Meta-analysis of Rapid Rehabilitation Surgery in Hip and Knee Replacement.

CONTEXT

Total knee arthroplasty (TKA) and total hip arthroplasty (THA) have become well-established and standardized procedures. However, complications can easily occur, such as joint pain and swelling, due to the high trauma of surgery and intraoperative blood loss, which can affect patients' recovery. A treatment that can effectively shorten postoperative recovery time and reduce complications is key to the perioperative treatment of TKA and THA.

OBJECTIVE

The study aimed to evaluate the efficacy of the Rapid Rehabilitation Surgery (RRS) protocol, an enhanced recovery after surgery (ERAS) approach, for TKA and THA to substantiate its application by the current research team.

DESIGN

The research team performed a narrative review by searching the Excerpta Medica Database (Embase), the Kirkland database, the China National Knowledge Infrastructure (CNKI), the Wanfang database, and the VIP database, using the keywords rapid rehabilitation surgery, hip replacement, knee replacement, and perioperative period, and randomized controlled trials or randomized controlled trials (RCTs) or clinical trials. The team also performed a meta-analysis of the data from the studies that the search found.

SETTING

The study took place at Yulin No. 2 Hospital, Yulin, China.

PARTICIPANTS

The studies included 1673 patients in six studies that conducted RCTs, including 565 patients who received ERAS and 1108 patients who received RCTS.

OUTCOME MEASURES

The research team used Cochrane software for risk assessment for the included studies. For the meta-analysis, the team examined the included studies' data related: (1) to length of hospital stay, (2) to postoperative complications, (3) to blood-transfusion rate, and (4) to postoperative pain.

RESULTS

The ERAS nursing reduced the mean length of hospital stay by 2.17 days compared to that of the combined control groups from five studies (MD=-2.17, 95% CI [3.36-0.99], P < .01). In the analysis of four studies, the incidence of surgical complications was 9.1% lower in the combined intervention groups than in the combined control groups (r=0.30, 95% CI [0.10 to 0.94], P = .02).

CONCLUSIONS

RRS is a safe and effective method of treating patients undergoing THA and TKA and can significantly reduce hospitalization time and postoperative complications. This approach deserves promotion.