Enhanced Recovery After Surgery for Hip and Knee Replacements

Area of Science:

• Orthopedic surgery
• Patient recovery protocols
• Healthcare management

Background:

• Enhanced Recovery After Surgery (ERAS) programs streamline patient care for hip and knee replacements.
• These programs aim to shorten hospital stays and improve patient outcomes without increasing complications or mortality.

Purpose of the Study:

• To compare patient outcomes after implementing an institutional ERAS program for hip and knee replacements.
• The study evaluated outcomes against a historical patient cohort.

Main Methods:

• ERAS protocols were developed, focusing on pre-admission, patient education, anemia management, anesthesia, mobilization, and discharge planning.
• Outcomes of 528 ERAS patients were compared to 507 historical control patients over 18-month periods.

Main Results:

• Average length of stay (ALOS) decreased significantly for both hip (5.6 to 4.3 days) and knee (5.7 to 4.8 days) replacements (p < .001).
• Six-month Oxford knee scores improved in the ERAS group (39.8 vs. 36.3, p = .03), with no increase in mortality or early revision rates.
• The 30-day readmission rate saw a slight, non-significant increase (3.2% to 5.5%, p = .065).

Conclusions:

• ERAS protocols can substantially reduce ALOS in public hospital settings.
• High patient satisfaction and no increase in complications were observed.
• Successful implementation requires a multidisciplinary approach and strong clinical input.