Enhanced recovery after surgery for hip and knee arthroplasty: A systematic review and meta-analysis on randomized control trials

Geriatr Nurs. 2024 Nov-Dec:60:249-257. doi: 10.1016/j.gerinurse.2024.08.002. Epub 2024 Sep 21.

Abstract

Objectives: This review aimed to compare the efficacy and safety of enhanced recovery after surgery (ERAS) versus traditional care in patients who underwent total hip arthroplasty (THA) and total knee arthroplasty (TKA).

Methods: All randomized controlled trials (RCTs) were acquired via a comprehensive search of multiple databases. A meta-analysis was performed using Cochrane Collaboration's RevMan 5.4 software to calculate effect sizes.

Results: This meta-analysis included 850 patients in the ERAS group and 845 patients in the control group (patients who received traditional care). The outcomes suggested no significant difference in operative time, intraoperative blood loss, visual analogue scale, 30-day readmission rate, and mortality rate between the two groups. However, the ERAS group was associated with a significant decrease in transfusion rate, hospital length of stay, and postoperative complications. Moreover, the ERAS group had higher Hospital for Special Surgery scores and satisfaction rates.

Conclusions: Patients who underwent THA and TKA would benefit more from ERAS than traditional care.

Keywords: Enhanced recovery after surgery; Meta-analysis; Randomized controlled trials; Total hip arthroplasty; Total knee arthroplasty.

Publication types

  • Systematic Review
  • Meta-Analysis

MeSH terms

  • Arthroplasty, Replacement, Hip* / rehabilitation
  • Arthroplasty, Replacement, Knee* / rehabilitation
  • Enhanced Recovery After Surgery*
  • Humans
  • Length of Stay* / statistics & numerical data
  • Postoperative Complications / prevention & control
  • Randomized Controlled Trials as Topic*