Clearing the Backlog of Elective Surgeries Due to COVID-19

According to a new study from researchers at Johns Hopkins University School of Medicine, surgeons in the US will need between 7 and 16 months to complete the backlog of elective orthopaedic procedures that were suspended during the COVID-19 pandemic. This includes more than 1 million delayed surgeries for hip and knee arthroplasty and spinal fusion.

This study has been published online ahead of print by The Journal of Bone and Joint Surgery.

Lead author Amit Jain, MD, noted that in fields such as orthopaedic surgery, where procedures are frequently performed in an inpatient setting, the ramp-up may be slower than for surgeries typically done in outpatient facilities.

“We will keep adding to the backlog as long as we are not operating at 100% capacity,” he  said. Dr. Jain is chief of minimally invasive and outpatient spine surgery and associate professor of orthopaedic surgery and neurosurgery at the Johns Hopkins University School of Medicine in Baltimore, Maryland.

Dr. Jain and his colleagues used the Agency for Healthcare Research and Quality National Inpatient Sample, a national database that contains hospital inpatient data, to model the number of current and forecasted hip and knee arthroplasties and spinal fusion surgeries in the United States. They found that in an optimistic scenario – in which most elective surgeries are back to full capacity in June – it would take approximately 7 months to get through the backlog. In a more pessimistic scenario, delays to the ramp-up to full capacity could extend the backlog to 16 months.

To help ease the backlog, Dr. Jain has proposed several strategies to increase surgical throughput, including:

  • Increased use of telemedicine
  • Greater availability of OR timeslots for orthopaedic surgeries
  • Dedicated anesthesia and nursing teams for orthopaedics
  • More resources for care coordination
  • Care shifted to ambulatory surgery centers as much as possible



Jain A, Jain P, Aggarwal S. SARS-CoV-2 impact on elective orthopaedic surgery: implications for post-pandemic recovery. J Bone Joint Surg Am. 12 May 2020. doi: 10.2106/JBJS.20.00602. Published ahead of print.

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