The ongoing coronavirus pandemic has vastly increased pressure on healthcare systems worldwide. In many countries, resources have been redistributed toward intensive care units and other COVID-19 dedicated sites, and many patients have faced the cancellation or postponement of elective surgical procedures. The COVID-19 pandemic has impacted health care in numerous ways. In many hospitals, cancellation or postponement of elective procedures, including surgery, has been required to protect patients from in-hospital viral transmission, preserve personal protective equipment supplies, and release ward and critical care beds for COVID-19 patients. Analysis based on a survey of 359 hospitals in 71 countries estimated that 28,404,603 operations would be cancelled worldwide during the 12 weeks of the first wave of the pandemic, with an overall 12-week cancellation rate of 72%. Owing to the negative impacts of surgery delays on patient physical and mental health, ability to work and requirement for family or caregiver support, recovery plans focus on strategies to mitigate the risk of operating in COVID-19 environments to ensure that surgical procedures restart as soon as possible. However, with ongoing coronavirus surges in numerous countries worldwide, will long-term changes in patient management be required?
Are novel disease-modifying osteoarthritis drugs (DMOADs) an option for those who face delays to joint replacement surgery?
An enormous number of joint replacement surgeries were cancelled during the first COVID-19 wave. Living with chronic pain is strongly associated with substance abuse and impaired mental health. It will undoubtedly take many years to grasp the totality of the consequences of delayed joint replacement surgeries. Under such circumstances, are there any alternative treatment strategies to surgery that can be explored? DMOADs target key tissues in the osteoarthritis pathophysiology process. It is hoped that they will prevent structural progression, control inflammation, and relieve pain. Currently, no DMOADs have been licensed for use but a number of potential therapies are under investigation. Their use as an alternative to surgery could deliver a cutting‐edge approach to manage osteoarthritis and efficacy data are eagerly anticipated.
Further reading
COVID Surg. Collaborative. Elective surgery cancellations due to the COVID‐19 pandemic: global predictive modelling to inform surgical recovery plans. BJS. 2020. Available from: Elective surgery cancellations due to the COVID‐19 pandemic: global predictive modelling to inform surgical recovery plans (wiley.com) Too long to wait: the impact of COVID-19 on elective surgery. Available from: Too long to wait: the impact of COVID-19 on elective surgery – The Lancet Rheumatology Ghouri A & Conaghan PG. Update on novel pharmacological therapies for osteoarthritis. Ther Adv Musculoskeletal Dis. 2019;11:1759720X19864492. Available from: https://pubmed.ncbi.nlm.nih.gov/31384314/
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