M. Stowers1,2, D. Lemanu1,4, B. Coleman2, A. Hill1, J. Munro1,4 1University Of Auckland,Department Of Surgery,Auckland, -, New Zealand 2Middlemore Hospital,Department Of Orthopaedic Surgery,Auckland, , New Zealand 3University Of Auckland,Auckland Medical School,Auckland, , New Zealand 4Auckland City Hospital,Department Of Orthopaedic Surgery,Auckland, , New Zealand
Introduction: Hip and knee arthroplasty induce significant physiological stress. ERAS has been shown to improve patient outcomes in a range of surgical settings through attenuation of this stress response. A prospective study aiming to hasten recovery and improve patient outcomes in hip and knee arthroplasty was undertaken.
Methods: Patients undergoing elective primary hip or knee replacement surgery at our hospital were consecutively recruited after implementation of our ERAS protocol. Primary outcome was length of stay (LOS) and secondary outcomes included 30-day complications, readmission rates and cost. This study was powered to detect a reduction in LOS of 1 day. These patients were compared to a retrospective cohort.
Results: There were 204 patients who met eligibility criteria (104 ERAS, 100 control). With the exception of ERAS patients having a slightly higher BMI (p<0.05) than the control group all baseline characteristics were similar. Post implementation of ERAS, median LOS was reduced by 1 day (5 control vs 4 ERAS; p<0.001). Short-term complications were similar (p=0.372), as were readmission rates in 30 days (p=0.258). Cost analysis identified ERAS patients to have reduced cost overall.
Conclusion: ERAS in hip and knee arthroplasty has been shown to be safe, effective in improving recovery through shorter day stay and cost effective.