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

Almost 9 months’ value of joint alternative surgical procedure has been missed within the UK—round 160,000 operations—for the reason that begin of the COVID-19 pandemic, a brand new examine led by the College of Bristol has discovered. The analysis means that returning to pre-pandemic ranges won’t deal with the backlog, and even with fast growth, it can take a few years, if not many years, to repair this joint alternative disaster.

The examine, printed in The Bone & Joint Journal at this time, appeared intimately on the impact of the COVID-19 pandemic on the numbers of joint (hip, knee, shoulder, elbow, and ankle) alternative 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 alternative operations.

The examine 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 similar degree as 2019.

The analysis group 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 subsequently 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 value 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, Scientific Analysis Fellow on the Bristol Medical College: Translational Well being Science (THS), and corresponding writer, mentioned, “Sufferers awaiting various kinds of joint alternative surgical procedure in England, Wales, and Northern Eire have been affected disproportionately, and restoration to pre-pandemic ranges might be difficult. This can 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 College: THS, and senior scientific lead for the paper, defined, “If capability was instantly expanded by 5 p.c on high of 2019 ranges, it could take till 2040 to deal with the backlog. An instantaneous ten p.c growth, if potential, would nonetheless take till 2031 to catch up. This represents a extreme problem that’s at present 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 availability and demand and provision of surgical orthopedic companies. There’s a clear have to plan and regulate service volumes based mostly 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 based mostly in opposition to the quantity of circumstances accomplished in 2019, are prone to be an underestimate of the catching-up required as the quantity of circumstances was rising yearly earlier than 2019 fairly than being static.”

Joint alternative surgical procedure is a typical and really efficient surgical process used to deal with a wide range 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.