Enhanced recovery program in total hip arthroplasty.
BACKGROUND
Enhanced recovery program (ERP) was implemented to optimize the hospital stay in total hip arthroplasty. This study assessed the effects of optimizing preoperative and perioperative care using enhanced recovery (ER) on patients undergoing Total hip arthroplasty.


METHODS
We compared a prospective group of 64 patients on the ER program with a historic cohort of 63 patients that received conventional care (non ER).


RESULTS
ER patients were discharged earliest from hospital [mean length of stay (LOS) 5.3 days, median 4; P < 0.001] as compared to a mean of 8.3 days among non ER patients. Comparison based on American Association of Anesthesiologists (ASA) grades, preoperative hemoglobin, and body mass index (BMI) revealed that patients with ASA grade 3, preoperative hemoglobin of <14 g/dl, and BMI >30 on ER program spent shorter time in hospital as compared to the non ER's conventionally treated patients with more favorable physiological parameters of ASA grade 1 and 2, preoperative hemoglobin of >14 g/dl, and BMI <30.


CONCLUSIONS
The ER protocol is universally beneficial and confers an advantage regardless of the patients' preoperative condition.
Department of Trauma and Orthopaedic Surgery, Yeovil District Hospital, Higher Kingston, Yeovil, Somerset BA21 4AT, UK.
Amitabh J
AJ
Dwyer
Payam
P
Tarassoli
William
W
Thomas
Paul
P
Porter