Enhanced recovery after surgery (ERAS) in hip and knee replacement surgery: description of a multidisciplinary program to improve management of the patients undergoing major orthopedic surgery

Frassanito, Luciano; Vergari, Alessandro; Nestorini, Roberta; Cerulli, Giuliano Giorgio; Placella, Giacomo; Pace, Valerio; Rossi, Marco

doi:10.1007/s12306-019-00603-4

Cited by 87 publications

(65 citation statements)

References 23 publications

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“…In addition, joint function at 3 and 7 days after surgery was significantly better in the ERAS group than in the routine nursing group. Such good outcomes, which are associated with early exercise, were observed in patients with osteoarthritis in previous studies (Frassanito et al, 2019;Soffin & YaDeau, 2016;Vendittoli et al, 2019). In our study, patients with haemophilia A require a specific coagulation factor management in order not to aggravate bleeding.…”

Section: Discussionsupporting

confidence: 70%

Application of enhanced recovery after surgery in total knee arthroplasty in patients with haemophilia A: A pilot study

Han

Zhang

et al. 2020

Nursing Open

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Aim To identify the effect of enhanced recovery after surgery (ERAS) and rapid rehabilitation concepts on the outcomes of patients with haemophilia A undergoing total knee arthroplasty. Design Randomized controlled trial. Methods The primary endpoint was postoperative hospital stay. The secondary endpoints were pain scores, joint function scores, haemoglobin levels at 3 and 7 days after surgery and satisfaction with hospitalization. Results Thirty‐two patients were enrolled. Compared with the routine nursing group, the ERAS group showed shorter postoperative hospital stay (14.2 SD 0.8 vs. 16.6 ± 1.3 days, p < .001), smaller amounts of blood transfusion (924 SD 317 vs. 1,263 SD 449 ml, p = .020) and coagulation factors (37,325 SD 5,996 vs. 48,475 SD 8,019 U, p < .001), lower pain scores at 3 (3.3 SD 0.7 vs. 4.3 SD 0.7, p = .002) and 7 (2.3 SD 0.7 vs. 2.8 ± 0.5, p = .015) days, lower hospital for special surgery knee scores at 3 (59.9 SD 7.8 vs. 53.6 SD 5.9, p = .016) and 7 (77.9 SD 6.9 vs. 71.1 ± 7.1, p = .009) days and higher satisfaction with hospitalization (94.3 SD 1.4 vs. 92.7 SD 1.6, p = .004).

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Section: Discussionsupporting

confidence: 70%

Application of enhanced recovery after surgery in total knee arthroplasty in patients with haemophilia A: A pilot study

Han

Zhang

et al. 2020

Nursing Open

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“…Because surgery start time is typically determined a few weeks in advance and under the surgeon's control, we included this variable as preoperatively determined. Greater number of patientreported allergies has been associated with severe postoperative pain [17] and longer LOS [18] conferring 1.1 hours longer LOS per allergy reported [19,20]. We considered whether self-reported allergies might be a proxy for some other factor such as anxiety.…”

Section: Discussionmentioning

confidence: 99%

Enhanced Selection of Candidates for Same-Day and Outpatient Total Knee Arthroplasty

Moore

Brigati

Crijns

et al. 2020

The Journal of Arthroplasty

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“…In recent years, there has been an increasing trend toward early mobilization and a shorter length of stay to prevent medical complications and decrease costs. 11,19 Yet, some claim that rehabilitation that starts too early or is too intense might prevent the patients from participating in training and achieving PT goals due to joint pain and effusion along with medical and surgical complications. 1,20 This, in turn, may result with an increase in LOS and subsequent hospitalization costs, as pain following TKA has been shown to be associated with postoperative morbidity, decreased early functional accomplishments, increased LOS, and reduced patient satisfaction scores.…”

Section: Discussionmentioning

confidence: 99%

Earlier Initiation of Postoperative Physical Therapy Decreases Opioid Use after Total Knee Arthroplasty

et al. 2020

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For patients with advanced osteoarthritis of the knee, total knee arthroplasty (TKA) has been shown to provide significant pain relief and improved function with consistent, reproducible results. Post-operative physical therapy (PT) plays an important role is restoring muscle strength and range of motion (ROM). Yet, the impact of earlier physical therapy initiation after TKA has not been well defined. We assessed 205 patients that underwent primary TKA including 136 patients who started PT on the first post-operative day (POD1) and a second group that started PT 3 days after surgery (POD3), or later. Length of hospital stay (LOS), opioid use during hospital stay, complications, re-admissions, knee ROM and the need for subsequent hospitalized rehabilitation were recorded. LOS was not significantly shorter in the early PT group, compared with the delayed PT group (6.4 ± 2.2 days vs. 6.8 ± 2 days, respectively, P = .217). Patients in the delayed PT group consumed more opioids during their inpatient stay compared with the early PT group on both POD 3 (89% vs 82%, p = 0.013) and POD 4 (81% vs 66%, p = 0.005). There was no significant difference in the incidence of Immediate post-operative complications or final knee ROM between the two groups. While early postoperative PT did not impact hospital LOS or final knee ROM, it was associated with an earlier reduction in postoperative opioid consumption after primary TKA.

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Enhanced recovery after surgery (ERAS) in hip and knee replacement surgery: description of a multidisciplinary program to improve management of the patients undergoing major orthopedic surgery

Cited by 87 publications

References 23 publications

Application of enhanced recovery after surgery in total knee arthroplasty in patients with haemophilia A: A pilot study

Application of enhanced recovery after surgery in total knee arthroplasty in patients with haemophilia A: A pilot study

Enhanced Selection of Candidates for Same-Day and Outpatient Total Knee Arthroplasty

Earlier Initiation of Postoperative Physical Therapy Decreases Opioid Use after Total Knee Arthroplasty

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