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Introduction Previous studies demonstrate that retired service members who undergo total joint arthroplasty (TJA) through the Veterans Affairs (VA) healthcare system experience poorer short-term outcomes than the general population. Given that many healthcare disparities were exacerbated during the COVID-19 pandemic, the aim of this study is to determine if veterans who underwent total knee arthroplasty (TKA) at a single VA medical center experienced poorer 30-day outcomes during versus before COVID-19. Methods A retrospective review of electronic medical records was conducted to identify patients who underwent primary TKA between July 2017 and November 2021 at a single VA medical center. A total of 208 patients (n=238 knees) were included in the study and divided into two cohorts: TKAs performed before COVID-19 (July 2017-March 2020, n=143 knees) and TKAs performed during COVID-19 (June 2020-November 2021, n=95 knees). Inpatient outcomes of interest included length of stay (LOS), pain, opioid use, and physical therapy (PT) attendance and performance. Outpatient outcomes of interest included 30-day complication, readmission, and mortality. Results Veterans in the COVID-19 group had a significantly shorter LOS (1.02 vs. 1.42 days) than the pre-pandemic group (p < 0.0001; d = -0.61, 95% CI: -0.87, -0.34). The COVID-19 group further demonstrated significantly greater PT attendance on postoperative day (POD) 0 (p = 0.0419; RR = 1.51, 95% CI: 0.98, 2.30), and reported less pain (p = 0.0185; d = -0.32, 95% CI: -0.58, -0.06), required fewer opioids (p < 0.0001; d = -0.59, 95% CI: -0.85, -0.32), and demonstrated superior PT performance on POD 1. There was no significant difference in 30-day complication, readmission, or mortality between groups. Conclusion In general, veterans who underwent TKA during COVID-19 had better 30-day outcomes than their pre-pandemic counterparts, which is consistent with trends observed in the general population.
Published in: Journal of Orthopaedic Experience & Innovation
Volume 7, Issue 1
DOI: 10.60118/001c.146742