The impact of restricted provision of publicly funded elective hip and knee joints replacement during the COVID-19 pandemic in England.
| Title: | The impact of restricted provision of publicly funded elective hip and knee joints replacement during the COVID-19 pandemic in England. |
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| Authors: | Penfold CM; Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, 1st Floor Learning & Research Building, Southmead Hospital, Bristol, United Kingdom.; National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom.; The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom.; Blom AW; Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, 1st Floor Learning & Research Building, Southmead Hospital, Bristol, United Kingdom.; National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom.; Redaniel MT; The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom.; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.; Jones T; The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom.; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.; Eyles E; The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom.; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.; Keen T; North Bristol NHS Trust, Southmead Hospital, Westbury-on-Trym, Bristol, United Kingdom.; Elliott A; North Bristol NHS Trust, Southmead Hospital, Westbury-on-Trym, Bristol, United Kingdom.; Judge A; Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, 1st Floor Learning & Research Building, Southmead Hospital, Bristol, United Kingdom.; National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom. |
| Source: | PloS one [PLoS One] 2023 Nov 29; Vol. 18 (11), pp. e0294304. Date of Electronic Publication: 2023 Nov 29 (Print Publication: 2023). |
| Publication Type: | Journal Article; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: San Francisco, CA : Public Library of Science |
| MeSH Terms: | COVID-19*/epidemiology ; Arthroplasty, Replacement, Hip*; England/epidemiology ; Humans ; Pandemics ; Knee Joint |
| Abstract: | Aims: Elective hip and knee replacement operations were suspended in April 2020 due to the COVID-19 pandemic. The impact of this suspension and continued disruption to the delivery of joint replacement surgery is still emerging. We describe the impact of the pandemic on the provision of publicly funded elective hip and knee replacement surgery at one teaching hospital in England and on which patients had surgery.; Methods: We included all elective primary and revision hip and knee replacements performed at one hospital between January 2016 and June 2021. Using data for the years 2016-2019, we estimated the expected number of operations and beds occupied per month in January 2020 to June 2021 using time series linear models (adjusting for season and trend). We compared the predictions with the real data for January 2020 to June 2021 to assess the impact of the pandemic on the provision of elective hip and knee replacements. We compared the length of stay and characteristics (age, gender, number of comorbidities, index of multiple deprivation) of patients who had surgery before the pandemic with those who had surgery during the pandemic.; Results: We included 6,964 elective primary and revision hip and knee replacements between January 2016 and June 2021. Between January 2020 and June 2021 primary hip replacement volume was 59% of predicted, and 47% for primary knee replacements. Revision hip replacement volume was 77% of predicted, and 42% for revision knee replacement. Median length of stay was one day shorter for primary (4 vs 3 days) and revision (6 vs 5 days) operations during the pandemic compared with before. Patients operated on during the pandemic were younger and had slightly more comorbidities than those operated on before the pandemic.; Conclusions: The restricted provision of elective hip and knee replacements during the COVID-19 pandemic changed the patient casemix, but did not introduce new inequalities in access to these operations. Patients were younger, had more comorbidities, and stayed in hospital for less time than those treated before the pandemic. Approximately half the number of operations were performed during the pandemic than would have been expected and the effect was greatest for revision knee replacements.; (Copyright: © 2023 Penfold et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.) |
| Competing Interests: | I have read the journal’s policy and the authors of this manuscript have the following competing interests: AB (Stryker) has received research and other financial support from companies or suppliers outside the submitted work. AJ declares advisory board positions with receipt of fees (Anthera Pharmaceuticals, INC.) and paid consultancy work (Freshfields Bruckhaus Deringer) for companies outside the submitted work. All other authors declare no competing interests. This does not alter our adherence to PLOS ONE policies on sharing data and materials. |
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| Entry Date(s): | Date Created: 20231129 Date Completed: 20231201 Latest Revision: 20251231 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC10686417 |
| DOI: | 10.1371/journal.pone.0294304 |
| PMID: | 38019830 |
| Database: | MEDLINE |
Journal Article; Research Support, Non-U.S. Gov't