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Cited by 90Enhanced Recovery After SurgeryHemodynamic Monitoring and TherapyAnesthesia and Pain Management

The DOI matches its Crossref record; 122 of the 122 references it cites were found in a registry or an index.

Enhanced recovery after surgery for major orthopedic surgery: a narrative review

Open access
Choi, Yun Seong, Kim, Tae Woo, Chang, Moon Jong, Kang, Seung-Baik, Chang, Chong Bum·2022·Knee Surgery & Related Research
DOI 10.1186/s43019-022-00137-3PMC PMC8864772
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Abstract

BACKGROUND: With increasing interest in enhanced recovery after surgery (ERAS), the literature on ERAS in orthopedic surgery is also rapidly accumulating. This review article aims to (1) summarize the components of the ERAS protocol applied to orthopedic surgery, (2) evaluate the outcomes of ERAS in orthopedic surgery, and (3) suggest practical strategies to implement the ERAS protocol successfully. MAIN BODY: Overall, 17 components constituting the highly recommended ERAS protocol in orthopedic surgery were identified. In the preadmission period, preadmission counseling and the optimization of medical conditions were identified. In the preoperative period, avoidance of prolonged fasting, multimodal analgesia, and prevention of postoperative nausea and vomiting were identified. During the intraoperative period, anesthetic protocols, prevention of hypothermia, and fluid management, urinary catheterization, antimicrobial prophylaxis, blood conservation, local infiltration analgesia and local nerve block, and surgical factors were identified. In the postoperative period, early oral nutrition, thromboembolism prophylaxis, early mobilization, and discharge planning were identified. ERAS in orthopedic surgery reduced postoperative complications, hospital stay, and cost, and improved the patient outcomes and satisfaction with accelerated recovery. For successful implementation of the ERAS protocol, various strategies including the standardization of care system, multidisciplinary communication and collaboration, ERAS education, and continuous audit system are necessary. CONCLUSION: The ERAS pathway enhanced patient recovery with a shortened length of stay, reduced postoperative complications, and improved patient outcomes and satisfaction. However, despite the significant progress in ERAS implementation in recent years, it has mainly focused on major surgeries such as arthroplasty. Therefore, further efforts to apply, audit, and optimize ERAS in various orthopedic surgeries are necessary.

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Show all 122 references

Research works printed but not linked: 3

  1. Sun K (2020) Clinical application of enhanced recovery after surgery in the perioperative period of anterior cruciate ligament reconstruction. Chin J Tissue Eng Res 25:1647–51
  2. Xiao H, Li T, Mi M, Zhou L, Liu H, Gao Z et al (2019) Enhanced Recovery After Surgery used in close reduction of distal radius fracture in emergency traumatic patients: a prospective cohort study. Chin J Orthop Trauma 12:945–51
  3. Schwarzkopf R, Zamansani T, Houng M, Bridgeman T (2016) The effect of a clinical pathway strategy for managing care in total joint replacement: the impact on perioperative outcomes. J Clin Exp Orthop 2:11

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Metadata

Authors
Choi, Y. S., Kim, T. W., Chang, M. J., Kang, S.-B., & Chang, C. B.
Affiliations
Seoul National University (KR)
Corresponding author
Chang, Chong Bum
ORCID
Venue
Knee Surgery & Related Research
Publisher
Springer Science and Business Media LLC
Published
2022-02-22
Volume
34
Issue
1
Pages
8-8
ISSN
  • 2234-0726 (ISSN-L)
  • 2234-2451
DOI
10.1186/s43019-022-00137-3
PMC
PMC8864772
OpenAlex
W4213316922
Cited by
83
References
122
Citations by year
2026: 19 · 2025: 31 · 2024: 22 · 2023: 8 · 2022: 3
FWCI
3.80
Type
journal article
Language
en
Open access
Licence
Locations
  • Knee Surgery and Related Research (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Seoul National University Open Repository (Seoul National University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
  • Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Pain Management
Keywords
enhanced recovery after surgery, orthopedic surgery, preoperative optimization, multimodal analgesia, postoperative nausea and vomiting, intraoperative fluid management, local nerve block, thromboprophylaxis, early mobilization, length of hospital stay, postoperative complications, arthroplasty

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