Enhanced recovery after orthopaedic surgery: global research trends, collaboration, and emerging themes

Enhanced recovery after surgery (ERAS) pathways are increasingly used in arthroplasty and spine surgery, but the structure of the orthopaedic literature remains incompletely characterized. This study mapped publication growth, contributors, collaboration, citation influence, and research themes.

Web of Science Core Collection records were retrieved with a title-based search and exported on June 15, 2026. Reproducibility screening of 655 exported records excluded 347 stemming-related false positives in which "ERAS" matched the word "era" and 13 enhanced-recovery records that were trauma-related but not orthopaedic, leaving 295 eligible publications. Publication patterns, co-authorship, keyword co-occurrence, and reference co-citation were analyzed.

The 295 publications spanned 2012-2026; 242 (82.0%) were published from 2020 onward, and annual output peaked at 53 in 2025. China contributed to 129 records (43.7%), the United States to 59 (20.0%), and England to 16 (5.4%). Sichuan University was the leading standardized organization (12 publications). Major themes centered on total knee and hip arthroplasty, length of stay, complications, perioperative care, pain, and spine surgery.

Orthopaedic ERAS research has grown rapidly and continued to increase through 2025, but output remains geographically concentrated. The literature is mature around clinical efficacy and perioperative outcomes; implementation, dissemination, and broader international representation are important priorities.