Research Notebook is a series highlighting research activities at LSU Health Shreveport. This notebook focuses on articles written by Department of Orthopaedic Surgery faculty members early in the pandemic that were published in national academic journals resulting in providing best practices for the specialty throughout the COVID-19 pandemic.

The COVID-19 pandemic has impacted many aspects of the world around us, including the workplace. Many would say that hospitals and healthcare workers are those who are most affected by COVID-19 due to the unprecedented scenarios it presents. Early in the pandemic, there were orders issued across the country relating to postponing or moving forward with medical and surgical procedures based on the strain and threat of COVID-19 on healthcare systems and to patients. Orthopaedic surgeries were among many types of procedures that needed to adjust accordingly. LSU Health Shreveport faculty members - Dr. Patrick Massey, Associate Clinical Professor of Orthopaedic Surgery; Dr. Andrew Zhang, Assistant Professor of Orthopaedic Surgery; Dr. Kaylan McClary, former Orthopaedic Surgery Resident; and Dr. Shane Barton, Thomas Norris MD Endowed Professor and Chairman of the Department of Orthopaedic Surgery at LSU Health Shreveport, in collaboration with Dr. Buddy Savoie at Tulane University, published an article in the American Academy of Orthopaedic Surgeons’ Journal of the AAOS, which is being used by institutions around the country for guidelines on elective and urgent surgical selection for orthopaedics during the COVID-19 pandemic.

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The article, “Orthopaedic Surgical Selection and Inpatient Paradigms During the Coronavirus (COVID-19) Pandemic,” predicted in 2020 when it was first published that the pandemic would move in and out of different phases and created a framework for which surgeries were urgent, emergent and elective.

The article highlights how orthopaedic departments can modify determining what surgeries to perform based on the procedure being urgent vs. elective, inpatient vs. outpatient, and what resources are needed, and sorting orthopaedic surgeries into categories based on priority. Factors like physical distancing, workforce changes, online document use, and physician well-being as they relate to COVID-19 were addressed in the publication. The American Academy of Orthopaedic Surgeons (AAOS) adopted many guidelines from the article for widespread use, and it has reached 100 citations by other publications. As a point of reference, publications receiving 100 or more citations are considered to be among the top 1.8% worldwide.

LSU Health Shreveport faculty members not only provide patient care, but also train the next generation of physicians which added another element in the management of COVID-19. Currently, LSU Health Shreveport has almost 600 residents and fellows who are receiving their postgraduate training in one of the nearly 50 residency and fellowship programs supported by the LSUHS Graduate Medical Education (GME) Office.

These programs, which doctors must complete after graduating from medical school in order to practice or specialize, were directly impacted by the COVID-19 pandemic as each specialty has a defined number of procedures that must be accomplished in order to complete their training. Another article published by Dr. Massey, Dr. Zhang, Dr. Barton and Orthopaedic Surgery Residents Dr. Mitchell Myers, Dr. Clarence J. Kee, and Dr. Kaylan McClary in the journal Arthroscopy, Sports Medicine, and Rehabilitation provides a guide for orthopaedic surgery residency programs at academic medical centers across the country.

The guide provides a roadmap for adapting during the pandemic, ensuring the safety of both patients and residents while maintaining the important training of residents. This article, “Adapting Orthopaedic Surgery Training Programs During the COVID-19 Pandemic and Future Directions,” was also forward-thinking in detailing sustainable measures that can be enacted during the current COVID-19 pandemic.

Of note is that the documented and sustainable measures can be adapted to future pandemics, including workforce and occupational modifications, personal protective equipment, telemedicine, online didactic education, resident wellness, return to elective surgery, and factors affecting medical students and fellows. The LSU Health Shreveport Department of Orthopaedics has and continues to focus on serving as a national leader among academic centers in addressing multiple aspects of the pandemic.

This article originally appeared on Shreveport Times: LSU Health Shreveport faculty publish COVID guidelines for orthopedic patient care