HSS COVID-19 Essential Surgeries

As of March 15, 2020

List of essential surgeries

Listed below is a “master list” of procedures that are applicable to all service lines as essential
procedures. Service line-specific procedures follow the master list.

Essential procedures - All service lines

• Any life- or limb-threatening injury
• Any infection, chronic or acute, requiring surgical intervention
• Any surgical wounds requiring surgical intervention
• Compartment syndrome
• Dislocation of native or prosthetic joint requiring reduction in the OR
• Malignant or benign tumors with impending fracture or neurovascular compromise
• Fractures (periprosthetic or native bone)
• Tendon injuries requiring surgical intervention
• Any loose body in the joint or displaced cartilage causing a locked joint
• Any injury to the lower extremity where the patient has an inability to bear weight or walk
• Any vascular or neurologic injuries
• Any injury where prompt intervention significantly improves outcomes
• Any debilitating pain which could lead to medical compromise, including avoidable opioid
treatment.

Adult Reconstruction and Joint Replacement (ARJR)

• No additional essential surgeries

Spine
● Progressive weakness on physical exam or weakness with active denervation on EMG
● Myelopathy with cord at risk
● Fracture or trauma with spinal instability
● Cauda Equina Syndrome

Sports Medicine
• Peri-articular and avulsion fractures

Pediatrics
• Pin removal (post fracture or osteotomy)
• Frame removal
• Clubfoot tenotomy
• Guided growth plate removal

Trauma
• Poorly compensated nonunions (e.g. those that effect the ability to perform ADL’s and/or
ambulation)
Limb Lengthening and Complex Reconstruction Service
• Nerve decompression in setting of compromised neurologic exam
• Removal of external fixation
• Bone grafting of bone transport docking sites
• Stabilization and correction of unstable limb with deformity

Foot and ankle

• No additional essential surgeries

Hand and upper extremity

• Lacerations with critical injury to tendons, nerves, arteries
• Ligament tears where timely treatment is necessary
• Brachial plexus or other significant nerve injury or problem

Hip preservation
• No additional essential surgery

Memorial Sloane Kettering patient musculoskeletal care

• Any urgent surgery for children under 18
• Neoadjuvant therapy awaiting surgery
• Primary sarcomas