Improved clinical outcomes of outpatient enhanced recovery hip and knee replacements in comparison to standard inpatient procedures: A study of patients who experienced both

Hardy, Alexandre; Courgeon, Margaux; Pelleï, Karina; Desmeules, François; Loubert, Christian; Vendittoli, Pascal‐André

doi:10.1016/j.otsr.2022.103236

Cited by 24 publications

(13 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, in recent years, multiple investigators looking at the complication rates of numerous outpatient programs in comparison to standard inpatient complication rates have concluded that outpatient surgery is not inferior. With the application of ERAS principles and the optimization of patient recovery to enable same-day discharge, we can obtain superior results compared to the inpatient standard of care [ 7 , 30 , 47 ]. Implementing the ERAS principles in the outpatient setting provides the opportunity to deliver better clinical outcomes for the patient whilst concomitantly providing cost-saving benefits for the healthcare system.…”

Section: Discussionmentioning

confidence: 99%

“…Improved pain control is one of the main pillars of patient satisfaction after surgery [ 30 ]. The management of postoperative pain has broad ramifications; some discomfort post-surgery is unavoidable, and depending on the severity, it can affect functional recovery, reduce patient satisfaction, and prolong the duration of the hospital stay.…”

Section: Pain Controlmentioning

confidence: 99%

“…Avoiding staples reduces nursing care time and affords the patient the opportunity to resume bathing sooner [ 8 , 45 , 46 ]. Optimizing wound closure was perceived as one of the most important improvements in the ERAS protocol [ 30 ].…”

Section: Wound Managementmentioning

confidence: 99%

“…Several studies have reviewed various ERAS-based short-stay protocols. The studies by Vendittoli et al indicated that the implementation of the ERAS short-stay protocol improved patient care while reducing direct healthcare costs, and shortening the duration of hospital stays when compared with a cohort of patients who followed a standard care pathway [ 7 , 30 , 47 ]. The mean hospital length of stay for the ERAS short-stay group decreased by 2.8 days for THAs (0.1 vs. 2.9 d, p < 0.001).…”

Section: Eras and Outpatient Pathway Integration For Thamentioning

confidence: 99%

See 3 more Smart Citations

Modernizing Total Hip Arthroplasty Perioperative Pathways: The Implementation of ERAS-Outpatient Protocol

Sivaloganathan

Blakeney

Vendittoli

2022

JCM

Self Cite

View full text Add to dashboard Cite

Pressure to reduce healthcare costs, limited hospital availability along with improvements in surgical technique and perioperative care motivated many centers to focus on outpatient pathway implementation. However, in many short-stay protocols, the focus has shifted away from aiming to reduce complications and improved rehabilitation, to using length of stay as the main factor of success. To improve patient outcomes and maintain safety, the best way to implement a successful outpatient program would be to combine it with the principles of enhanced recovery after surgery (ERAS), and to improve patient recovery to a level where the patient is able to leave the hospital sooner. This article delivers a case for modernizing total hip arthroplasty perioperative pathways by implementing ERAS-outpatient protocols.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Pain Controlmentioning

confidence: 99%

Section: Wound Managementmentioning

confidence: 99%

Section: Eras and Outpatient Pathway Integration For Thamentioning

confidence: 99%

See 2 more Smart Citations

Modernizing Total Hip Arthroplasty Perioperative Pathways: The Implementation of ERAS-Outpatient Protocol

Sivaloganathan

Blakeney

Vendittoli

2022

JCM

Self Cite

View full text Add to dashboard Cite

show abstract

“…While limited in number, such cases are consistent with recent evidence indicating the inadequacy of surgical decision-making based on a single BMI cutoff [ 30 , 31 ] and support standardized application of patient selection criteria, preoperative medical optimization, and perioperative risk management for patients undergoing both primary and revision TJA in an ambulatory setting. Evidence-based enhanced recovery, fast-track, and short-stay protocols for the preoperative, intraoperative, and postoperative management of TJA patients have a proven track record of success in reducing perioperative medical complications in both the inpatient and outpatient settings [ [32] , [33] , [34] , [35] ] Key features of these protocols include medical evaluation, patient optimization, and education before surgery, as well as perioperative strategies to control glycemia, adverse anesthesia effects, pain, nausea and vomiting, infection, venous thromboembolism, blood loss requiring transfusion, and urinary retention [ 36 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

Same-Day Discharge Following Aseptic Revision and Conversion Total Joint Arthroplasty: A Single-Institution Experience

Deans¹,

Buller²,

Ziemba-Davis³

et al. 2022

Arthroplasty Today

View full text Add to dashboard Cite

No clinically significant difference in postoperative pain and side effects comparing conventional and enhanced recovery total hip arthroplasty with early mobilization

Reinhard¹,

Schindler²,

Leiß³

et al. 2023

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

Introduction Enhanced recovery after surgery (ERAS) leads to less morbidity, faster recovery, and, therefore, shorter hospital stays. The expected increment of primary total hip arthroplasty (THA) in the U.S. highlights the need for sufficient pain management. The favorable use of short-lasting spinal anesthesia enables early mobilization but may lead to increased opioid consumption the first 24 h (h) postoperatively. Methods In a retrospective study design, we compared conventional THA with postoperative immobilization for two days (non-ERAS) and enhanced recovery THA with early mobilization (ERAS group). Data assessment took place as part of the “Quality Improvement in Postoperative Pain Treatment project” (QUIPS). Initially, 2161 patients were enrolled, resulting in 630 after performing a matched pair analysis for sex, age, ASA score (American-Society-of-Anesthesiology) and preoperative pain score. Patient-reported pain scores, objectified by a numerical rating scale (NRS), opioid consumption and side effects were evaluated 24 h postoperatively. Results The ERAS group revealed higher activity-related pain (p = 0.002), accompanied by significantly higher opioid consumption (p < 0.001). Maximum and minimum pain as well as side effects did not show significant differences (p > 0.05). Conclusion This study is the first to analyze pain scores, opioid consumption, and side effects in a matched pair analyses at this early stage and supports the implementation of an ERAS concept for THA. Taking into consideration the early postoperative mobilization, we were not able to detect a difference regarding postoperative pain. Although opioid consumption appeared to be higher in ERAS group, occurrence of side effects ranged among comparable percentages.

show abstract

Improved clinical outcomes of outpatient enhanced recovery hip and knee replacements in comparison to standard inpatient procedures: A study of patients who experienced both

Cited by 24 publications

References 28 publications

Modernizing Total Hip Arthroplasty Perioperative Pathways: The Implementation of ERAS-Outpatient Protocol

Modernizing Total Hip Arthroplasty Perioperative Pathways: The Implementation of ERAS-Outpatient Protocol

Same-Day Discharge Following Aseptic Revision and Conversion Total Joint Arthroplasty: A Single-Institution Experience

No clinically significant difference in postoperative pain and side effects comparing conventional and enhanced recovery total hip arthroplasty with early mobilization

Contact Info

Product

Resources

About