A NARRATIVE REVIEW OF IMPROVED RECUPERATION ROUTES IN ORTHOPAEDIC SURGERY.

Abstract

Enhanced Recovery After Surgery (ERAS), also known as "fast track," "accelerated," or "Rapid Recovery" surgery, was introduced in 1997 to address delayed postoperative recovery, particularly the physiological stress and organ dysfunction induced by surgical procedures. ERAS employs evidence-based interventions within a coordinated clinical care pathway to mitigate complications, reduce hospitalization duration, enhance patient satisfaction, and expedite recovery. While initially designed for abdominal and colorectal surgery, ERAS protocols have expanded to various medical specialties, including orthopedic surgery, specifically elective hip and knee arthroplasty. This narrative review covers ERAS protocols in orthopedic surgery, emphasizing on recovery-optimizing components. It reviews the evidence on ERAS interventions and their effects on hospitalization duration, readmission rates, and functional recovery after orthopedic surgery. The narrative review explores the implementation of ERAS in orthopedic surgery, emphasizing its impact on patient outcomes. ERAS interventions encompass the preoperative, intraoperative, and postoperative phases of care. Studies have shown that ERAS protocols in orthopedic surgery are associated with reduced hospitalization duration, lower readmission rates, and improved functional recovery. These interventions include patient education, multimodal pain management, early mobilization, and nutritional optimization. Future research in the field of ERAS should focus on refining and customizing protocols for specific orthopedic procedures, patient populations, and comorbidities. Additionally, investigating the long-term outcomes and cost-effectiveness of ERAS in orthopedic surgery is essential. Comparative studies assessing ERAS versus traditional care can provide valuable insights. Orthopedic surgery can benefit from ERAS protocols' efficiency and patient-centeredness. For elective hip and knee arthroplasty, hospitals should apply ERAS principles to reduce hospital stays, improve patient satisfaction, and improve surgical outcomes. Policymakers may also consider incentives or guidelines to encourage ERAS use in orthopedic surgery, which could enhance resource utilization and cost savings.