The Efficacy of Pre-Operative Self-Isolation Guidelines for Safe Elective Orthopaedic Surgeries: A Prospective Pilot Study

Objectives This study aimed to determine the efficacy of the self-isolation guidance for elective orthopaedic surgery. We aimed to evaluate the relationship between patient compliance with the self-isolation guidance and the resulting COVID-19 status. This would give planning strategies for managing elective orthopaedic lists. Method For the study, 110 patients who underwent elective orthopaedic surgical procedures during a one-month period were identified. Patients scheduled for surgery were asked to take a SARS-CoV-2 PCR test three days prior to surgery and they were asked to follow the self-isolation guidance. On the day of admission, patients declared compliance with self-isolation regulations. Admission was refused in cases of non-compliance. After discharge, telephone calls were made to patients to determine the degree of compliance with the self-isolation guidance. Results Overall, 106 out of 107 patients that were compliant with the self-isolation guidance tested negative for COVID-19; 15 patients had their operation cancelled over the one-month period; of which one-third were cancelled by the patients themselves. Three patients were found to be non-compliant with the self-isolation guidance. Of these three non-compliant patients, one tested positive for COVID-19. Adherence to the self-isolation guidelines helped to prevent last-minute cancellations and manage the list effectively. Conclusions Compliance with our self-isolation guidance accompanied by PCR screening minimises the risk of testing positive for COVID-19 and is thus an effective system to safely perform elective orthopaedic surgery. Intentionally overbooking theatre lists by 10 to 12.5% may account for cancellations and improve theatre efficiencies during post-pandemic recovery plans for elective orthopaedic surgeries.