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The impact of COVID-19 on hip and knee arthroplasty surgical volume in China

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Abstract

Purpose

The reduction of hip and knee arthroplasty surgical volume has been reported in many countries during the COVID-19 pandemic. In China, there is no national joint registry system and the impact of COVID-19 towards surgical volume remains unclear. The aim of this study was to investigate the hip and knee arthroplasty surgical volume in China during the pandemic and evaluate its change trends.

Methods

Annual sale numbers of prostheses used in total knee arthroplasty (TKA), total hip arthroplasty (THA), and femoral head replacement (FHR) from 2011 to 2021 was collected from providers registered in National Medical Products Administration (NMPA). Annual surgical volume of TKA, THA, FHR, unicompartmental knee arthroplasty (UKA), and revision of hip/knee arthroplasty (RJA) was collected from member hospitals of Beijing Joint Society (BJS). We used linear regression to estimate the loss of surgical volume. Annual surgical volume obtained from Britain and Australian joint registries were used to make comparison.

Results

In China, the surgical volume of THA/FHR, TKA, and UKA in 2020 all decreased compared to the predicted value, with a reduction of 82,525 cases (13.46%), 165,178 cases (33.50%), and 151 cases (0.65%), respectively. All the three procedures showed significant recovery in 2021. The surgical volumes of THA/FHR and UKA were 68,813 and 9402 cases higher than predicted levels, respectively, while TKA volume remained slightly below the predicted level. The regional statistics in Beijing showed similar change mode. In 2020, the surgical volume of THA/FHR, TKA, FHR, and UKA all decreased compared to the predicted value, with a reduction of 5031 cases (43.37%), 5290 cases (40.69%), 620 cases (29.18%), and 925 cases (39.11%), respectively. In 2021, with the exception of FHR, the number of these procedures increased compared to 2020, but remained below the predicted value. Compared with the data from Britain and Australia, China experienced less reduction and faster recovery in the proportions of elderly people (> 65 years old) who undergo hip and knee arthroplasty during the COVID-19 pandemic.

Conclusion

During the COVID-19 pandemic, although hip and knee arthroplasty surgical volume in China showed a similar “restoration-recovery” change pattern with other countries, China took fewer losses in this field.

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Data availability

The original contributions presented in the study are included in the article. Further inquiries can be directed to the corresponding author.

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Acknowledgements

We deeply thank all medical institutions and enterprises joined our survey during the past 10 years for their generous help in providing fundamental data.

Funding

This study was supported by the National Key Research and Development Program of China (No. 2018YFF0301105).

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Author notes

  1. Zhanqi Wei and Yiming Xu contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China

    Zhanqi Wei, Yiming Xu, Bin Feng & Xisheng Weng

  2. School of Medicine, Tsinghua University, Beijing, 100084, China

    Zhanqi Wei

  3. State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China

    Xisheng Weng

Authors
  1. Zhanqi Wei
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  2. Yiming Xu
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Zhanqi Wei and Yiming Xu. The first draft of the manuscript was written by Zhanqi Wei and Yiming Xu, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Bin Feng or Xisheng Weng.

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Ethics approval

This study did not involve human or animal subjects; thus, the Peking Union Medical Hospital Research Ethics Committee has confirmed that no ethical approval is required.

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The authors declare no competing interests.

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Wei, Z., Xu, Y., Feng, B. et al. The impact of COVID-19 on hip and knee arthroplasty surgical volume in China. International Orthopaedics (SICOT) 48, 49–56 (2024). https://doi.org/10.1007/s00264-023-05944-1

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  • DOI: https://doi.org/10.1007/s00264-023-05944-1

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