Should I Have Orthopaedic Surgery During the Covid-19 Pandemic?

As the Covid-19 pandemic was beginning in early March, an Italian doctor, Dr Daniele Macchine from Bergamo, said: “There are no more surgeons, urologists, orthopaedists, we are only doctors who suddenly become part of a single team to face this tsunami that has overwhelmed us…”

If you have been unfortunate enough to injure yourself during the Covid-19 pandemic or if you were scheduled to have orthopaedic surgery at this time, you will know that surgery, for all but the most serious injuries or life-threatening conditions, has been put on hold.

New guidance for surgeons

However, as we start to emerge from lockdown and move into the next phase, The British Orthopaedic Association has published guidance (on 15 May 2020) on how hospitals can begin the process of resuming surgery for non-urgent trauma and orthopaedic conditions. All hospitals have now produced policy, based on this guidance, for the process of restarting surgical procedures.

If you are a patient who has been waiting for news, what does the new guidance mean for you and how soon are you likely to be able to undergo surgery?

As you might expect, it is the most serious cases that will take priority. Over the next few weeks, surgical teams will review waiting lists and prioritise patients. Non-elective surgery – which means urgent cases, such as treatment for trauma – are likely to resume before elective surgery (such as joint replacements).

If you are currently on a waiting list, your hospital will keep you informed about their plans for your care and what to do if your condition deteriorates in the meantime.

Surgical priorities

NHS England, the Royal College of Surgery and specialty bodies such as the British Orthopaedic Association have published a prioritisation list setting out which types of surgery should happen first. Key points include:

  • Many urgent surgical procedures continued throughout the pandemic, but those that didn’t take place will be prioritised ahead of non-urgent surgery.
  • For patients with multiple conditions who may be particularly vulnerable, surgeons will give careful consideration to weighing up the benefit of orthopaedic surgery against the risk of catching the Covid-19 coronavirus.
  • Patients who have been socially shielding may have lost mobility and functionality during lockdown, which may result in poorer surgical outcomes.

If you are waiting for orthopaedic surgery, your hospital may contact you to ask if you still want to continue with the planned treatment or if you wish to have surgery at a later date or not at all.

What will happen if you are offered surgery

Due to ongoing Covid-19 restrictions, most hospitals will continue to operate at significantly reduced capacity and staff will follow strict precautions, including wearing PPE.

Patients will be expected to follow social distancing guidelines while being treated in hospital. Much of post-surgical care, such as follow-up consultations, physiotherapy and rehabilitation, may have to be delivered ‘virtually’ into patients’ homes, and there are likely to be longer waits than normal for routine surgery due to the backlog caused by the virus.

No-one who is suspected of having the virus will be offered elective surgery. As a precaution you will be asked to stay at home for 14 days prior to surgery to reduce your risk of exposure to the virus. Other people in your household may also be asked to self-isolate during this time. You will be asked if you or any of your household have any symptoms 48 hours before surgery and again when you are admitted. You will also be required to undergo a test for the coronavirus 72-48 hours before surgery.

You should not take public transport to get to the hospital. If you don’t have a way to get there by private transport, speak to the hospital about arranging transport. In hospital you will be subject to measures to restrict the risk of infection. You will be discharged as soon as it is safe to do so and most follow-up appointments will be done remotely wherever possible.

Tips for managing your condition at home

We realise it can be frustrating waiting for surgery, particularly if you are experiencing pain and loss of mobility. There are some steps you can take to manage your condition in the meantime:

  • Take your prescribed pain medication regularly to keep on top of the pain.
  • Take some gentle exercise to prevent joint stiffness.
  • Try to lose weight, if needed, to relieve pressure on your joints.
  • Eat a health balanced diet and avoid processed and fried food.

Thames Shoulder & Elbow is here to help

Thames Shoulder & Elbow is available for consultations, face-to-face for first appointments with virtual follow-up offered subsequently. If you need surgery, we can now start to plan a date for this to be completed.

All our clinics have implemented precautions to minimise the risk to you and to us. Social distancing, face covering and hand hygiene rules are strictly observed. If you develop symptoms of fever, cough or loss of sense of taste and smell before the appointment you should not come to the clinic, instead please stay at home and contact our team to reschedule your appointment.

Please contact us to arrange a consultation and we can work out the next best steps for you