Introduction: Optimizing Hip and Knee Arthroplasty in the COVID Era

Originating in Wuhan, People’s Republic of China with the first reported cases in December 2019, the COVID-19 virus has infected millions worldwide. In March 2020, the World Health Organization declared COVID-19 a world pandemic and as of the date of this publication, over 114 million people worldwide have been infected with the virus, resulting in over 2.5 million deaths. The health and economic consequences have been profound and have affected nearly all countries across the globe and will persist for years. The COVID pandemic has created a unique and challenging environment in which to provide safe care for hip and knee arthroplasty patients.

This collection of symposium papers was presented at the 2020 American Association of Hip and Knee Surgeons Annual Meeting and covers a variety of aspects related to performing hip and knee arthroplasty safely and effectively in the era of COVID-19. The papers discuss the latest data-driven and evidence-based recommendations involving preoperative testing, optimal personal protective equipment, perioperative care, protocols, and methodologies to minimize personal contact such as outpatient same-day discharge and utilizing telehealth and remote monitoring technology. Admittedly, efficiency has been a focus of arthroplasty surgeons for the past 2 decades, largely due to decreased reimbursement and increased patient demand for hip and knee arthroplasty procedures. However, practice and surgical efficiencies have been thrust into the spotlight once again. Efficiency strategies are detailed for surgeons to provide low-cost and high-quality care essential to accommodate the backlog of elective hip and knee arthroplasty patients created by cessation of elective surgeries during the peak of the COVID pandemic. Finally, an exploration of the Medicare claims database has been undertaken to understand the impact of the COVID pandemic on total hip and knee arthroplasty in the United States. The content and material contained within this collection of papers is intended to assist the arthroplasty surgeon, caregivers, and institutions in caring for the hip and knee arthroplasty patient during the ensuing and persistent era of COVID-19.