimed to look at the number of orthopaedic surgeries performed before, during, and after the pandemic. The focus was on the third quarter of each year, specifically July to September 2019, 2020, and 2022.

Using electronic health records, the investigators explored the types of procedures performed, classifying them as elective or emergency surgeries. They wanted to see how the patient numbers changed and what that meant for healthcare delivery.

#The Findings: A Rollercoaster of Surgical Activity

The results were quite enlightening. Before the pandemic, 120 surgical cases were performed. During the pandemic, that number dropped to 110, and then climbed to 131 in the following year. Some elective procedures, such as joint replacements and arthroscopies, experienced a significant decline, while spinal surgeries showed an unexpected jump in the number performed.

In terms of emergency trauma surgeries, there were notable changes. Fracture fixations and manipulations saw a decrease during the pandemic. Yet, procedures involving K-wires, particularly for children, shot up dramatically. It seems that kids at home decided to find new ways to test their limits, leading to a rise in fractures. Meanwhile, some parents could finally put that first-aid kit they received as a baby shower gift to good use!

#The Economic Influence

Interestingly, the cost of healthcare played a significant role in patient behavior during the pandemic. In private hospitals, more people sought affordable solutions, which may explain the rise in certain surgeries. Patients may have been timing their elective surgeries based on their financial situations, which is a lesson in both economics and human nature. After all, who hasn’t waited for a sale to grab those must-have shoes?

By 2022, most surgical numbers returned to what they were before COVID-19, with only arthroscopy remaining lower than normal. This suggests that many people who postponed surgeries during the pandemic finally made their way back to the operating room. Perhaps they had all developed an appreciation for knee surgery during their time at home.

#A Mixed Bag for Trauma

When it came to trauma surgeries, the figures told a different story. While the overall number of trauma surgeries decreased during the lockdown due to restrictions on movement, this trend didn’t carry over into pediatric cases. Reports of increased injuries among children during the pandemic were confirmed in this study. It became apparent that kids, deprived of their usual activities, found new ways to get into trouble.

And as restrictions eased, it looks like people were ready to resume their old hobbies—sometimes a little too enthusiastically. The increase in sports and outdoor activities likely contributed to an uptick in injuries once the lockdowns were lifted.

#The Bigger Picture

The pandemic forced a spotlight on healthcare systems everywhere. Resources became a focal point, and missed appointments, delayed surgeries, and canceled procedures showed just how vulnerable these systems can be. The emphasis on emergency surgeries and cancer care meant that many non-urgent procedures faced postponement.

This crisis has indicated a need for healthcare systems to be adaptable. The increased reliance on technology, such as telehealth services, also emerged as a silver lining, making it easier for patients to consult with doctors from the comfort of their homes.

#Limitations and Future Directions

While this study provides valuable insights, it also has limitations. Seasonal variations and changes in healthcare personnel during the study period could affect the findings. The focus on a single hospital means that more research across multiple facilities is needed to truly assess the lasting impacts of the pandemic.

In conclusion, the COVID-19 pandemic has dramatically reshaped the landscape of orthopaedic surgery. While some procedures fell dramatically, others like K-wire fixations for children skyrocketed. The pandemic serves as a reminder that while the world of medicine can be unpredictable, it's essential to remain flexible and innovative in the face of challenges. So, next time you see an empty waiting room, remember that it might just be a temporary pause in the whirlwind of healthcare!