Impact of the Covid-19 pandemic on elective and trauma orthopaedic surgery in a tertiary referral hospital in Kenya: A retrospective cross-sectional study

Abstract

The impact of the COVID-19 pandemic is still being felt in multiple spheres of life. In healthcare, COVID-19 noticeably affected surgical practice in sub-Saharan Africa indicated by a reduction in elective cases with prioritisation of cancer and emergency cases. This study sought to describe the impact of COVID-19 on orthopaedic surgery volumes in a private tertiary referral hospital. Ethical approval was obtained for this retrospective cross-sectional study carried out at the Aga Khan University Hospital, Nairobi. The orthopaedic data was collected using the Electronic Healthcare Record (EHR) system in the hospital. Elective and trauma caseloads recorded during COVID-19 were compared with similar quarters in the pre and post COVID-19 periods. In the third quarter before the COVID-19 pandemic, there were 15 arthroplasty, 53 arthroscopy and 31 implant removal cases. During the pandemic, there was an expected fall in the numbers of procedures by 33%, 30% and 13% respectively compared to the previous (pre pandemic) year. There was also the expected drop in the number of adult trauma cases, however, there was an increase in paediatric fracture fixation with k-wires. In spinal surgery, there was a 71% increase in the number of laminectomies and anterior cervical decompression and fusions (ACDF) from the pre pandemic 21 cases recorded. The COVID-19 pandemic had an impact on elective and emergency orthopaedic procedure volumes. There was a reduction in the number of elective arthroplasty, arthroscopy, nailing and orthopaedic implant removal procedures. On the other hand there was a significant increase in the number of paediatric fracture fixation and with K-wires and ACDF/laminectomy volumes.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

No financial disclosures from any of the authors

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval was obtained for this retrospective cross-sectional study carried out at the Aga Khan University Hospital, Nairobi. Ethical approval for the study was obtained from the hospital Institutional Scientific Ethics Review Committee (ISERC).

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

Data readily available

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