title: Enhanced recovery in total hip replacement: a clinical review.
abstract: The outcome after total hip replacement has improved with the development of surgical techniques, better pain management and the introduction of enhanced recovery pathways. These pathways require a multidisciplinary team to manage pre-operative education, multimodal pain control and accelerated rehabilitation. The current economic climate and restricted budgets favour brief hospitalisation while minimising costs. This has put considerable pressure on hospitals to combine excellent results, early functional recovery and shorter admissions. In this review we present an evidence-based summary of some common interventions and methods, including pre-operative patient education, pre-emptive analgesia, local infiltration analgesia, pre-operative nutrition, the use of pulsed electromagnetic fields, peri-operative rehabilitation, wound dressings, different surgical techniques, minimally invasive surgery and fast-track joint replacement units.
authors.affiliation: University College Hospital, Department of Trauma & Orthopaedics, 235 Euston Road, London NW1 2BU, UK.
authors.forename: M S
authors.initials: MS
authors.lastname: Ibrahim
authors.forename: H
authors.initials: H
authors.lastname: Twaij
authors.forename: D E
authors.initials: DE
authors.lastname: Giebaly
authors.forename: I
authors.initials: I
authors.lastname: Nizam
authors.forename: F S
authors.initials: FS
authors.lastname: Haddad
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000379:methods / Q000534:rehabilitation*; D019317:Evidence-Based Medicine / Q000379:methods; D006801:Humans; D007902:Length of Stay; D010149:Postoperative Pain / Q000517:prevention & control; D010353:Patient Education as Topic / Q000379:methods; D019990:Perioperative Care / Q000379:methods; D020127:Recovery of Function; D016896:Treatment Outcome
keywords: Enhanced recovery; Fast track; Hip; Length of stay; THR; Total hip replacement