title: Rapid recovery protocol for peri-operative care of total hip and total knee arthroplasty patients.
abstract: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are among the most successful procedures performed in terms of quality-of-life years gained. The long-term goals of arthroplasty, to relieve pain, increase function, provide stability, and obtain durability, are accomplished in the vast majority of cases. The short-term goals, however, have become the target of aggressive peri-operative programs that aim to speed recovery, reduce morbidity and complications, and create a program of efficiency while maintaining the highest level of patient care. The concept of rapid recovery is built upon the burgeoning interest in less-invasive and small-incision surgeries for (THA and TKA). However, the incision size does not appear to be the most critical aspect of the program. This article outlines the specific elements of the rapid-recovery program for lower-extremity arthroplasty patients, including pre-operative patient education, peri-operative nutrition, vitamin and herbal medication supplementation, preemptive analgesia, and post-operative rehabilitation. A holistic peri-operative, rapid-recovery program has lead to a significantly decreased hospital length of stay and significantly lower hospital readmission rates in patients who undergo primary THAs and TKAs. Combining these results with minimally invasive techniques and instrumentation should make recovery even faster.
authors.affiliation: Joint Implant Surgeons, Inc., Division of Adult Reconstruction, Department of Orthopaedics, The Ohio State University, Columbus, Ohio, USA.
authors.forename: Keith R
authors.initials: KR
authors.lastname: Berend
authors.forename: Adolph V
authors.initials: AV
authors.lastname: Lombardi
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Mallory
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods / Q000534:rehabilitation*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods / Q000534:rehabilitation*; D019587:Dietary Supplements; D005260:Female; D006694:Holistic Health; D006801:Humans; D008297:Male; D008875:Middle Aged; D009747:Nutritional Physiological Phenomena; D015207:Osteoarthritis, Hip / Q000175:diagnosis / Q000601:surgery; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000601:surgery; D019990:Perioperative Care / Q000379:methods*; D026741:Physical Therapy Modalities; D011379:Prognosis; D011788:Quality of Life; D020127:Recovery of Function; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology