A Retrospective Study of the Implementation of Enhanced Recovery After Unicompartmental Knee Arthroplasty

The goal of this study is to report our findings on the application of the enhanced recovery after surgery (ERAS) protocol for patients undergoing unicompartmental knee arthroplasty (UKA) and to evaluate the benefits and drawbacks of this approach.

Sixty patients with medial unicompartmental knee osteoarthritis (UKOA) who underwent UKA were the subject of a retrospective investigation. The patients were categorized into 2 groups based on the use of ERAS protocols. Among the metrics that were measured and statistically analyzed were Kellgren-Lawrence grade, femorotibial angle (FTA), Tegner activity score, Lysholm knee score, University of California at Los Angeles (UCLA) activity score, Berg Balance Scale (BBS), numeric pain rating scale (NPRS) score, forgotten joint score, range of motion (ROM), hospital length of stay (LOS), procedure duration, intraoperative bleeding volume, time to ambulation, time to resume normal walking, duration of urinary catheter retention, time to resume a regular diet, and postoperative satisfaction.

The patients allocated to the ERAS cohort showed distinct characteristics compared with the control cohort, including faster resumption of regular dietary intake, ambulation, and gait patterns. The ERAS group showed a decreased FTA and improved BBS scores. On final evaluation, the ERAS group had lower UCLA scores, indicative of superior overall outcomes.

The initial application of ERAS showed promising results in enhancing patient rehabilitation outcomes, reducing the impact of hospitalization, and improving efficient allocation of health care resources. Nevertheless, additional research is necessary to assess the feasibility and effectiveness of widespread implementation for patients undergoing UKA. [Orthopedics. 2025;48(2):87-97.].