Summary

The study describes the effect of cancelled elective surgeries during the COVID-19 pandemic on minimum 1-year patient-reported outcomes of hip arthroscopy at a large city hospital

Abstract

Purpose

Beginning in mid-March of 2020, a large city hospital cancelled elective surgeries including hip arthroscopy due to the COVID-19 pandemic, resuming in mid-June of 2020. Currently, little is known about how these cancellations have impacted outcomes of patients undergoing hip arthroscopy. In prior studies, duration of symptoms has been demonstrated to influence clinical outcomes. The current study looks at patient-reported outcomes (PROs) collected from patients who underwent hip arthroscopy for FAI and compares the outcomes to a cohort that underwent hip arthroscopy for FAI in 2019 to determine any differences in outcomes.

Methods

37 patients underwent hip arthroscopy for FAI between Mid-June 2020 to Mid-September 2020. Patients were excluded if they had previous arthroscopy on the same hip. 1-year and 2-year outcomes were prospectively collected, and patients who did not report a minimum-1 year outcome were excluded from the study, leaving a final cohort of 22 patients. Age-and-BMI matches from patients operated in 2019 were retrospectively identified for the 22 patients, and minimum 1-year and 2-year outcomes were obtained from a prospectively-collected database for the matches.

Results

For patients that underwent arthroscopy post-COVID cancellations, the mean mHHS was 90.5, HOS-SS 83.8, and HOS-ADL 91.8. For the matched cohort, the mean mHHS was 86.9, HOS-SS 81.7, and HOS-ADL 93.4. The post-COVID cohort had mean improvements of 36.8 on mHHS, 41.4 on HOS-SS, and 33.8 on HOS-ADL compared to improvements of 33.8, 47.6, and 27.5, respectively for the pre-COVID cohort. Duration from initial visit to date of surgery was an average of 5.2 months in the post-COVID cohort and 3.5 months in the pre-COVID cohort, but the difference was not significant (p = 0.112). In both cohorts, the survivorship of hip arthroscopy was 100% with no revisions or THR. 1 patient from the post-COVID cohort reported heterotopic ossification as a post-operative complication.

Conclusion

There was no significant difference between short-term PROs or survivorship in the post-COVID cohort vs. the pre-COVID cohort, even after normalizing against preoperative scores. Despite patients on average waiting longer for their surgeries post-COVID cancellations, there is little evidence that cancelled elective surgeries resulted in a negative impact on short-term outcomes of hip arthroscopy.