The new coronavirus covert 19 has caused a pandemic which has had massive impacts on health care in England. Virtually all elective (planned) surgery has halted and many private hospitals are now being used for NHS patients in the short-term. As a group we recognize that orthopaedic conditions are still affecting many patients and indeed many patients are developing new conditions which need treatment. Here we have some advice and sources of help:
Acute conditions.
During this period of time people still develop acute infections, fractures and other conditions which clearly need treating urgently and possible hospital admission.
The NHS still provides the normal A&E service, GPs are still available though the ability to do face-to-face consultations may be significantly restricted, the 111 telephone line is still available for urgent advice.
The British Orthopaedic Association has been very clear with guidance for urgent treatment of fractures, if a fracture still needs an operation it will be done via the NHS or treated in a plaster cast or brace if indicated. Given the very difficult access to private hospitals and their operating theatres even insured patients are best treated by the NHS for these conditions. We can however give advice or have telephone consultations with patients if the fracture has been diagnosed and further advice is being sought. If after a telephone consultation it is thought that the potential benefits of a face-to-face consultation outweighs risks then face-to-face consultations can be arranged.
More chronic conditions.
Some acute conditions can be managed on a much more chronic basis, some patients will develop arthritic symptoms and patients may develop sporting symptoms or have sporting injuries. Many of these may be managed in a conservative fashion over the next few weeks having had a sensible advice.
Telephone consultations and potentially video consultations can be arranged via our group. It is possible to arrange imaging such as MRI scans even during this crisis many providers of scans are performing them adhering rigidly to social distancing and to heightened cleanliness and sterility. If necessary or appropriate a face-to-face meeting can be arranged or a telephone consultation with physiotherapists can be arranged.
Use of steroid injections.
Currently the general advice regarding steroid injections is that these should be avoided during the Covid pandemic. Non-steroid injections such as Hyalgan or PRP can be performed with safety, prior to considering these as treatment options we should debate the risk versus benefit of such procedures in your condition.
Use of anti-inflammatory drugs (NSAID’s)
During the early phases of the pandemic it was thought that anti-inflammatory drugs, such as ibuprofen, naproxen, Voltarol or similar drugs were contra indicated. There has been a central statement from the MHRA and similar bodies to say that on close examination of the evidence there is no contraindication all risk to using NSAID’s during the Covid epidemic.