The impact of the Covid-19 pandemic on emergency and elective hip surgeries in Norway

Magnusson, K.; Helgeland, J.; Grosland, M.; Telle, K. E.

Objective: To assess the effects of Covid-19 pandemic lockdown restrictions on the number of emergency and elective hip joint surgeries, and explore whether these procedures are more/less affected by lockdown restrictions than other hospital care. Methods: In 1.344.355 persons aged [≥]35 years in the Norwegian emergency preparedness (BEREDT C19) register, we studied the daily number of persons having 1) emergency surgeries due to hip fractures, and 2) electively planned surgeries due to hip osteoarthritis before and after Covid-19 lockdown restrictions were implemented nationally on March 13th 2020, for different age and sex groups. Incidence Rate Ratios [IRR] reflect the after-lockdown number of surgeries divided by the before-lockdown number of surgeries. Results: After-lockdown elective hip surgeries were one third the number of before-lockdown (IRR ~0.3), which is a greater drop than the drop seen in all-cause elective hospital care (IRR ~0.6) (no age/sex differences). Men aged 35-69 had half the number of emergency hip fracture surgeries (IRR ~0.6), whereas women aged [≥]70 had the same number of emergency hip fracture surgeries after lockdown (IRR ~1). Only women aged 35-69 and men aged [≥]70 had emergency hip fracture surgery rates after lockdown comparable to what may be expected based on analyses of all-cause acute care (IRR ~0.80) Conclusion: Important to note for future pandemics management is that lockdown restrictions may impact more on scheduled joint surgery than other scheduled hospital care. Lockdown may also impact on the number of emergency joint surgeries for men aged [≥]35 but not for women aged [≥]70.