Insights into patient preferences for elective surgery during the COVID-19 pandemic A prospective analysis of 400 patients awaiting arthroplasty

• Published in: Bone & joint open Vol. 2; no. 4; pp. 261 - 270
• Main Authors: Hotchen, Andrew James, Khan, Saad A., Khan, Maaz A., Seah, Matthew, Charface, Zain H., Khan, Zarif, Khan, Wasim, Kang, Niel, Melton, Joel Thomas Kirk, McCaskie, Andrew W., McDonnell, Stephen M.
• Format: Journal Article
• Language: English
• Published: London The British Editorial Society of Bone & Joint Surgery 01.04.2021
• Subjects: Activity Level; Arthroplasty; covid-19; patient reported outcomes; Return to Work; Revision Hip Arthroplasty; Revision Knee Arthroplasty
• ISSN: 2633-1462; 2633-1462
• DOI: 10.1302/2633-1462.24.BJO-2020-0201

Aims To investigate factors that contribute to patient decisions regarding attendance for arthroplasty during the COVID-19 pandemic. Methods A postal questionnaire was distributed to patients on the waiting list for hip or knee arthroplasty in a single tertiary centre within the UK. Patient factors that may have influenced the decision to attend for arthroplasty, global quality of life (QoL) (EuroQol five-dimension three-level (EQ-5D-3L)), and joint-specific QoL (Oxford Hip or Knee Score) were assessed. Patients were asked at which ‘COVID-alert’ level they would be willing to attend an NHS and a “COVID-light” hospital for arthroplasty. Independent predictors were assessed using multivariate logistic regression. Results Of 540 distributed questionnaires, 400 (74.1%; 236 awaiting hip arthroplasty, 164 awaiting knee arthroplasty) complete responses were received and included. Less than half (48.2%) were willing to attend for hip or knee arthroplasty while a UK COVID-19 epidemic was in circulation (COVID-alert levels 3 to 5). Patients with worse joint-specific QoL had a preference to proceed with surgery at COVID-alert levels 3 to 5 compared to levels 1 and 2 (hip arthroplasty odds ratio (OR) 1.54 (95% confidence interval (CI) 1.45 to 1.63); knee arthroplasty OR 1.16 (1.07 to 1.26)). The odds of patients with worse joint-specific QoL being willing to attend for surgery at COVID-alert levels 3 to 5 increased further if surgery in a private, “COVID-light” hospital was available (hip arthroplasty OR 3.50 (95% CI 3.26 to 3.71); knee arthroplasty OR 1.41 (95% CI 1.29 to 1.53). Conclusion Patient decisions surrounding elective surgery have been influenced by the global COVID-19 pandemic, highlighting the importance of patient involvement in ensuring optimized provision of elective surgery during these challenging times. Cite this article: Bone Jt Open 2021;2(4):261–270.