The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

The Persistent Backlog of Knee and Shoulder Orthopedic Sport Surgery Case Volume Following the COVID-19 Pandemic

Document Type : RESEARCH PAPER

Authors
Uzoma Ahiarakwe 1
Amil R. Agarwal 1
Yang Chi-Ya 1
Zachary C. Pearson 1
Miriam Weisberg 2
Umasuthan Srikuaran 1
Matthew J. Best 1
1 Johns Hopkins University School of Medicine, Department of Orthopaedic Surgery, Columbia
2 Johns Hopkins University School of Medicine, Department of Orthopaedic Surgery, Columbia oor
10.22038/abjs.2023.71724.3348
Abstract
Objectives: As COVID-19 will not be the last pandemic, understanding our historical response allows
us to predict and improve our current practices in preparation for the next pandemic. Following the
removal of the elective surgery suspension at the onset of the COVID-19 pandemic, it is unclear whether
sports medicine surgery volume has returned to pre-pandemic levels as well as whether the backlog
from the original suspension was addressed. The purpose of this study to observe the monthly changes
in volume and backlog of knee and shoulder sports surgery one year since the original suspension.
Methods: National all-payer data was utilized to identify patients undergoing knee and shoulder sports procedures
from January 2017 to April 2021. Descriptive analysis was utilized to report the monthly changes in surgeries. A
linear forecast analysis using historical data was utilized to determine the expected volume. This was compared to
the observed case volume. The difference in expected and observed volume was utilized to calculate the estimated
change in backlog.
Results: From March to May 2020, there was a persistent decrease in the observed shoulder and knee sports
volume when compared to the expected volume. By June 2020, all knee and shoulder sports volume reached the
expected volume. By April 2021, the estimated backlog for shoulder and knee procedures had increased by 49.8%
(26,412 total cases) and 19.0% (26,412 total cases), respectively, with respect to the original calculated backlog
from March to May 2020.
Conclusion: Within four months, the sudden decrease in volume for knee and shoulder sports procedures had
returned to pre-pandemic levels; however, the original backlog in cases has continually increased one year following
the suspension. Additionally, the backlog is significantly higher for knee when compared to shoulder surgeries.
 Level of evidence: IV
Keywords
COVID-19
Knee surgery
Shoulder surgery
Sports medicine
Surgical volume
Subjects
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The Archives of Bone and Joint Surgery
Volume 11, Issue 12
December 2023
Pages 738-751

  • Receive Date 01 May 2023
  • Accept Date 28 October 2023