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June 07, 2022
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COVID-19 disruptions to postoperative care did not greatly affect elective TKA results

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Results showed disruptions to elective surgery and postoperative care due to the onset of the COVID-19 pandemic in March of 2020 did not adversely affect patient-reported outcomes or complications after elective total knee arthroplasty.

Researchers from the department of orthopedic surgery at Hospital for Special Surgery compared outcomes of 624 patients who underwent primary unilateral TKA and were discharged home between Jan. 1, 2020, and March 15, 2020, and a control group of 558 patients who were discharged home between Jan. 1, 2019, and March 15, 2019. According to the study, outcome measures included 90-day complication rates, 120-day rate of manipulation under anesthesia (MUA) and 1-year patient-reported outcome measures (PROMs).

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“Our findings suggest that reduced post-discharge care access and an increased reliance on telehealth did not result in significantly inferior outcomes among TKA patients.” Data were derived from Ong CB, et al. Arch Orthop Trauma Surg. 2022;doi:10.1007/s00402-022-04422-4.

Researchers noted several differences in postoperative care between the 2020 cohort and the 2019 cohort. Specifically, the 2020 cohort reported less access to physical therapy and care after hospital discharge. These patients also reported fewer prescribed physical therapy sessions after hospital discharge and increased telehealth utilization.

Overall, 90-day complications rates were lower in the 2020 cohort (3.5%) compared with the 2019 cohort (5.9%). According to the study, PROMs and 120-day rates of MUA were similar between the cohorts. Additionally, lower extremity activity scale scores and Veterans RAND 12-Item Health Survey mental scores were “marginally inferior” in the 2020 cohort, the researchers noted.

“Our findings suggest that reduced post-discharge care access and an increased reliance on telehealth did not result in significantly inferior outcomes among TKA patients,” the researchers wrote in the study. “The importance of in-person follow-up may be overstated, and further externalizing postoperative care may be desirable for TKA patients,” they added.