Recommendations for Orthopedic Surgeons during the COVID-19 Pandemic.

BACKGROUND: Toward the end of 2019, the coronavirus disease-2019 (COVID-19) pandemic began to create turmoil for global health organizations. The illness, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), spreads by droplets and fomites and can rapidly lead to life-threatening lung disease, especially for the old and those with health co-morbidities. Treating orthopedic patients, who presented with COVID-19 while avoiding nosocomial transmission, became of paramount importance. OBJECTIVES: To present relevant methods for pandemic control and hospital accommodation with emphasis on orthopedic surgery. METHODS: We searched search PubMed and Google Scholar electronic databases using the following keywords: COVID-19, SARS-CoV-2, screening tools, personal protective equipment, and surgery triage. RESULTS: We included 25 records in our analysis. The recommendations from these records were divided into the following categories: COVID-19 disease, managing orthopedic surgery in the COVID-19 era, general institution precautions, triage of orthopedic surgeries, preoperative assessment, surgical room setting, personal protection equipment, anesthesia, orthopedic surgery technical precautions, and department stay and rehabilitation. CONCLUSIONS: Special accommodations tailored for each medical facility, based on disease burden and available resources can improve patient and staff safety and reduce elective surgery cancellations. This article will assist orthopedic surgeons during the COVID-19 medical crisis, and possibly for future pandemics.

User Assessment of a Novel Suspension for a Wheelchair-A Prospective, Randomized, Double Blind Trial.

BACKGROUND: Many Wheelchair users experience adverse effects specific to their situation, some of which might be avoided if suspension systems are integrated into the wheelchair. OBJECTIVES: Our study aimed to compare the user experience using a novel wheelchair suspension system with normal wheels. We tried to quantify the user feelings and impressions while using the different wheels. STUDY DESIGN: Double blinded comparative randomized study. METHODS: The patients were randomized into 2 groups. One used shock absorbing wheels, and the other group had a set of standard wheels with the same exact wheelchairs. The patients were taken to a daily trip by the caregivers and given questionnaires in the second and fourth days. On the morning of the third day the wheels were interchanged, creating a cross over between the groups. We collected general and medical information from the participants. The main outcome measures were the questionnaires filled by the patients and the caregivers aiming to quantify the user experience with the suspension equipped wheels. RESULTS: Statistical significance was reached in 2 questions referred to the patients: "In general-During the ride I didn't feel the bumps" and "I feel very confident when riding the chair" and in one question referred to the caregiver-"It was easy to push the chair in suboptimal ground." CONCLUSIONS: We conclude that the shock absorbing system provided a better user experience in the immediate term than standard wheels. Further study is needed to assess the long-term implications.