The impact of COVID-19 in total hip arthroplasty: a comparison study in a center without elective surgery protocols

Abstract

Background: The COVID-19 pandemic has affected elective surgeries, including Total Hip Arthroplasty (THA). This study compared THA outcomes before and after the COVID-19 outbreak in a center without a specific COVID-19 protocol for elective surgeries. Methods: This cross-sectional study included a total of 304 THA surgeries. The study period was divided into pre-COVID-19 outbreak (April 21, 2017 to April 21, 2019) and post-COVID-19 outbreak (April 21, 2020 to April 21, 2022) groups. Demographic characteristics, etiology of operations, anesthesia time, pre-operation length of stay (LOS), post-operation LOS, comorbidities, mortality, complications, and transfusion needs were compared between the two periods. Results: Patients during the COVID-19 pandemic were significantly younger (mean = 49.2 ± 16.3 vs. 53.7 ± 17.1 years) (P-value = 0.02). The most common indication for THA in both periods was trauma, but there was a significant difference in the distribution of etiologies between the two periods (P-value = 0.01). Pre-operative LOS was significantly longer during the COVID-19 pandemic (mean = 2.75 ± 1.69 days) compared to the pre-pandemic period (mean = 2.28 ± 1.5 days) (P-value = 0.01). However, there was no significant difference in post-operative LOS or total LOS. There were no significant differences in comorbidities between the two periods. In-hospital mortality was low in both periods, with no significant difference. Complications and transfusion needs did not show any significant differences. Conclusions: COVID-19 pandemic led to younger THA patients, changes in etiologies, longer pre-operative LOS, but no difference in mortality, complications, anesthesia time or transfusion needs. Further research is needed to better understand the impact of the pandemic on elective orthopedic surgeries.