Reduction in Surgical Volume for Metastatic Disease to the Femur and Humerus During the COVID-19 Pandemic with an Associated Backlog of Surgeries

The purpose of this study was to observe how the COVID-19 pandemic impacted surgical volume for metastatic bone disease to the femur and humerus and whether the proportion of surgeries performed prophylactically significantly changed during the pandemic (March 2020 to April 2021). Patients who underwent surgical management for metastatic disease of the humerus and femur from January 2018 to April 2021 were identified in the PearlDiver Database. These patients were further stratified to surgeries performed prophylactically or not. The monthly changes in surgical volume and percentage of surgeries performed prophylactically were recorded. A linear forecast analysis using historical data from January 2018 to February 2020 was utilized to determine the expected volume and percentage of surgeries performed prophylactically during the pandemic period. From March to May 2020, there was a significant decrease in the volume of surgical procedures for metastatic bone disease to the humerus and femur. The surgical volume returned to pre-pandemic projections by June 2020. From March 2020, the backlog of surgical cases increased by 245%. The proportion of surgeries performed prophylactically did not significantly change during the COVID-19 pandemic. This study demonstrates a reduction in surgical management for metastatic lesions in the humerus and femur with an associated increase in backlog of cases during the COVID-19 pandemic in the United States. (Journal of Surgical Orthopaedic Advances 35(1):022 – 026, 2026)

Key words: epidemiology, oncology, COVID, metastatic disease to the femur and humerus