The Orthopaedic Forum Guidelines for Ambulatory Surgery Centers for the Care of Surgically Necessary/Time-Sensitive Orthopaedic Cases during the COVID-19 Pandemic

Authors:

Nicholas N. DePhillipo, PhD, ATC, Christopher M. Larson, MD, Owen R. O’Neill, MD, and Robert F. LaPrade, MD, PhD

Introduction:

The current pandemic caused by the novel coronavirus disease 2019 (COVID-19) has created unprecedented times. As communities strive to control infectious outbreaks, the virus continues to cause substantial economic, social, and political disruption. As emergency departments are preparing for increased volume because of infected patients, the closure of non- emergency health-care facilities may further increase inappropriate demand on emergency medical staff. Approximately 77% of all injury-related health-care visits in the U.S. are for musculoskeletal injuries1, totaling >65 million visits in 2010 and 2011. Thus, to lessen the burden on emergency department personnel, it is vital for continued limited operation of orthopaedic outpatient centers. Additionally, recent government mandates are now excluding medical care and treatment for elective procedures, thus causing ambulatory surgery centers (ASCs) to cease operations for non-urgent orthopaedic-related procedures; however, for certain pathologies, inability to operate or failure to recognize injuries that are “surgically necessary” may result in serious long-term health consequences, including neurological, vascular, and joint morbidity.