COVID-era Delayed Time to Surgery for Emergent Orthopaedic Procedures

Surgical specialties experienced significant changes during the COVID-19 pandemic including new preoperative testing protocols and altered perioperative workflows, which this study hypothesized led to delays in care for emergent orthopaedic cases. Operative cases performed between January 1, 2019 to March 7, 2021 were identified, with a threshold date separating pre- COVID-era from COVID-era of March 1, 2020. Demographics, perioperative timing, and COVID testing data were examined for 308 pre-COVID and 353 COVID-era cases with posted urgency classification of level 1, 2, or 3. Pre-COVID cases averaged shorter time-to-surgery compared to COVID-era, while even COVID-negative patients saw significantly prolonged times during the COVID-era. There were no significant differences in time-to-surgery between COVID-positive and COVID-negative patients, but COVID-positive patients saw significantly longer post-procedure operating room times during the COVID-era. Emergent orthopaedic surgical cases experienced significantly greater delays in time to procedure start during the COVID-era than cases with the same level of urgency in the pre-COVID-era. (Journal of Surgical Orthopaedic Advances 34(4):181–184, 2025)

Key words: COVID, time-to-surgery, orthopaedic surgery, preoperative protocol