Major consequences for hip arthroplasty services in Europe during the COVID-19 : Pandemic results of an online survey of members of the European Hip Society

Background: The emergence of the SARS-CoV-2 pandemic in early 2020 necessitated a rapid reallocation of healthcare resources across Europe to manage infected patients. This shift significantly disrupted standard orthopedic practice, particularly elective surgical services, creating a need to quantify the extent of service suspension and its impact on hip arthroplasty specialists.

Objective: This study aims to evaluate the impact of the initial COVID-19 pandemic wave on total joint arthroplasty (TJA) services and the professional activities of surgeons within the European Hip Society (EHS).

Key Points: A prospective online survey of 222 EHS members from 39 countries revealed that 26.6% of departments cancelled all surgical procedures, while 64.9% suspended elective inpatient operations. Primary total hip arthroplasty (THA) and aseptic revisions were maintained by only 6.3% and 4.7% of respondents, respectively. Conversely, high-priority procedures such as surgery for periprosthetic fractures (86.2%) and femoral neck fractures (83.2%) continued. Personal surgical volume decreased for 81.8% of surgeons, and 38.6% were reassigned to non-orthopedic duties. Postoperative follow-up and rehabilitation services were also severely restricted, with 31.5% of surgeons reporting a total cessation of physical therapy services.

Conclusion: The first wave of the pandemic caused a near-total cessation of elective hip arthroplasty in Europe, with surgical activity limited primarily to life-threatening or acute traumatic conditions. These findings document a historic disruption in orthopedic care that may have long-term implications for patient outcomes and healthcare economics.