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Background <p>Enhanced Recovery After Surgery (ERAS®) is a coordinated, evidence-based program delivered through a multidisciplinary team, which objective is to improve outcomes and patient satisfaction, while minimizing complications. The objective of this two-cohort study is to evaluate the clinical impact of an ERAS program on elective primary hip (THA) and knee (TKA) arthroplasties with regards to hospital length of stay, during the first 12&#xa0;months after implementation.</p> Methods <p>We compared a retrospective pre-ERAS with a prospective ERAS cohort. Key aspects of this program included preoperative education, minimal fasting, standardised, anaesthetic and surgical techniques, multimodal analgesia, and early mobilization. The primary outcome was hospital length of stay. Other outcomes included rest, dynamic pain scores, and rates of complications.</p> Results <p>From December 1st, 2021 to November 30th, 2022, data from 267 patients (138 THA, 129 TKA) were compared with data from 258 patients (128 THA, 130 TKA) collected between December 1st, 2022, and November 30th, 2023, who underwent the ERAS® program (total: 525 patients). The mean hospital length of stay for THA patients before ERAS® was 5.5 ± 2.9&#xa0;days versus 4.5 ± 2.0&#xa0;days after ERAS® implementation (<i>p</i> = 0.002). For TKA patients, it was 6.6 ± 3.1&#xa0;days before vs 5.6 ± 1.9&#xa0;days after ERAS® implementation (<i>p</i> = 0.001). Rest, dynamic pain scores, and rates of complications were similar between groups except for pneumonia in patients undergoing TKA.</p> Conclusion <p>The implementation of an ERAS® program for hip and knee arthroplasty led to a reduced hospital length of stay, below the Swiss national average, without impacting pain outcomes and rates of complications.</p>

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Effect of an enhanced recovery after surgery program on total hip and knee arthroplasty in a university hospital: a two-cohort study

  • 期刊论文

  • 发表日期：

    2026年2月2日

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  • Eric Albrecht,
  • Alexandre Koninckx,
  • Corey Kull,
  • Marcio Oliveira,
  • Valérie Addor,
  • Jean-Benoit Rossel,
  • Julien Wegrzyn

摘要

Background

Enhanced Recovery After Surgery (ERAS®) is a coordinated, evidence-based program delivered through a multidisciplinary team, which objective is to improve outcomes and patient satisfaction, while minimizing complications. The objective of this two-cohort study is to evaluate the clinical impact of an ERAS program on elective primary hip (THA) and knee (TKA) arthroplasties with regards to hospital length of stay, during the first 12 months after implementation.

Methods

We compared a retrospective pre-ERAS with a prospective ERAS cohort. Key aspects of this program included preoperative education, minimal fasting, standardised, anaesthetic and surgical techniques, multimodal analgesia, and early mobilization. The primary outcome was hospital length of stay. Other outcomes included rest, dynamic pain scores, and rates of complications.

Results

From December 1st, 2021 to November 30th, 2022, data from 267 patients (138 THA, 129 TKA) were compared with data from 258 patients (128 THA, 130 TKA) collected between December 1st, 2022, and November 30th, 2023, who underwent the ERAS® program (total: 525 patients). The mean hospital length of stay for THA patients before ERAS® was 5.5 ± 2.9 days versus 4.5 ± 2.0 days after ERAS® implementation (p = 0.002). For TKA patients, it was 6.6 ± 3.1 days before vs 5.6 ± 1.9 days after ERAS® implementation (p = 0.001). Rest, dynamic pain scores, and rates of complications were similar between groups except for pneumonia in patients undergoing TKA.

Conclusion

The implementation of an ERAS® program for hip and knee arthroplasty led to a reduced hospital length of stay, below the Swiss national average, without impacting pain outcomes and rates of complications.