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Abstract

BACKGROUND:

In total knee arthroplasty (TKA), fast-track or enhanced recovery after surgery (ERAS) programs are proven to be cost-effective without compromising patient safety or functional outcomes. The aim of this study is to determine if these promising results could be reproduced in Indian practice.

METHODS:

This retrospective study compared patients who underwent simultaneous bilateral TKA through ERAS protocol (n = 100) from January 2021 to June 2022 with a propensity-matched historical group operated through conventional protocol (n = 100) from July 2019 to June 2020. The time for straight leg raise (SLR), time to discharge, Visual Analog Score (VAS) for pain, range of motion (ROM), the Knee Society Score (KSS), complication rate, and readmission rate were compared between the groups in the early postoperative and follow-up periods up to 1 year.

RESULTS:

The mean length of stay (LOS) was significantly shorter in the ERAS group (2.3 days vs. 5.1 days, P < 0.001). The time to SLR was also significantly earlier in the ERAS group. The VAS score was significantly low on days 1, 2, 7, and 14 postsurgery. The KSS and ROM were significantly better in the ERAS group till 14 days. The VAS, KSS, and ROM were comparable between the groups at 1 month and later follow-up periods. There was no significant difference with regard to the rate of complications and readmissions.

CONCLUSION:

ERAS protocols used in bilateral TKA significantly reduced the LOS without compromising patient safety or functional outcomes. Standardized ERAS practices for all TKAs could benefit patients as well as health-care systems.

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Creative Commons License

Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.

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