Research Spotlight: Orthopaedic Surgery Volume Trends During the COVID-19 Pandemic and Post-Vaccination Era

Marc Succi, MD, a physician investigator in the Department of Radiology at Massachusetts General Hospital, associate chair of innovation and commercialization at Mass General Brigham Enterprise Radiology and an assistant professor of Radiology at Harvard Medical School, is the lead author of a recently published paper in Journal of Arthroplasty, Orthopaedic Surgery Volume Trends During the COVID-19 Pandemic and Post-Vaccination Era: Implications for Healthcare Planning

 

What Question Were You Investigating?

The goal of this study was to look at how the number of orthopaedic surgeries (such as hip and knee replacements) changed because of the COVID-19 pandemic at a large city hospital.

The aims of this study were to:

1) Quantify the declines in orthopaedic surgery volume during and after the pandemic peak;
2) Characterize surgical volume recovery during the post-vaccination period; 
3) Characterize recovery in the one-year post-vaccine release period

What Methods or Approach Did You Use?

We conducted a retrospective cohort study of 27,476 orthopaedic surgeries from January 2019 to December 2022 at one urban academic quaternary referral center.

We reported trends over the following periods:

• Baseline pre-COVID-19 period (1/6/2019 to 1/4/2020)
• COVID-19 peak (3/15/2020 to 5/16/2020)
• Post-COVID-19 peak (5/17/2020 to 1/2/2021)
• Post-vaccine release (1/3/2021 to 1/1/2022)
• One-year post-vaccine release (1/2/2022 to 12/30/2022)

What Did You Find?

Pre-COVID-19 surgical volume fell by 72% at the COVID-19 peak, especially impacting elective procedures (P < 0.001) and both hip and knee joint arthroplasty (P < 0.001) procedures.

Non-urgent (P = 0.024) and urgent or emergency (P = 0.002) cases also significantly decreased.

Post-peak recovery before the vaccine saw volumes rise to 92% of baseline, which further rose to 96% and 94% in 2021 and 2022, respectively.

While elective procedures surpassed the baseline in 2022, non-urgent and urgent or emergency surgeries remained low.

What Are the Implications?

The COVID-19 pandemic substantially reduced orthopaedic surgical volumes, which have still not fully recovered through 2022, particularly non-elective procedures.

The differential recovery within an orthopaedic surgery program may result in increased morbidity and can serve to inform department-level operational recovery.

About the Massachusetts General Hospital

Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The Mass General Research Institute conducts the largest hospital-based research program in the nation, with annual research operations of more than $1 billion and comprises more than 9,500 researchers working across more than 30 institutes, centers and departments. In July 2022, Mass General was named #8 in the U.S. News & World Report list of "America’s Best Hospitals." MGH is a founding member of the Mass General Brigham healthcare system.