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Overnight joint replacement surgery: a pilot Australian study.

Sol Qurashi^1,2,3,4, Jason Chinnappa^5,6, Sam Aktas³

¹Department Of Orthopaedic Surgery, Nepean Hospital, Penrith, New South Wales, Australia.

ANZ Journal of Surgery

|October 12, 2022

Summary

This summary is machine-generated.

An enhanced recovery after surgery (ERAS) protocol-led overnight model significantly reduced hospital length of stay for total hip replacement and total knee replacement patients, without increasing adverse events.

Keywords:

enhanced recovery after surgery health care rationing health economics total hip replacement total knee replacement

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Area of Science:

Orthopedic Surgery
Healthcare Management
Patient Recovery Protocols

Background:

Healthcare systems face strain, necessitating improved efficiency and cost reduction in surgical procedures.
Enhanced recovery after surgery (ERAS) protocols aim to optimize patient outcomes and streamline surgical pathways.
This study investigates a multidisciplinary, overnight ERAS model for total hip replacement (THR) and total knee replacement (TKR).

Purpose of the Study:

To compare the benefits of a multidisciplinary, ERAS protocol-led overnight model versus a standard ERAS approach for THR and TKR.
To evaluate the impact on length of stay, rehabilitation needs, functional outcomes, patient satisfaction, and safety.
To determine the feasibility and effectiveness of an overnight ERAS model in joint replacement surgery.

Main Methods:

Prospective enrollment of THR and TKR patients in two private hospitals.
One hospital implemented a full, multidisciplinary ERAS overnight model (treatment group).
The control group received ERAS only during anesthesia and operation, lacking comprehensive perioperative measures.

Main Results:

Median length of stay was significantly shorter in the overnight ERAS group (1 day) compared to the control group (3 days).
The overnight ERAS group showed substantially lower rates of inpatient rehabilitation utilization (4% vs. 41.2%).
Functional outcomes, patient satisfaction, adverse events, and readmission rates were comparable between the groups.

Conclusions:

An overnight enhanced recovery after surgery model for total hip and total knee replacements is safe and effective for most patients.
Multidisciplinary collaboration and comprehensive perioperative stakeholder involvement are key to successful implementation.
This approach offers significant benefits in reducing hospital length of stay and rehabilitation needs.