Enhanced recovery principles applied to revision hip and knee arthroplasty leads to better patient outcomes.

Journal of Orthopaedics
Zacharia JosephPiers Yates

Abstract

There is very little published literature on Enhanced Recovery Principles (ERP) used in primary joint replacements applied to revision hip and knee arthroplasty (rTHA, rTKA). Retrospective series of 268 rTHA and rTKA surgeries from 2010 -2018, treated with ERP, focusing on multimodal pain management, blood management and early functional recovery. No patients from the latest cohort required readmission within 6 weeks. Only 20 patients (7.5%) required a blood transfusion. Surgical site local anaesthetic infiltration was associated with lower PCA use in aseptic rTHA and rTKA (p<0.001; p<0.001). Revisions for infection had a longer length of stay (LOS) and increased PCA usage in both rTHA (6.5 vs. 5.2 days) and rTKA (10.1 vs. 5.3 days), similar to our previous study.1 Use of an intra-articular catheter for analgesia in rTKA showed reduced PCA use. Tourniquets were not beneficial for blood loss in rTKA and had greater PCA use post-operatively (p<0.001). The application of ERP to revision THA and TKA surgery is safe and effective.

References

Feb 27, 2001·BMJ : British Medical Journal·D W Wilmore, H Kehlet
Nov 21, 2007·The Journal of Arthroplasty·Amar S Ranawat, Chitranjan S Ranawat
Apr 12, 2012·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Masahiko IkeuchiToshikazu Tani
Dec 12, 2012·Acta Orthopaedica. Supplementum·Henrik Husted
Feb 19, 2013·International Orthopaedics·Charlotta OlivecronaRichard Blomfeldt
Dec 3, 2013·The Bone & Joint Journal·M S IbrahimF S Haddad
Feb 26, 2014·JPEN. Journal of Parenteral and Enteral Nutrition·Olle Ljungqvist
Jun 19, 2014·British Journal of Anaesthesia·L Ø Andersen, H Kehlet
Mar 29, 2016·ANZ Journal of Surgery·Marinus D J StowersJacob T Munro
Jun 11, 2016·Orthopedics·Kai TieLiaobin Chen
Mar 25, 2017·The Journal of Arthroplasty·Chukwuweike U GwamRonald E Delanois
May 1, 2017·The Journal of Arthroplasty·Ronald E DelanoisMichael A Mont
Aug 11, 2017·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·James C SenturkEdward Whang
Sep 25, 2017·Journal of Surgical Oncology·Daniel Zainfeld, Hooman Djaladat
Oct 12, 2018·Journal of Cellular Biochemistry·Pengcheng LiuQingcai Meng
Jan 30, 2019·The Journal of Surgical Research·Jeremy E SpringerCagla Eskicioglu

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.