ArticleBone & joint open2021
The impact of an enhanced recovery programme on length of stay and post-discharge resource usage following hip and knee arthroplasty : a service evaluation and cost analysis.
Article in Bone & joint open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Enhanced Recovery after Total Joint Arthroplasty (TJA): A Contemporary Systematic Review of Clinical Outcomes and Usage of Key Elements.Orthopaedic surgery · 2023Pooled it
- Intraoperative Liposomal Bupivacaine Is Associated With Reduced Opioid Use and Enhanced Recovery After Total Knee Arthroplasty: A Multicenter Registry Study.Arthroplasty today · 2026Article
- Non-selective enhanced recovery pathway in primary hip and knee arthroplasty: a propensity score matched analysis on safety and efficacy.Arthroplasty (London, England) · 2026Article
- Trends in hip and knee replacement length of stay and patient demographics in England: a population-based study of 1,455,842 primary procedures.BMC medicine · 2025Article
- High-volume day-case hip arthroplasty in a district general hospital.Bone & joint open · 2025Article
- Are pre-operative exercise interventions for joint arthroplasty effective at improving peri‑operative outcomes? A systematic review and meta-analysis of randomized controlled trials.Journal of sport and health science · 2025Review
- Advancements in Total Knee Arthroplasty over the Last Two Decades.Journal of clinical medicine · 2025Review
- Enhanced recovery after surgery day surgery for MAKO® robotic-arm assisted TKA; better outcome for patients, improved efficiency for hospitals.Journal of orthopaedics · 2024Article
- Incidence and impact of surgical site infections on length of stay and cost of care for patients undergoing open procedures.Surgery open science · 2023Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsThe aim of this study is to assess the impact of a pilot enhanced recovery after surgery (ERAS) programme on length of stay (LOS) and post-discharge resource usage via service evaluation and cost analysis.
methodsBetween May and December 2019, 100 patients requiring hip or knee arthroplasty were enrolled with the intention that each would have a preadmission discharge plan, a preoperative education class with nominated helper, a day of surgery admission and mobilization, a day one discharge, and access to a 24/7 dedicated helpline. Each was matched with a patient under the pre-existing pathway from the previous year.
resultsMean LOS for ERAS patients was 1.59 days (95% confidence interval (CI) 1.14 to 2.04), significantly less than that of the matched cohort (3.01 days; 95% CI 2.56 to 3.46). There were no significant differences in readmission rates for ERAS patients at both 30 and 90 days (six vs four readmissions at 30 days, and nine vs four at 90 days). Despite matching, there were significantly more American Society of Anesthesiologists (ASA) grade 3 patients in the ERAS cohort. There was a mean cost saving of £757.26 (95% CI £-1,200.96 to £-313.56) per patient. This is despite small increases in postoperative resource usage in the ERAS patients.
conclusionERAS represents a safe and effective means of reducing LOS in primary joint arthroplasty patients. Implementation of ERAS principles has potential financial savings and could increase patient throughput without compromising care. In elective care, a preadmission discharge plan is key. Cite this article:
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