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Enhanced recovery protocol and hidden blood loss in patients undergoing total knee arthroplasty
Rohit Dhawan1, Harshadkumar Rajgor1, Rathan Yarlagadda1
1Department of Arthroplasty, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, SY10 7AG, UK.
Background:
Perioperative blood loss and postoperative pain following total knee arthroplasty prevent early mobilisation of patients. The Enhanced Recovery Protocol (ERP) followed for patients in our institute aims at reducing post operative pain, blood loss and length of stay.
Materials And Methods:
50 consecutive patients that underwent ERP following total knee arthroplasty with another group of 70 patients that underwent the same surgery without ERP were compared in terms of hidden blood loss and length of hospital stay. Hidden blood loss was calculated according to previously described method.
Results:
Reduction in blood loss was found in both males (305 ml) and females (150 ml) following ERP. Length of stay reduced by 1.5 days in both genders. Regression analysis showed a significant correlation between body weight and blood loss in females.
Conclusion:
Enhanced recovery protocol could be a useful tool to reduce patient morbidity and reduce length of inpatient stay.