Orthopaedic Surgery Volume Trends During the COVID-19 Pandemic and Post-Vaccination Era: Implications for Healthcare Planning.

Publication date: Mar 19, 2024

The Coronavirus Disease 2019 (COVID-19) pandemic decreased surgical volumes, but prior studies have not investigated recovery through 2022, or analyzed specific procedures or cases of urgency within orthopaedic surgery. 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; and 3) characterize recovery in the 1-year post-vaccine release period. 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), and 1-year post-vaccine release (1/2/2022 to 12/30/2022). Comparisons were performed with two sample t-tests. 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. 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.

Concepts Keywords
Coronavirus COVID-19 Pandemic
December COVID-19 Recovery
Surgery Orthopaedic Surgery Trends
Orthopaedic Surgery Volumes
Volume Trends


Type Source Name
disease VO volume
disease MESH COVID-19 Pandemic
disease VO vaccination
disease VO vaccine
pathway REACTOME Release
disease MESH emergency
disease MESH morbidity

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