There has been a 40 per cent decline in knee replacement surgeries in India due to COVID, said expert, ahead of the World Arthritis Day on October 12.

The elderly have seen an increased vulnerability for COVID infection with poor outcomes for survival, with a higher risk associated among those with pre-existing medical conditions. Besides diabetes and other comorbidities, the elderly with pre-existing arthritis and osteoporosis also experienced debilitating painful symptomatology during COVID.

In the elderly, osteoarthritis is the most common form of knee arthritis. It is a bone degeneration disorder that leads to joint pain and stiffness in old age. Another common reason for knee pain among the elderly is osteoporosis the most common locomotor disability.

"The contagious evolving COVID pandemic posed new challenges in the surgical management of joint arthritis. The personal observation suggests for a 40 per cent decline in replacement surgeries with additional delay in rescheduling of the planned surgeries," Dr L. Tomar, Director Department of Orthopaedics, Max Super Specialty Hospital, Delhi, reported.

It is because they were not able to do regular follow up with their doctors and continue the medications, maintain regular exercise and walking routine because of lockdown. This lead to reduced muscle and bone strength and progression of the disease, according to Dr Subhash Jangid, director and Unit Head, Bone and Joint Institute, Fortis Memorial Research Institute, Gurugram.

This was coupled with reluctance for consultation due to lockdown restrictions, societal pressures to remain home-bound to avoid COVID exposure, fear of affecting the family members and re-allocation of resources in hospitals have all contributed immensely to the delay and initiation of timely management for arthritis and osteoporosis.

The COVID vaccine diplomacy along with the early vaccine hesitancy has also contributed to the fear of psychosis amongst both the educated and uneducated masses of the population, the experts said. Delay in surgery has rendered many elderly unfit for surgery, Jangid said.

"The poor chest compliance, lower exercise tolerance, thrombotic episodes, susceptibility to secondary infections, weak cardiac health have significantly increased the risks in elderly planned for elective surgery. The pre-COVID fit elderly population have now been graded as high-risk candidates for procedures," Tomar added.

The experts urged people to get treated knees timely because walking with deformed and painful knees can also damage the spine to an irreparable stage. Reduced mobility and low physical activity may also give rise to other diseases like diabetes, hypertension, and obesity, which further worsens the condition.