Abstract
Aim:
To synthesize evidence from randomized controlled trials (RCTs) comparing Enhanced Recovery After Surgery (ERAS) protocols with standard care for primary hip and knee arthroplasty.
Design:
Systematic review of randomized controlled trials.
Method:
A comprehensive search of four databases identified RCTs comparing enhanced
recovery pathways with standard care in hip and knee arthroplasty. Primary outcome was length of stay, with secondary outcomes including patient-reported outcomes, functional measures, and complications. Assessment of methodological quality was performed using the Cochrane risk-of-bias tool. Narrative and tabular synthesis was utilised for all individual studies and comparisons between ERAS and standard care pathways were grouped and reported on.
Results:
Five RCTs (710 patients) met inclusion criteria. ERAS pathways reduced length of 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 favored ERAS protocols, though measurement heterogeneity limited synthesis. No studies reported increased complications with ERAS implementation.
Conclusion:
ERAS pathways significantly reduce length of stay following primary hip and knee arthroplasty while improving early functional recovery and without compromising patient safety. While early functional benefits were evident, standardisation of outcome measures is needed to improve comparability across studies.
Key practice points
• Enhanced recovery pathways reduce hospital length of stay without increasing
complications.
• Early postoperative mobility and function are improved with enhanced recovery.
• Further research is needed to refine protocols and standardise outcome
measures.
To synthesize evidence from randomized controlled trials (RCTs) comparing Enhanced Recovery After Surgery (ERAS) protocols with standard care for primary hip and knee arthroplasty.
Design:
Systematic review of randomized controlled trials.
Method:
A comprehensive search of four databases identified RCTs comparing enhanced
recovery pathways with standard care in hip and knee arthroplasty. Primary outcome was length of stay, with secondary outcomes including patient-reported outcomes, functional measures, and complications. Assessment of methodological quality was performed using the Cochrane risk-of-bias tool. Narrative and tabular synthesis was utilised for all individual studies and comparisons between ERAS and standard care pathways were grouped and reported on.
Results:
Five RCTs (710 patients) met inclusion criteria. ERAS pathways reduced length of 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 favored ERAS protocols, though measurement heterogeneity limited synthesis. No studies reported increased complications with ERAS implementation.
Conclusion:
ERAS pathways significantly reduce length of stay following primary hip and knee arthroplasty while improving early functional recovery and without compromising patient safety. While early functional benefits were evident, standardisation of outcome measures is needed to improve comparability across studies.
Key practice points
• Enhanced recovery pathways reduce hospital length of stay without increasing
complications.
• Early postoperative mobility and function are improved with enhanced recovery.
• Further research is needed to refine protocols and standardise outcome
measures.
| Original language | English |
|---|---|
| Pages | 378-379 |
| Number of pages | 2 |
| Publication status | Published - 24 Oct 2025 |
| Event | Australian Physiotherapy Association Scientific Conference 2025: Lead the physiotherapy evolution - Adelaide Convention Centre, Adelaide, Australia Duration: 23 Oct 2025 → 25 Oct 2025 https://physiotherapy.eventsair.com/apasc25/ |
Conference
| Conference | Australian Physiotherapy Association Scientific Conference 2025: Lead the physiotherapy evolution |
|---|---|
| Abbreviated title | APASC25 |
| Country/Territory | Australia |
| City | Adelaide |
| Period | 23/10/25 → 25/10/25 |
| Other | APA invites you to its biennial scientific conference APASC25, the Australian Physiotherapy Association Scientific Conference 2025. Take this opportunity to: •explore the latest in research, technology, evidence-based practice and social change •advance your profession and enhance patient care •learn from international and local speakers |
| Internet address |