Key Elements of Enhanced Recovery after Total Joint Arthroplasty: A Reanalysis of the Enhanced Recovery after Surgery Guidelines

Recent guidelines have produced a consensus statement for perioperative care in hip and knee replacement. However, there is still a need for reanalysis of the evidence and recommendations. Therefore, we retrieved and reanalyzed the evidence of each recommended components of enhanced recovery after s...

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Bibliographic Details
Published in:Orthopaedic surgery 2023-03, Vol.15 (3), p.671-678
Main Authors: Changjun, Chen, Xin, Zhao, Yue, Luo, Liyile, Chen, Pengde, Kang
Format: Article
Language:English
Subjects:
Analgesics
Anemia
Bone surgery
Counseling
Disease prevention
Enhanced recovery after surgery
Epidural
Evidence‐based review
Exercise
Fasting
General anesthesia
Insulin resistance
Joint replacement surgery
Joint surgery
Meta-analysis
Morphine
Mortality
Narcotics
Nausea
Orthopedics
Pain
Patient education
Perioperative care
Physical fitness
Recovery (Medical)
Review
Systematic review
Total hip arthroplasty
Total knee arthroplasty
Vomiting
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Summary:Recent guidelines have produced a consensus statement for perioperative care in hip and knee replacement. However, there is still a need for reanalysis of the evidence and recommendations. Therefore, we retrieved and reanalyzed the evidence of each recommended components of enhanced recovery after surgery (ERAS) based on the guidelines of total joint arthroplasty. For each one, we included for the highest levels of evidence and those systematic reviews and meta‐analyses were preferred. The full texts were analyzed and the evidence of all components were summarized. We found that most of the recommended components of ERAS are supported by evidence, however, the implementation details of each recommended components need to be further optimized. Therefore, implementation of a full ERAS program may maximize the benefits of our clinical practice but this combined effect still needs to be further determined. Key Elements of Enhanced Recovery after TJA.
ISSN:1757-7853
1757-7861
DOI:10.1111/os.13623