No Patients Having Elective Outpatient Orthopaedic Surgery Performed in an Ambulatory Surgery Center Using Preoperative Screening Protocols During the Coronavirus Pandemic Developed COVID-19

Singh, Harsh; Isak, Inis; Knapik, Derrick M.; Vadhera, Amar S.; Gursoy, Safa; Cole, Brian J.; Verma, Nikhil N.

Purpose The purpose of this study is to determine the safety of elective, outpatient orthopaedic sports procedures during the Coronavirus (COVID-19) pandemic at a high-volume orthopaedic practice. Methods All patients who were scheduled for elective, outpatient orthopaedic sports medicine procedures at one of two of outpatient surgical centers between July 1, 2020 and December 31, 2020 were asked to complete a custom survey during a post-operative clinic visit or phone call at a minimum of two-weeks or were subject to a routine screening questionnaire and temperature screen at the time of the first post-operative follow-up visit. The survey questionnaire assessed for any COVID-19-related symptoms. Surgical case logs were retrieved to review for any cancelled surgeries due to a positive pre-operative COVID-19 test. Results A total of 3.5% of patients (n=39/1119) scheduled for surgery were diagnosed with COVID-19 during preoperative testing, resulting in surgical cancellation. Patients with a positive pre-operative COVID-19 test were found to be significantly younger (46 ± 20 years) when compared to all other patients with a negative test (51 ± 21 years; p=0.002). No patient was diagnosed with COVID-19, reported symptoms concerning for COVID infection, underwent additional testing, or reported close contact with another individual with a positive test or possessed symptoms concerning for COVID-19 at a minimum of two-weeks post-operatively. Conclusion This study found that 3.5% of patients tested positive for COVID-19 and were significantly younger when compared to patients testing negative. No patient investigated for potential infection post-operatively reported the development of any symptoms related to COVID-19 or reported a positive test post-operatively. Using current protocols for pre-operative screening, elective outpatient orthopaedic surgery performed in an ASC is safe with no documented cases of COVID-19 transmission in this cohort.