Recommendations of protective measures for orthopedic surgeons during COVID-19 pandemic

Knee Surg Sports Traumatol Arthrosc. 2020 Jul;28(7):2027-2035. doi: 10.1007/s00167-020-06092-4. Epub 2020 Jun 10.


Purpose: It was the primary purpose of the present systematic review to identify the optimal protection measures during COVID-19 pandemic and provide guidance of protective measures for orthopedic surgeons. The secondary purpose was to report the protection experience of an orthopedic trauma center in Wuhan, China during the pandemic.

Methods: A systematic search of the PubMed, Cochrane, Web of Science, Google Scholar was performed for studies about COVID-19, fracture, trauma, orthopedic, healthcare workers, protection, telemedicine. The appropriate protective measures for orthopedic surgeons and patients were reviewed (on-site first aid, emergency room, operating room, isolation wards, general ward, etc.) during the entire diagnosis and treatment process of traumatic patients.

Results: Eighteen studies were included, and most studies (13/18) emphasized that orthopedic surgeons should pay attention to prevent cross-infection. Only four studies have reported in detail how orthopedic surgeons should be protected during surgery in the operating room. No detailed studies on multidisciplinary cooperation, strict protection, protection training, indications of emergency surgery, first aid on-site and protection in orthopedic wards were found.

Conclusion: Strict protection at every step in the patient pathway is important to reduce the risk of cross-infection. Lessons learnt from our experience provide some recommendations of protective measures during the entire diagnosis and treatment process of traumatic patients and help others to manage orthopedic patients with COVID-19, to reduce the risk of cross-infection between patients and to protect healthcare workers during work.

Level of evidence: IV.

Keywords: 2019 novel coronavirus; 2019-nCoV; COVID-19; Cross-infection; Fracture; Novel coronavirus disease; Orthopedic surgery; Protection; Traumatology; Treatment and diagnosis.

Publication types

  • Systematic Review

MeSH terms

  • Air Filters
  • Betacoronavirus
  • China
  • Clinical Laboratory Techniques
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / prevention & control*
  • Coronavirus Infections / transmission
  • Cross Infection / prevention & control*
  • Elective Surgical Procedures
  • Emergencies
  • Emergency Service, Hospital
  • First Aid
  • Fractures, Bone / surgery
  • Humans
  • Infectious Disease Transmission, Patient-to-Professional / prevention & control*
  • Operating Rooms
  • Orthopedic Procedures / methods*
  • Orthopedic Surgeons
  • Orthopedics*
  • Pandemics / prevention & control*
  • Personal Protective Equipment
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / prevention & control*
  • Pneumonia, Viral / transmission
  • Telemedicine / methods*
  • Transportation of Patients
  • Trauma Centers

Supplementary concepts

  • COVID-19
  • COVID-19 diagnostic testing
  • severe acute respiratory syndrome coronavirus 2