The Persistent Backlog of Knee and Shoulder Orthopedic Sport Surgery Case Volume Following the COVID-19 Pandemic

As COVID-19 will not be the last pandemic, understanding our historical response allowsus to predict and improve our current practices in preparation for the next pandemic. Following theremoval of the elective surgery suspension at the onset of the COVID-19 pandemic, it is unclear whethersports medicine surgery volume has returned to pre-pandemic levels as well as whether the backlogfrom the original suspension was addressed. The purpose of this study to observe the monthly changesin volume and backlog of knee and shoulder sports surgery one year since the original suspension. National all-payer data was utilized to identify patients undergoing knee and shoulder sports proceduresfrom January 2017 to April 2021. Descriptive analysis was utilized to report the monthly changes in surgeries. Alinear forecast analysis using historical data was utilized to determine the expected volume. This was compared tothe observed case volume. The difference in expected and observed volume was utilized to calculate the estimatedchange in backlog. From March to May 2020, there was a persistent decrease in the observed shoulder and knee sportsvolume when compared to the expected volume. By June 2020, all knee and shoulder sports volume reached theexpected volume. By April 2021, the estimated backlog for shoulder and knee procedures had increased by 49.8%(26,412 total cases) and 19.0% (26,412 total cases), respectively, with respect to the original calculated backlogfrom March to May 2020. Within four months, the sudden decrease in volume for knee and shoulder sports procedures hadreturned to pre-pandemic levels; however, the original backlog in cases has continually increased one year followingthe suspension. Additionally, the backlog is significantly higher for knee when compared to shoulder surgeries. Level of evidence: IV