Around 160,000 UK joint replacement surgeries missed during COVID-19 pandemic, study finds

Practically 9 months’ price of joint substitute surgical procedure has been missed within the UK—round 160,000 operations—because the begin of the COVID-19 pandemic, a brand new research led by the College of Bristol has discovered. The analysis means that returning to pre-pandemic ranges won’t sort out the backlog, and even with fast enlargement, it can take a few years, if not many years, to repair this joint substitute disaster.

The research, revealed in The Bone & Joint Journal at present, appeared intimately on the impact of the COVID-19 pandemic on the numbers of joint (hip, knee, shoulder, elbow, and ankle) substitute surgical procedure carried out in England, Wales, and Northern Eire.

The researchers analyzed Nationwide Joint Registry (NJR) information between January 2019 and December 2022 inclusive, which incorporates all NHS and privately-funded hip, knee, shoulder, elbow, and ankle substitute operations.

The research in contrast the interval together with and after the pandemic (2020 to 2022 inclusive) to what number of operations would have been carried out had surgical procedure continued on the identical stage as 2019.

The analysis staff discovered that by the top of 2022, nearly three-quarters of a yr of deliberate operations—71.6% of 2019 exercise and 158,994 joint replacements—had been misplaced. This hole continues to extend and due to this fact the restoration from this deficit doesn’t seem to have began. Knee, shoulder, and ankle surgical procedure has been affected extra severely than hip and elbow surgical procedure.

The NHS has been extra impacted than the personal sector. By 2022, NHS exercise was nonetheless solely 73.2% of 2019 ranges, whereas operations within the personal sector had elevated to 126.8% of 2019 ranges. The personal sector is now the primary supplier of joint replacements (53% in 2022) in England, Wales, and Northern Eire.

Wales and Northern Eire have been worse affected than England. Each international locations recorded a backlog of greater than a yr’s price of operations between 2020-2022; 136% in 2019 for Wales and 121.3% for Northern Eire, whereas the deficit in England was 66.7%.

Jonathan French, Medical Analysis Fellow on the Bristol Medical Faculty: Translational Well being Science (THS), and corresponding creator, mentioned, “Sufferers awaiting various kinds of joint substitute surgical procedure in England, Wales, and Northern Eire have been affected disproportionately, and restoration to pre-pandemic ranges might be difficult. It will inevitably result in many sufferers enduring pointless ache, incapacity and wider decline in psychological and bodily well-being.”

Michael Whitehouse, Professor of Trauma and Orthopaedics on the Bristol Medical Faculty: THS, and senior scientific lead for the paper, defined, “If capability was instantly expanded by 5 p.c on prime of 2019 ranges, it could take till 2040 to handle the backlog. A direct ten p.c enlargement, if doable, would nonetheless take till 2031 to catch up. This represents a extreme problem that’s at the moment underestimated in planning and provision that requires prioritization to mitigate the affect of debilitating joint associated circumstances on sufferers.”

Tim Wilton, Medical Director of the NJR, added, “The worth of the quantity information held by the NJR is that we are able to glean an correct perception into the longer-term affect of COVID on the provision and demand and provision of surgical orthopedic providers. There’s a clear have to plan and regulate service volumes primarily based on this perception and analysis, in order that affected person ready listing numbers begin to cut back throughout the completely different joints. These information, being primarily based in opposition to the quantity of instances achieved in 2019, are more likely to be an underestimate of the catching-up required as the quantity of instances was rising yearly earlier than 2019 reasonably than being static.”

Joint substitute surgical procedure is a standard and really efficient surgical process used to deal with quite a lot of musculoskeletal issues together with osteoarthritis and acute trauma. Joint replacements are long-lasting, with over half of hip and knee replacements lasting over 25 years, and 90% of shoulder replacements lasting over ten years.