Early Postoperative Complications in Total Hip and Knee Arthroplasties Before and During the COVID-19 Pandemic: A Retrospective Analysis of 38,234 Patients

Daniel Badin, MD; Carlos D. Ortiz-Babilonia, BS; Andrew B. Harris, MD; Micheal Raad, MD; Julius K. Oni, MD

Arthroplasty Today (Dec 2022)

Early Postoperative Complications in Total Hip and Knee Arthroplasties Before and During the COVID-19 Pandemic: A Retrospective Analysis of 38,234 Patients

Daniel Badin, MD,
Carlos D. Ortiz-Babilonia, BS,
Andrew B. Harris, MD,
Micheal Raad, MD,
Julius K. Oni, MD

Affiliations

Daniel Badin, MD: Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA
Carlos D. Ortiz-Babilonia, BS: Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA
Andrew B. Harris, MD: Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA
Micheal Raad, MD: Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA
Julius K. Oni, MD: Corresponding author. Department of Orthopaedic Surgery, The Johns Hopkins University, 4940 Eastern Avenue, Baltimore, MD 21224, USA. Tel.: +1 443 400 9979.; Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA

Journal volume & issue: Vol. 18
pp. 24 – 30

Abstract

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Background: The outcomes of total joint arthroplasty during the coronavirus disease 2019 (COVID-19) pandemic are unknown. We sought to compare early postoperative complications in total hip arthroplasty (THA) and total knee arthroplasty (TKA) prior to and during the COVID-19 pandemic. Methods: Patients in the American College of Surgeons National Surgical Quality Improvement Program database who had THA or TKA in the latter halves (July to December) of 2019 and 2020 were identified. Patients were divided into pre-COVID-19 (2019) and during-COVID-19 (2020) cohorts. Propensity score matching and logistic regression were used to detect correlations between operative period and outcomes. Statistical significance was set at α = 0.05. Results: A total of 38,234 THA and 61,956 TKA patients were included. There was a significantly higher rate of outpatient procedures in 2020 than that in 2019 for both THA (41.68% vs 6.59%, P 1 day (THA: odds ratio [OR] 0.889; P < .001) (TKA: OR 0.644; P < .001) and nonhome discharge (THA: 0.655; P < .001) (TKA: 0.497; P < .001). There was also increased odds of superficial surgical site infection in THA (OR 1.272; P = .040) and myocardial infarction in TKA patients (OR 1.488; P = .042) in 2020 compared to those in 2019. There was no difference in the 15 other outcomes assessed. Conclusions: Total joint arthroplasty surgery remains safe despite the COVID-19 pandemic. A statistically significant increase was detected in superficial surgical site infection and myocardial infarction risk during 2020 compared to 2019; however, the clinical significance of this is questionable. A shift away from inpatient stay was also present, possibly reflecting efforts to minimize nosocomial exposure to COVID-19.

Published in Arthroplasty Today

ISSN: 2352-3441 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery: Orthopedic surgery
Website: https://www.journals.elsevier.com/arthroplasty-today/

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Abstract

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