Updates in Enhanced Recovery Pathways for Total Knee Arthroplasty

Area of Science:

• Orthopedic Surgery
• Anesthesiology
• Patient Recovery

Background:

• Enhanced Recovery After Surgery (ERAS) programs utilize a multidisciplinary approach to optimize surgical outcomes.
• Orthopedic ERAS protocols are tailored to specific procedures, differing from those in other surgical fields.
• Total knee arthroplasty (TKA) ERAS pathways prioritize different goals compared to intracavitary surgery.

Purpose of the Study:

• To describe the specific components and goals of ERAS pathways for total knee arthroplasty.
• To highlight the differences between orthopedic ERAS protocols and those for other surgical types.
• To emphasize the focus on pain control and early ambulation in TKA recovery.

Main Methods:

• Review and synthesis of existing literature on ERAS protocols in orthopedic surgery, specifically TKA.
• Comparative analysis of ERAS elements in TKA versus intracavitary surgery.
• Identification of key performance indicators for orthopedic ERAS pathways.

Main Results:

• Orthopedic ERAS programs aim to accelerate return to function, reduce pain, improve patient satisfaction, and decrease hospital stay and costs.
• ERAS pathways for TKA are distinct, emphasizing optimized systemic and local analgesia.
• The primary focus for TKA is balancing high-quality pain control with an accelerated return to ambulation.

Conclusions:

• ERAS programs are crucial for improving outcomes in orthopedic surgery, particularly total knee arthroplasty.
• Tailoring ERAS pathways to specific procedures, like TKA, is essential for maximizing patient benefits.
• The success of TKA ERAS relies on effective pain management strategies that facilitate early mobilization.