{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T20:26:13Z","timestamp":1769199973952,"version":"3.49.0"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,12,21]],"date-time":"2020-12-21T00:00:00Z","timestamp":1608508800000},"content-version":"vor","delay-in-days":355,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,12,21]],"date-time":"2020-12-21T00:00:00Z","timestamp":1608508800000},"content-version":"vor","delay-in-days":355,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The primary aim of our study was to investigate elective orthopaedic care during the first wave government\u2010imposed COVID\u201019 lockdown and at four weeks and 21 weeks after resuming elective care. The secondary aim of our study was to evaluate the implementation of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA) COVID\u201019 Guidelines and Recommendations for Resuming Elective Surgery in the clinical practice of Belgian knee surgeons.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We sent three anonymous online surveys to 102 Belgian Knee Society members (BKS) at times mentioned above. Addressed topics were: (1) participant demographics, (2) elective surgeries, (3) outpatient visits, (4) ESSKA Guidelines, (5) patient and surgeon safety.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the COVID\u201019 lockdown, there was a decrease of 97% in elective knee surgeries and 91% in outpatient visits. At four and 21 weeks after resuming elective care, volumes were respectively 67% and 89% for elective surgeries and 81% and 91% for outpatient visits. Regarding ESSKA guidelines, 91% of surgeons had no COVID\u201019 testing prior to resuming elective care. Ninety\u2010two per cent reported preoperative (&lt;\u200972 h) patient PCR testing, and 45% gave preference to young patients without comorbidities. Seventy\u2010two per cent did not use additional personal protective equipment (PPE) if a patient PCR test was negative. Forty\u2010nine per cent continued to give preference to general anaesthesia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study shows that elective surgeries and outpatient visits were almost completely interrupted during the COVID\u201019 lockdown and were still below normal at four and 21 weeks after resuming elective care. Regarding ESSKA COVID\u201019 guidelines, our study observes good compliance in preoperative patient COVID\u201019 testing, but lower compliance for preoperative health care personnel testing, patient selection, use of PPE, and locoregional anaesthesia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>V<\/jats:p><\/jats:sec>","DOI":"10.1186\/s40634-020-00316-9","type":"journal-article","created":{"date-parts":[[2020,12,21]],"date-time":"2020-12-21T18:02:37Z","timestamp":1608573757000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The long road to recovery: at six months since the first COVID\u201019 wave, elective orthopedic care has still not fully recovered in Belgium"],"prefix":"10.1002","volume":"7","author":[{"given":"Y. N.","family":"Tan","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Traumatology University Hospital Brussels Laarbeeklaan 101 1090 Jette Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"PJ.","family":"Vandekerckhove","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology Sint\u2010Jan Hospital Ruddershove 10 8000 Orthoclinic AZ Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Verdonk","sequence":"additional","affiliation":[{"name":"ORTHOCA AZ Monica Stevenslei 20 2100 Deurne Belgium"},{"name":"Department of Orthopedics and Traumatology University Hospital Antwerp Antwerp Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,21]]},"reference":[{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.01.018"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010020\u201006031\u20103"},{"key":"e_1_2_11_4_2","unstructured":"Daniel K.Guy MD FAAOS;Joseph A.BoscoIII MD FAAOS;andFelix H.SavoieIIIM AAOS Guidelines for elective surgery during the COVID\u201019 pandemic.https:\/\/www.aaos.org\/about\/covid\u201019\u2010information\u2010for\u2010our\u2010members\/aaos\u2010guidelines\u2010for\u2010elective\u2010surgery\/. Accessed 21 Apr 2020."},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010020\u201006213\u2010z"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010020\u201006104\u20103"},{"issue":"1","key":"e_1_2_11_7_2","first-page":"5e68","article-title":"SARS\u2010CoV\u20102 impact on elective orthopaedic surgery","volume":"102","author":"Jain A","year":"2020","journal-title":"J Bone Jt Surg"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010020\u201006233\u20109"},{"key":"e_1_2_11_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010020\u201006212\u20100"},{"key":"e_1_2_11_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010020\u201006032\u20102"},{"key":"e_1_2_11_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40634\u2010020\u201000272\u20104"},{"key":"e_1_2_11_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2019.09.020"},{"key":"e_1_2_11_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40634\u2010020\u201000248\u20104"},{"key":"e_1_2_11_14_2","doi-asserted-by":"publisher","DOI":"10.2106\/jbjs.20.00844"},{"key":"e_1_2_11_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2020.04.011"},{"key":"e_1_2_11_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010020\u201006033\u20101"}],"container-title":["Journal of Experimental Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s40634-020-00316-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s40634-020-00316-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s40634-020-00316-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1186\/s40634-020-00316-9","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T19:28:32Z","timestamp":1760642912000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1186\/s40634-020-00316-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,1]]}},"alternative-id":["10.1186\/s40634-020-00316-9"],"URL":"https:\/\/doi.org\/10.1186\/s40634-020-00316-9","archive":["Portico"],"relation":{},"ISSN":["2197-1153","2197-1153"],"issn-type":[{"value":"2197-1153","type":"print"},{"value":"2197-1153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1]]},"assertion":[{"value":"20 November 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 November 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 December 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"None (no patient data involved).","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"99"}}