A multi-centre, registry-based cohort study was conducted to assess the effect of the coronavirus disease 2019 (COVID-19) pandemic on the provision of non-arthroplasty hip surgery (NAHS) in the UK by (i) comparing the number of NAHS performed during the pandemic to pre-pandemic levels, (ii) prospectively auditing compliance to established guidance and (iii) evaluating post-operative outcomes and their predictors. Patients who underwent NAHS during the pandemic/pre-pandemic were selected from the Non-Arthroplasty Hip Registry, which collects demographic, procedural and pre-operative outcome data. Patients during the pandemic period were emailed separate COVID-19 surveillance questionnaires, which evaluated adherence to guidelines and post-operative outcomes. Fisher’s exact tests and logistic regression were used to identify predictors for developing COVID-19 and being re-admitted into hospital, post-surgery. There was a 64% reduction of NAHS performed during the pandemic compared to the pre-pandemic period. Ninety-nine percent of participants self-isolated, and 96.8% received screening, pre-operatively. No participant was COVID-19-positive peri-operatively. Post-operatively, participants had an intensive care unit admission rate of 2%, median hospital stay of 1 day, hospital readmission rate of 4.2%, COVID-19 development rate of 2.3% and a thromboembolic complication rate of 0.32%. No COVID-19-positive patient developed adverse post-operative outcomes. Participants who developed COVID-19 post-operatively had greater odds of having undergone osteotomy in comparison to arthroscopic surgery (P = 0.036, odds ratio = 5.36). NAHS was performed with good compliance to established guidance, and adverse operative outcomes remained low. If guidance is followed, the risk of COVID-19 post-op development is low. Although bigger operations have a slightly higher risk, this does not impact their prognosis.

中文翻译：

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COVID-19 大流行对髋关节保留手术的影响——来自英国非关节置换髋关节登记处的前瞻性监测

进行了一项多中心、基于注册的队列研究，以评估 2019 年冠状病毒病 (COVID-19) 大流行对英国提供非关节置换髋关节手术 (NAHS) 的影响，方法是 (i) 比较NAHS 在大流行期间达到大流行前的水平，(ii) 前瞻性审计对既定指南的遵守情况，以及 (iii) 评估术后结果及其预测因素。在大流行/大流行前接受 NAHS 的患者选自非关节置换髋关节登记处，该登记处收集人口统计、程序和术前结果数据。大流行期间的患者通过电子邮件发送了单独的 COVID-19 监测问卷，该问卷评估了对指南的遵守情况和术后结果。费舍尔的精确检验和逻辑回归用于确定发展 COVID-19 并在手术后重新入院的预测因子。与大流行前相比，大流行期间进行的 NAHS 减少了 64%。99% 的参与者自我隔离，96.8% 的参与者在术前接受了筛查。没有参与者在围手术期出现 COVID-19 阳性。术后，参与者的重症监护病房入院率为 2%，中位住院天数为 1 天，再入院率为 4.2%，COVID-19 发生率为 2.3%，血栓栓塞并发症发生率为 0.32%。没有 COVID-19 阳性患者出现不良的术后结果。与关节镜手术相比，术后发生 COVID-19 的参与者接受截骨术的几率更大（P = 0.036，优势比 = 5.36）。NAHS 的实施符合既定指南，不良手术结果仍然很低。如果遵循指导，COVID-19 术后发展的风险很低。虽然较大的手术风险略高，但这并不影响他们的预后。