Abstract
Background:
Enhanced Recovery After Surgery (ERAS) protocols represent an evidence-based approach to perioperative care, though evidence from randomized controlled trials in primary hip and knee arthroplasty remains limited.
Objective:
This systematic review aims to synthesize evidence from randomized controlled trials (RCTs) comparing ERAS protocols with standard care for primary hip and knee arthroplasty.
Methods:
Four databases were searched following PRISMA guidelines. RCTs comparing ERAS protocols with standard care for primary hip or knee arthroplasty were included. Primary outcome was length of stay (LOS), with secondary outcomes including patient-reported outcomes, functional measures, and complications.
Results:
Five RCTs (710 patients) met inclusion criteria. ERAS pathways reduced LOS by an average of 4.7 days compared to standard care. Patients in ERAS protocols demonstrated superior early functional recovery, particularly in the first postoperative week, with improved performance in mobility tests and daily activities. Patient-reported outcomes generally favoured ERAS protocols, though measurement heterogeneity limited synthesis. No studies reported increased complications with ERAS implementation. The role of multidisciplinary teams, particularly nurse coordinators, was identified as an important for protocol success.
Conclusion:
This systematic review of RCTs provides strong evidence that ERAS pathways reduce length of stay following primary hip and knee arthroplasty without compromising patient outcomes or safety. While ERAS protocols were associated with improved early functional recovery, heterogeneity in assessment methods limits definitive conclusions.
Enhanced Recovery After Surgery (ERAS) protocols represent an evidence-based approach to perioperative care, though evidence from randomized controlled trials in primary hip and knee arthroplasty remains limited.
Objective:
This systematic review aims to synthesize evidence from randomized controlled trials (RCTs) comparing ERAS protocols with standard care for primary hip and knee arthroplasty.
Methods:
Four databases were searched following PRISMA guidelines. RCTs comparing ERAS protocols with standard care for primary hip or knee arthroplasty were included. Primary outcome was length of stay (LOS), with secondary outcomes including patient-reported outcomes, functional measures, and complications.
Results:
Five RCTs (710 patients) met inclusion criteria. ERAS pathways reduced LOS by an average of 4.7 days compared to standard care. Patients in ERAS protocols demonstrated superior early functional recovery, particularly in the first postoperative week, with improved performance in mobility tests and daily activities. Patient-reported outcomes generally favoured ERAS protocols, though measurement heterogeneity limited synthesis. No studies reported increased complications with ERAS implementation. The role of multidisciplinary teams, particularly nurse coordinators, was identified as an important for protocol success.
Conclusion:
This systematic review of RCTs provides strong evidence that ERAS pathways reduce length of stay following primary hip and knee arthroplasty without compromising patient outcomes or safety. While ERAS protocols were associated with improved early functional recovery, heterogeneity in assessment methods limits definitive conclusions.
| Original language | English |
|---|---|
| Article number | 101186 |
| Pages (from-to) | 1-9 |
| Number of pages | 9 |
| Journal | International Journal of Orthopaedic and Trauma Nursing |
| Volume | 57 |
| DOIs | |
| Publication status | Published - May 2025 |