# Locked down: Orthopaedic surgery in a regional health service during the COVID‐19 pandemic

## TL;DR

The study shows how the COVID-19 pandemic disrupted orthopedic surgery in a regional Australian hospital, causing waitlist increases and changes in procedure volumes.

## Contribution

The study provides insights into how elective orthopedic surgery and waitlists were affected during the pandemic in a regional healthcare setting.

## Key findings

- Planned joint replacement surgeries decreased by 19% in 2022 but increased by 66% in 2023.
- Waiting lists peaked at 786 in 2022 before declining to 390 in 2023 as surgical capacity improved.
- Wrist and ankle fracture procedures declined during the pandemic but rebounded sharply in 2023.

## Abstract

COVID‐19 affected access to healthcare. Victoria, Australia was heavily affected. Hospitals deferred non‐urgent operations and preserved health resources to manage people with COVID‐19. Elective orthopaedic surgery was directly impacted. This study investigated changes to orthopaedic procedures and the elective surgery waitlist during the COVID‐19 at a large regional health service in Victoria.

Data were acquired from University Hospital Geelong, a publicly funded regional health service in Victoria, Australia. Orthopaedic surgeries and waitlist numbers were collated for financial years ending (FYE) 2020–2023. Procedures were displayed as total, planned and unplanned (i.e., trauma).

From FYE 2020 to 2023 there was 8244 orthopaedic surgery cases with 8850 procedures. Planned joint replacements of knee, hip and shoulder decreased collectively by 19% in FYE 2022 and increased by 66% in FYE 2023. Waiting lists rose from 247 in FYE 2020 and peaked at 786 in FYE 2022, before falling to 390 in FYE 2023. The number of fractured neck of femur procedures were consistent each year (average 152/year), while ankle and wrist fractures declined by 55% and 43% during FYE 2022 and increased in FYE 2023 by 106% and 159% respectively.

Changes to planned orthopaedic procedures and waitlists in a regional centre were evident throughout the pandemic. These results can help to inform strategies to optimize the provision of orthopaedic surgery during future major disruptive events.

COVID‐19 affected access to healthcare, and orthopaedic surgery was significantly impacted. Wrist and ankle fractures declined, whilst neck of femur fractures were constant throughout the pandemic. Waiting lists increased after limitations were imposed on surgical activity, resulting in decreased planned orthopaedic surgery. Waiting lists then declined following enhanced operating capacity.