Reducing the length of hospital stay for patients undergoing primary total knee arthroplasty by application of enhanced recovery after surgery (ERAS) pathway: a multicenter, prospective, randomized controlled trial
Abstract
The proportion of elderly patients undergoing Total knee arthroplasty (TKA) is growing. Optimizing and accelerating postoperative recovery for TKA patients is critical in clinical practice. Enhanced Recovery After Surgery (ERAS) is a protocol involving a series of evidence-based perioperative optimization strategies to minimize surgical stress and expedite recovery, and a multidisciplinary ERAS pathway was established jointly by anesthesiologists and orthopedic surgeons in this study. The authors hypothesized that application of the ERAS pathway can reduce the length of hospital stay (LOS) for patients undergoing primary TKA. This multicenter, prospective, randomized controlled trial was conducted from February 1, 2021 to January 31, 2023, and included patients undergoing elective primary TKA. 320 patients were randomly assigned to either the ERAS group (practice according to the ERAS pathway) or the control group (without ERAS pathway implementation) in a 1:1 ratio. The primary outcome was the total LOS in hospital. LOS in the ERAS group was 5.92 ± 1.16 days, significantly shorter than the 8.17 ± 1.76 days in the control group (p < 0.001). Postoperative LOS and time to independent ambulation were significantly shorter in the ERAS group compared to the control group (p < 0.001). On postoperative day 1, significantly less participants reported pain both in rest and during mobilization in the ERAS group than the control group (p < 0.001). The incidences of thirst and…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 320 participants or records.
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