[Fast-track arthroplasty-intra- and post-operative management]

Area of Science:

• Orthopedic Surgery
• Anesthesiology
• Pain Management

Background:

• Fast-track surgery enhances patient recovery and outcomes.
• Multimodal pain management is key to early mobilization after joint replacement.

Purpose of the Study:

• To evaluate the efficacy of a fast-track protocol in hip and knee arthroplasty.
• To assess the impact of multimodal pain management on surgical outcomes.

Main Methods:

• Utilized local infiltration anesthesia as part of a multimodal pain concept.
• Omitted surgical drains, femoral nerve blocks, and urinary catheters.
• Administered tranexamic acid and cortisone to manage blood loss and pain.

Main Results:

• Minimal invasive techniques and tourniquet renouncement led to improved functional results and reduced pain.
• Tranexamic acid decreased blood loss and transfusion rates.
• Cortisone effectively reduced pain, postoperative nausea, vomiting, and stress response.

Conclusions:

• Fast-track protocols, incorporating multimodal pain management and minimally invasive techniques, are effective for hip and knee arthroplasty.
• Abandoning non-evidence-based restrictions and precautions facilitates better patient outcomes.
• This approach promotes early and safe mobilization, leading to enhanced functional recovery.