Enhanced recovery pathways in orthopedic surgery

Area of Science:

• Medicine
• Orthopedic Surgery
• Evidence-Based Practice

Background:

• The Enhanced Recovery After Surgery (ERAS) concept, introduced in 1997, aims to mitigate postoperative recovery delays caused by surgical stress and organ dysfunction.
• ERAS protocols are multimodal, evidence-based interventions designed to reduce complications, shorten hospital stays, and enhance patient satisfaction.
• Initially focused on abdominal surgery, ERAS principles are now widely applied across various specialties, including orthopedic surgery.

Purpose of the Study:

• To summarize the clinical application of ERAS principles in orthopedic surgery, particularly for elective hip and knee arthroplasty.
• To highlight the key elements and interventions characterizing orthopedic ERAS programs.
• To review the evidence supporting ERAS in improving outcomes for orthopedic patients.

Main Methods:

• A PubMed literature search was conducted using terms 'enhanced recovery' and 'orthopedic surgery'.
• The review focused on articles detailing the implementation and outcomes of ERAS in orthopedic settings.
• Interventions were categorized into preoperative, intraoperative, and postoperative phases.

Main Results:

• ERAS principles have been successfully adopted in orthopedic surgery, demonstrating significant benefits.
• Adoption of ERAS in orthopedic procedures, especially hip and knee arthroplasty, is associated with reduced hospital stays and readmission rates.
• ERAS programs contribute to improved functional recovery and patient satisfaction post-orthopedic surgery.

Conclusions:

• ERAS protocols represent a multidisciplinary approach that effectively accelerates patient recovery and improves outcomes in orthopedic surgery.
• Key elements across preoperative, intraoperative, and postoperative phases are crucial for successful ERAS implementation in orthopedics.
• The widespread adoption of ERAS in orthopedics underscores its value in modern surgical care pathways.