gms | German Medical Science

Objectives: The impact of previous SARS-CoV-2 infection on the morbidity of elective total joint replacement is not fully understood. This study reports on the in-hospital outcome and complication rate of patients undergoing elective joint replacement surgeries at a large orthopedic specialty hospital during the SARS-CoV-2 pandemic.

Methods: Comorbidities, hospital course and in-hospital complication rate of 340 consecutive patients with history of SARS-CoV-2 undergoing elective total joint arthroplasty (TJA) were compared to those of 5,014 SARS-CoV-2 antibody negative patients operated on between May 2020 and December 2020.

Results and Conclusion: There was no difference in early postoperative complication rate between the two study groups. Patients in the SARS-CoV-2 group were more likely to be obese (p-value <0.0001) and more likely to present with preoperative anemia (p-value 0.002). Patients in the COVID-19 group were less likely white (p<0.0001). There was no difference in the percentage of outpatient procedures (p=0.78), percentage of regional versus general anesthesia (p=0.14), duration of the procedure (p=0.33) and length of stay in the postoperative acute care unit (p=0.23). While the length of inpatient stay was significantly shorter in the control group (p=0.006) there was no difference in length of stay when groups were controlled for age, BMI, gender, race and comorbidity index (Hips p=0.10, Knees p=0.06). More COVID-19 patients were discharged to higher care facilities (4.7% vs. 1.9%; p=0,0004).

The current study does not report differences inin-hospital complication rate, perioperative management and length of stay in patients with a history of SARS-CoV-2.