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 accessAbstract
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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“Traditionally, treatments such as surgical repair, physical therapy, and pharmaceutical interventions have been employed to address these conditions, but they frequently result in variable outcomes and inconsistent recovery periods [1].”
From Advancements in Regenerative Therapies for Orthopedics: A Comprehensive Review of Platelet-Rich Plasma, Mesenchymal Stem Cells, Peptide Therapies, and Biomimetic Applications (2025) · cites this paper as [1]
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Cites
Prevention of Venous Thromboembolism
Geerts, W. H., Bergqvist, D., Pineo, G. F., Heit, J. A., Samama, C. M., Lassen, M. R., & Colwell, C. W. (2008) · CHEST Journal · doi:10.1378/chest.08-0656 · Cited by 3,950
Enhanced Recovery After Surgery: A Review
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The Timing of Prophylactic Administration of Antibiotics and the Risk of Surgical-Wound Infection
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A Factorial Trial of Six Interventions for the Prevention of Postoperative Nausea and Vomiting
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Restrictive versus Liberal Fluid Therapy for Major Abdominal Surgery
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Research works printed but not linked: 3
- 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
- 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
- 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
Cited by
Salamanna, F., Contartese, D., Brogini, S., Visani, A., Martikos, K., Griffoni, C., Ricci, A. L., Gasbarrini, A., & Fini, M. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11144222 · Cited by 62
Goulian, A. J., Goldstein, B., & Saad, M. A. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14062061 · Cited by 25
Enhanced Recovery After Surgery (ERAS) Pathways in Elective Total Joint Arthroplasty
Ishaku, Z., Koshy, D. I., & Bala, M. A. (2025) · Cureus · doi:10.7759/cureus.91481 · Cited by 24
He, Y., Tang, X., Ning, N., Chen, J., Li, P., & Kang, P. (2022) · Orthopaedic Surgery · doi:10.1111/os.13424 · Cited by 20
Development of a Surgery-specific Comorbidity Score for Use in Administrative Data
Chervu, N. L., Balian, J., Verma, A., Sakowitz, S., Cho, N. Y., Mallick, S., Russell, T. A., & Benharash, P. (2024) · Annals of Surgery · doi:10.1097/sla.0000000000006544 · Cited by 20
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
- Venue
- Knee Surgery & Related Research
- Published
- 2022-02-22
- Volume
- 34
- Issue
- 1
- Pages
- 8-8
- ISSN
- 2234-0726 (ISSN-L)
- 2234-2451
- 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
- diamond
- doi.org
- Licence
- cc-by
- creativecommons.org/licenses/by/4.0 (tdm)
- creativecommons.org/licenses/by/4.0 (vor)
- 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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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
