Desouza C, Shetty V
SAANVI Orthopaedics, Mumbai, India.
Dr L H Hiranandani Hospital, Mumbai, India.
Musculoskelet Surg. 2025 Aug 8. doi: 10.1007/s12306-025-00914-9.
Knee osteoarthritis (OA) is a common degenerative condition that significantly affects quality of life. Total Knee Arthroplasty (TKA) is an effective treatment for end-stage OA, but recovery can be challenging. Enhanced Recovery After Surgery (ERAS) protocols aim to optimize perioperative care and improve outcomes.
This prospective cohort study evaluated the impact of ERAS protocols on 300 patients undergoing primary TKA. Patients were divided into an ERAS group (n = 150) and a traditional care group (n = 150). ERAS included preoperative education, multimodal analgesia, early mobilization, and multidisciplinary care. Primary outcomes were postoperative pain, length of hospital stay (LOS), and complication rates. Secondary outcomes included functional recovery and patient satisfaction.
The ERAS group had significantly shorter LOS (3 vs. 7 days, P = 0.01) and lower blood transfusion rates (21.3% vs. 36.7%, P = 0.01). Postoperative pain scores were consistently lower in the ERAS group (P = 0.01-0.04). Functional recovery, measured by Knee Society Score, and patient-reported outcomes were significantly better in the ERAS group at 3, 6, 12, and 24 months (P < 0.01).
ERAS protocols significantly improve outcomes in TKA, reducing hospital stays and enhancing patient satisfaction and recovery, supporting their broader use in orthopaedic surgery.
膝关节骨关节炎（OA）是一种常见的退行性疾病，严重影响生活质量。全膝关节置换术（TKA）是终末期OA的有效治疗方法，但恢复过程可能具有挑战性。术后加速康复（ERAS）方案旨在优化围手术期护理并改善治疗效果。
这项前瞻性队列研究评估了ERAS方案对300例行初次TKA患者的影响。患者分为ERAS组（n = 150）和传统护理组（n = 150）。ERAS包括术前教育、多模式镇痛、早期活动和多学科护理。主要结局指标为术后疼痛、住院时间（LOS）和并发症发生率。次要结局指标包括功能恢复和患者满意度。
ERAS组的LOS显著缩短（3天对7天，P = 0.01），输血率更低（21.3%对36.7%，P = 0.01）。ERAS组术后疼痛评分持续较低（P = 0.01 - 0.04）。在3、6、12和24个月时，通过膝关节协会评分衡量的功能恢复以及患者报告的结局在ERAS组中显著更好（P < 0.01）。
ERAS方案显著改善了TKA的治疗效果，缩短了住院时间，提高了患者满意度和恢复情况，支持其在骨科手术中更广泛的应用。
