Enhanced Recovery After Surgery Protocols in Total Joint Arthroplasty: Length of Stay and Readmission
DOI:
https://doi.org/10.5281/zenodo.22328086Keywords:
Enhanced recovery after surgery, Total joint arthroplasty, Length of stay, Hospital readmission, Multimodal analgesiaAbstract
Background: Enhanced Recovery After Surgery (ERAS) pathways bundle preoperative optimisation, multimodal analgesia, blood
management, and early mobilisation to accelerate recovery after total hip and knee arthroplasty (THA/TKA). Objective: To synthesise evidence on ERAS protocol components and their effect on length of stay (LOS), readmission, complications, satisfaction, and cost in total joint arthroplasty (TJA). Methods: Narrative review of systematic reviews, meta-analyses, randomised trials, and national registry studies. Findings: ERAS pathways reduce LOS by roughly one to three days across meta-analyses and registries, without increasing 30- or 90-day readmission; several studies show fewer complications and lower transfusion and mortality rates. Economic analyses
consistently report cost savings, driven mainly by shortened hospitalisation, while satisfaction is equal or improved.
Conclusions: ERAS protocols are a validated, cost-effective standard of care for TJA, though preoperative optimisation
components remain the least standardised element of current pathways.
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