Preparation for the next COVID-19 wave: The European Hip Society and European Knee Associates recommendations

Knee Surg Sports Traumatol Arthrosc. 2020 Sep;28(9):2747-2755. doi: 10.1007/s00167-020-06213-z. Epub 2020 Aug 17.


Purpose: To plan for the continuance of elective hip and knee arthroplasty during a resurgence or new wave of COVID-19 infections.

Method: A systematic review was conducted using the terms "COVID-19" or "SARS-Cov-2" and "second wave". No relevant citations were found to inform on recommendations the plan. Therefore, an expert panel of the European Hip Society and the European Knee Associates was formed to provide the recommendations.

Results: Overall, the recommendations consider three phases; review of the first wave, preparation for the next wave, and during the next wave. International and national policies will drive most of the management. The recommendations focus on the preparation phase and, in particular, the actions that the individual surgeon needs to undertake to continue with, and practice, elective arthroplasty during the next wave, as well as planning their personal and their family's lives. The recommendations expect rigorous data collection during the next wave, so that a cycle of continuous improvement is created to take account of any future waves.

Conclusions: The recommendations for planning to continue elective hip and knee arthroplasty during a new phase of the SARS-Cov-2 pandemic provide a framework to reduce the risk of a complete shutdown of elective surgery. This involves engaging with hospital managers and other specialities in the planning process. Individuals have responsibilities to themselves, their colleagues, and their families, beyond the actual delivery of elective arthroplasty.

Keywords: Arthroplasty; COVID-19; Hip; Knee; Recommendations; SARS-Cov-2; Second phase; Second wave.

Publication types

  • Practice Guideline

MeSH terms

  • Arthroplasty, Replacement, Hip*
  • Arthroplasty, Replacement, Knee*
  • Betacoronavirus
  • Coronavirus Infections / epidemiology*
  • Elective Surgical Procedures / methods*
  • Europe
  • Humans
  • Orthopedics
  • Pandemics
  • Pneumonia, Viral / epidemiology*
  • Societies, Medical
  • Surgeons

Supplementary concepts

  • COVID-19
  • severe acute respiratory syndrome coronavirus 2