The Impact of Covid-19 on Patients Waiting for Knee Surgery
Research type
Research Study
Full title
The Impact of Covid-19 on Patients Waiting for Elective Knee Surgery: An Investigation into Patient Perceptions of Knee Function and Pain
IRAS ID
295444
Contact name
Leela Biant
Contact email
Sponsor organisation
University of Manchester
Clinicaltrials.gov Identifier
N/A, N/A
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Summary of Research
The Covid-19 pandemic has led to elective orthopaedic surgeries being postponed or cancelled across the world. These delays have led to increasingly longer waiting list times.Orthopaedic surgeries are most commonly carried out on the knee. Knee surgeries aim to relieve pain and improve function in joints damaged by degenerative diseases or traumatic injuries. Long waits for surgery can be detrimental to a patient’s quality of life, as the symptoms of pain and poor function can worsen over time. This can impact the success of the treatment, as patients who have worse pain and function pre-operatively have poorer outcomes post-operatively.
This cross-sectional pilot study aims to investigate the change in patients’ perceptions of their knee pain and function since they have been waitlisted for surgery. A bespoke survey will be administered to eligible patients over the phone from Trafford General Hospital, Manchester. The survey will also investigate the coping mechanisms and the preventative measures patients are taking to manage their symptoms during the pandemic, and question what kinds of support patient would like to be offered whilst waiting for treatment.
This pilot study will improve our understanding of how patients are coping with their symptoms during this pandemic, and provide us with information on how to better support those who are waiting for knee surgery. This information could be used to enhance orthopaedic care during, and in the aftermath, of this pandemic.
Summary of Results
Eleven people took part in this survey; 4 males and 7 females. On average participants were 68.6 years old. Seven participants (63.6%) believed they had gained weight since being waitlisted for surgery (pre-pandemic), one participant believed they had lost weight (9.0%), and 3 participants did not think their weight had changed (27.3%). Most participants were waiting for a knee replacement (9/11 – 81.8%). One participant was waiting for a revision knee replacement, and one was waiting for an arthoscopic trim of their meniscus.In general, the participants, whose knee surgery was delayed because of the COVID-19 pandemic, reported their knee pain and function had worsened since they were waitlisted. The activities that were most mechanically demanding and time consuming, such as walking outdoors for >15 minutes, walking up and down stairs, standing for a long time and doing housework or gardening, scored most poorly for pain and function. Participants were also found to actively avoid these activities, along with kneeling, to manage their symptoms.
In general, participants found their knee pain to be the most prominent symptom. However, more participants reported a worsening in function than pain in all but one activities, suggesting that the rate of symptom worsening may be greater for function than pain. If this is true true, patients whose surgeries are delayed may benefit from prehabilitation while awaiting surgery to prevent further worsening of knee function and mobility pre-operatively.A variety of coping mechanisms were reported by the participants, ranging from exercise to the use of prescription medication. The use of medication was reported to have increased while the patients were on the waiting list, to manage the worsening symptoms.
While the onset of the pandemic had not changed anyone’s mind about wanting surgery, participants reported a lack of information on how to manage their symptoms and prevent worsening while waiting for surgery. Future patients may therefore benefit from additional appointments or information leaflets about symptom management while waiting for surgery.
REC name
North West - Liverpool Central Research Ethics Committee
REC reference
21/NW/0093
Date of REC Opinion
7 Apr 2021
REC opinion
Further Information Favourable Opinion