{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T07:31:59Z","timestamp":1790839919808,"version":"4.1.0"},"reference-count":4,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7,15]]},"abstract":"\n Background:<\/jats:title>\n Coronavirus disease 2019 (COVID-19) has caused substantial disruptions to orthopaedic and trauma services. The purpose of the present study was to quantify its impact on surgical volume, hospitalizations, clinic appointments, and accident and emergency attendances to guide staffing and resource deployment for the sustenance of emergency services.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Data were retrieved from all 43 Hong Kong public hospitals and 122 outpatient clinics from a population of 7.5 million residents. The \u201cCOVID-19 cohort\u201d of patients who received treatment from January 25 to March 27, 2020, was compared with the \u201ccontrol cohort\u201d of patients who received treatment during the same time of year over the past 4 years. Primary outcomes consisted of changes in patient diagnoses, number of operations performed, and hospitalizations during the COVID-19 pandemic. Secondary outcomes included differences in patient age and comorbidity, the nature of operations performed, types of anesthesia for orthopaedic procedures, difference in anesthetic times, wait times, and personal protective equipment (PPE) reserves.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n A total of 928,278 patient-episodes (32,613 operations, 97,648 hospital admissions, 302,717 accident and emergency attendances, and 495,300 outpatient clinic attendances) were analyzed. Orthopaedic operations were reduced by 44.2%, from a mean (and standard deviation) of 795 \u00b1 115.1 to 443.6 \u00b1 25.8 per week (p < 0.001), with the ratio of emergency to elective operations increasing from 1.27:1 to 3.78:1. Operations for the treatment of upper and lower-limb fractures decreased by 23% (from 98.5 \u00b1 14 to 75.9 \u00b1 15.2 per week; p < 0.001) and 20% (from 210.6 \u00b1 29.5 to 168.4 \u00b1 16.9 per week; p < 0.001), respectively, whereas elective joint replacement and ligamentous reconstruction procedures decreased by 74% to 84% (p < 0.001). Operations for orthopaedic infections such as necrotizing fasciitis and septic arthritis remained similar (p > 0.05). The number of hospitalizations decreased by 41.2% (from 2,365 \u00b1 243 to 1,391 \u00b1 53 per week; p < 0.001), whereas clinical outpatient visits decreased by 29.4% (from 11,693 \u00b1 2,240 to 8,261 \u00b1 1,104 per week; p < 0.001). Patients did not endure longer wait times for emergency operations and accident and emergency consultations (p > 0.05). PPE consumption did not exceed procurement, with net increases in PPE reserves.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Demand for orthopaedic care remains, despite weekly reductions of 351 orthopaedic operations, 974 hospital admissions, and 3,432 clinic attendances. Orthopaedic surgeons and health-care professionals should factor this into consideration during staffing and resource deployment.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence:<\/jats:title>\n \n Prognostic\n Level III<\/jats:underline>\n . See Instructions for Authors for a complete description of levels of evidence.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.2106\/jbjs.20.00775","type":"journal-article","created":{"date-parts":[[2020,5,20]],"date-time":"2020-05-20T17:38:55Z","timestamp":1589996335000},"page":"e80","source":"Crossref","is-referenced-by-count":148,"title":["Impact of COVID-19 on Orthopaedic and Trauma Service"],"prefix":"10.2106","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1361-4733","authenticated-orcid":false,"given":"Janus Siu Him","family":"Wong","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8304-0419","authenticated-orcid":false,"given":"Kenneth Man Chee","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,5,21]]},"reference":[{"issue":"5","key":"bib4-20230811","doi-asserted-by":"crossref","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J Chronic Dis."},{"issue":"18","key":"bib6-20230811","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1056\/NEJMc2009790","article-title":"From a sprint to a marathon in Hong Kong","volume":"382","author":"Leung","year":"2020","journal-title":"N Engl J Med."},{"issue":"7","key":"bib13-20230811","doi-asserted-by":"crossref","DOI":"10.2105\/AJPH.2005.083055","article-title":"Outdoor falls among middle-aged and older adults: a neglected public health problem","volume":"96","author":"Li","year":"2006","journal-title":"Am J Public Health."},{"key":"bib14-20230811","doi-asserted-by":"crossref","DOI":"10.2106\/JBJS.20.00489","article-title":"Guidelines for ambulatory surgery centers for the care of surgically necessary\/time-sensitive orthopaedic cases during the COVID-19 pandemic","author":"DePhillipo","year":"2020","journal-title":"J Bone Joint Surg Am."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.20.00775","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:46:36Z","timestamp":1787751996000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.20.00775"}},"subtitle":["An Epidemiological Study"],"short-title":[],"issued":{"date-parts":[[2020,5,21]]},"references-count":4,"journal-issue":{"issue":"14","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.20.00775","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,21]]}}}