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. 2021 Aug:10:27-34.
doi: 10.1016/j.artd.2021.05.013. Epub 2021 May 28.

Pain and Anxiety due to the COVID-19 Pandemic: A Survey of Patients With Delayed Elective Hip and Knee Arthroplasty

Nick R Johnson  1   2 , Susan Odum  3   2 , James D Lastra  3 , Keith A Fehring  4 , Bryan D Springer  2   4 , Jesse E Otero  2   4
Affiliations

Pain and Anxiety due to the COVID-19 Pandemic: A Survey of Patients With Delayed Elective Hip and Knee Arthroplasty

Nick R Johnson et al. Arthroplast Today. 2021 Aug.

Abstract

Background: The COVID-19 pandemic led to cancelation of all elective surgeries for a time period in the vast majority of the United States. We compiled a questionnaire to determine the physical and mental toll of this delay on elective total joint arthroplasty patients.

Methods: All patients whose primary or revision total hip or knee arthroplasty was canceled because of the COVID-19 pandemic at a large academic-private practice were identified. An 11-question survey was administered to these patients via email. All data were deidentified and stored in a REDCAP database.

Results: Of 367 total patients identified, 113 responded to the survey. Seventy-seven percent of patients had their surgery postponed at least 5 weeks, and 20% were delayed longer than 12 weeks. Forty-one percent of patients reported an average visual analog scale pain score greater than 7.5. Forty percent of respondents experienced increased anxiety during the delay. Thirty-four percent of patients felt their surgery was not elective. Sixteen percent experienced a fall during the delay, and 1 patient sustained a hip fracture. Level of pain reported was significantly associated with negative emotions, negative effects of delay, and whether patients felt their surgery was indeed elective. Seventy-six percent reported trust in their surgeon's judgment regarding appropriate timing of surgery. Communication was listed as the number one way in which patients felt their surgeon could have improved during this time.

Conclusion: Surgical delay due to the COVID-19 pandemic resulted in increased pain and anxiety for many total joint arthroplasty patients. While most patients maintained trust in their surgeon during the delay, methods to improve communication may benefit the patient experience in future delays.

Level of evidence: Level II.

Keywords: COVID-19; Delay; Elective arthroplasty; Pain; Patient reported outcomes.

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Figures

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Figure 1
COVID-19 patient questionnaire.
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Figure 1
COVID-19 patient questionnaire.
Figure 1
Figure 1
COVID-19 patient questionnaire.
Figure 1
Figure 1
COVID-19 patient questionnaire.
See this image and copyright information in PMC

References

    1. Guy D.K., Bosco J.A. AAOS; 2020. AAOS guidelines for elective surgery during the COVID-19 pandemic.https://www.aaos.org/about/covid-19-information-for-our-members/aaos-gui... Available at: [accessed 23.02.21]
    1. Bedard N.A., Elkins J.M., Brown T.S. Effect of COVID-19 on hip and knee arthroplasty surgical volume in the United States. J Arthroplasty. 2020;35(7):S45. - PMC - PubMed
    1. Parvizi J., Gehrke T., Krueger C.A. Resuming elective orthopaedic surgery during the COVID-19 pandemic: guidelines developed by the international consensus group (ICM) J Bone Joint Surg Am. 2020;102(14):1205. - PMC - PubMed
    1. Bachmeier C.J.M., March L.M., Cross M.J. A comparison of outcomes in osteoarthritis patients undergoing total hip and knee replacement surgery. Osteoarthr Cartil. 2001;9(2):137. - PubMed
    1. Harris W.H., Sledge C.B. Total hip and total knee replacement. N Engl J Med. 1990;323(12):801. - PubMed