Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jun;28(6):1699-1704.
doi: 10.1007/s00167-020-06031-3. Epub 2020 Apr 27.

Returning to Orthopaedic Business as Usual After COVID-19: Strategies and Options

Free PMC article

Returning to Orthopaedic Business as Usual After COVID-19: Strategies and Options

Francesca de Caro et al. Knee Surg Sports Traumatol Arthrosc. .
Free PMC article


Purpose: The aim of this manuscript is to review the available strategies in the international literature to efficiently and safely return to both normal orthopaedic surgical activities and to normal outpatient clinical activities in the aftermath of a large epidemic or pandemic. This information would be beneficial to adequately reorganize outpatient clinics and hospitals to provide the highest possible level of orthopaedic care to our patients in a safe and efficient manner.

Methods: A literature search was performed for relevant research articles. In addition, the World Health Organisation (WHO), the US Centers for Disease Control (CDC), American Association of Orthopaedic Surgeons (AAOS), the EU CDC and other government health agency websites were searched for any relevant information. In particular, interest was paid to strategies and advise on managing the orthopaedic patient flow during outpatient clinics as well as surgical procedures including the necessary safety measures, while still providing a high-quality patient experience. The obtained information is provided as a narrative review.

Results: There was not any specific literature concerning the organization of an outpatient clinic and surgical activities and the particular challenges in dealing with a high-volume practice, in the afterwave of a pandemic.

Conclusion: As the COVID-19 crisis has abruptly halted most of the orthopaedic activities both in the outpatient clinic and the operating room, a progressive start-up scenario needs to be planned. The exact timing largely depends on factors outside of our control. After restrictions will be lifted, clinical and surgical volume will progressively increase. This paper offers key points and possible strategies to provide the highest level of safety to both the orthopaedic patient and the orthopaedic team including administrative staff and nurses, during the start-up phase.

Level of evidence: Review, Level V.

Keywords: COVID; Coronavirus; Orthopaedic surgery; Outpatient clinic.

Conflict of interest statement

Authors declare no conflict of interest.

Similar articles

See all similar articles

Cited by 2 articles


    1. Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, et al. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology. 2020 doi: 10.1148/radiol.2020200642. - DOI - PubMed
    1. Chang LZ, Wang W, Murphy D, Po Hui JH. Novel coronavirus and orthopaedic surgery: early experiences from Singapore. J Bone Jt Surg Am. 2020 doi: 10.2106/JBJS.20.00236. - DOI
    1. Chen T, Wu D, Chen H, Yan W, Yang D, Chen G. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ. 2019;368:m1091. doi: 10.1136/bmj.m1091. - DOI
    1. Day M. Covid-19: four fifths of cases are asymptomatic, China figures indicate. BMJ. 2020;369:m1375. doi: 10.1136/bmj.m1375. - DOI - PubMed
    1. Hirschmann MT, Hart A, Henkel J, Sadoghi P, Seil R, Mouton C. COVID-19 coronavirus: recommended personal protective equipment for the orthopaedic and trauma surgeon. Knee Surg Sports Traumatol Arthrosc. 2020 doi: 10.1007/s00167-020-06022-4. - DOI - PubMed

LinkOut - more resources