Changes in Orthopedic Services in Two Indonesian Tertiary-referral Hospitals during the Coronavirus-19 Pandemic

A One-year COVID-19 Pandemic Effect on the Orthopaedic Field in Indonesia: A Cross-sectional Multi-center Study

BACKGROUND: The World Health Organization announced the COVID-19 outbreak as a global pandemic on March 11, 2020. Despite the fact that orthopedists are not considered front-line staff in the fight against the pandemic, the pandemic has had an enormous impact on orthopedics daily practice. A few studies have looked at the pandemic effect on the orthopedics field, but none have looked at the impact of a 1-year pandemic, especially in Indonesia. MATERIALS AND METHODS: This cross-sectional multi-center study was conducted at seven tertiary referral hospitals in Indonesia. Through hospital medical records, data were collected for a year, starting from the month the Indonesian government announced the first case of COVID-19 (March 2020–February 2021) and compared to data from the year before COVID-19 as a control (March 2019–February 2020). In addition, the researchers analyzed the number of patients in the emergency room (ER), outpatient clinic, inpatient, and operating room. RESULTS: Overall, the number of orthopedic patients in the ER declined by 44% from 11.053 to 6.139 patients during the 1st year of the pandemic, with 28 patients reported as getting COVID-19. The outpatient clinic decreased by 34%, from 10.9780 to 72.200 patients, with two confirmed cases. Furthermore, the inpatient unit decreased from 15.365 to 9.526 patients, a 38% decrease, with the highest recorded case confirmed at 78 patients. The last, with 73 confirmed, showed a 27% reduction in OR from 12.954 to 9.431 patients. CONCLUSION: In this study, analysis on the effect of the COVID-19 pandemic on the field of orthopedics in seven tertiary referral hospitals in Indonesia shows a significant decrease almost in all units. LEVEL EVIDENCE: III, Cross-sectional multi-center study.

Changes in Pediatric Fracture Cases during the Coronavirus Disease 2019 Pandemic: Data from a National Referral Orthopedic Hospital in Indonesia

AIM: This study aims to compare the impact of coronavirus disease 2019 (COVID-19) on pediatric fracture services in a national referral orthopedic hospital in Indonesia to understand the service provisions that may be required during the pandemic. METHODS: The study compared the population group during 1 year of the COVID-19 pandemic in Indonesia to the same period 1 year before. This cross-sectional study was performed in Prof. Dr. R Soeharso Orthopedic Hospital, Surakarta, Indonesia, from March 2019 to February 2021. The subjects were pediatric fracture patients aged 0–18 years. Patients recorded on other orthopedic service support installations such as radiology, laboratory, or physiotherapy and diagnosed with any other orthopedic sub-specialty were excluded. RESULTS: A total of 1787 patients were recorded in this study, with the mean of pediatric fracture patients during the pre-COVID-19 period was 90.75 (standard deviation [SD]: 28.5) and during the COVID-19 period was 58.16 (SD: 19.17) monthly. In the 1st year of the pandemic, there was a significant reduction in clinical visits compared to the same period in 2019 (p < 0.005). CONCLUSION: There were significant differences in pediatric fracture cases clinic visits and patients’ length of stay in the COVID-19 period than before the COVID-19 occurred.

The Epidemiology of Knee Arthroscopy during Coronavirus Disease 2019 Pandemic

Introduction: Coronavirus disease (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus (SARS Cov-2) has made a huge impact on global health service including in orthopaedic surgical service. Knee surgery (including arthroscopy) is one of the emerging surgical services in Indonesia. As the pandemic goes on, some of the patients prefer to postpone or cancel the surgery planning. We tried to evaluate the epidemiology of knee arthroscopy procedure during Covid-19 pandemic at our institution. Material and methods: Retrospective data collection was performed on all patients who received knee arthroscopy procedure at Prof dr. R. Soeharso Orthopaedic Hospital, Surakarta, Indonesia during the year 2020. The study evaluated the demographic data, the indication of surgery, and trends of the number of surgeries according to period time. This study also compared the data of knee arthroscopy procedures performed during the corresponding period before the pandemic in Indonesia (January to December 2019). Results: There was a total of 88 knee arthroscopy surgery performed during the period January to December 2020. There was a decrease in the number of knee arthroscopy during April and May 2020.  The decreasing number of surgeries also occurred in November 2020 which was later followed by the increasing number of surgeries in December 2020. Among all patient received knee arthroscopy during 2020, none have post-operative complication or infection due to SARS Cov-2. Conclusion: There was some difference in the epidemiology of knee arthroscopy during the COVID-19 pandemic compared to the non-pandemic era. Comprehensive preoperative screening is needed before resume elective surgical service.