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. 2021 Jan 6;8:15–23. doi: 10.1016/j.artd.2020.12.028

Table 3.

Key studies describing surgical volume and strategies to aid recovery.

Author Results Conclusions
Bedard et al. [1] Projected canceled primary and revision arthroplasty procedures per month:
  • 100% cancellation: 130,001 primary, 12,436 revision

  • 75% cancellation: 97,508 primary, 9327 revision

  • 50% cancellation: 65,005 primary, 6218 revision

  • 25% cancellation: 32,503 primary, 3109 revision

  • Institutions will be hurt by lost revenue

  • Surge of rescheduling cases once the restrictions are lifted

  • With high patient unemployment and potential loss of insurance, it is unclear how pandemic will impact the patient’s willingness to undergo arthroplasty

O’Connor et al. [4] Six economic pillars are crucial or the resumption of elective total joint arthroplasty
  • Assessing patient demand for elective surgery

  • Evidence-based practices

  • Early discharge and outpatient surgery

  • Technology and innovation

  • Contracts and vendors

  • Government programs

  • Key strategies to successfully resume elective arthroplasty include renegotiating vendor contracts, using ambulatory surgical centers and hospital outpatient departments, adherence to evidence-based guidelines, and the incorporation of telemedicine and other technologies

Jain et al. [31] Using a Monte-Carlo simulation-based analysis, the time it will take for the healthcare system to perform 90% of pre-pandemic forecasted volume of surgery:
  • Optimistic scenario: 7 months

  • Ambivalent scenario: 12 months

  • Pessimistic scenario: 16 months

  • Deferment of cases will cause a lasting impact on the healthcare system

  • Strategies to combat this deferment include the utilization of telemedicine, increased operating room schedules, dedicated orthopedic anesthesia and nursing teams, utilization of ambulatory surgery centers, and amplification of care coordination resources

  • Suggest prioritizing certain surgical patients with the limitation that it may worsen existing health care disparities