title: Enhanced recovery programme for total knee replacement to reduce the length of hospital stay.
abstract: OBJECTIVE
  To compare the length of hospital stay in patients undergoing primary total knee replacement (TKR) with or without enhanced recovery (ER) programme.
  
  
  METHODS
  Medical records of 57 and 55 consecutive patients who underwent primary TKR with or without ER programme, respectively, were reviewed. 17 men and 40 women aged 43 to 87 (mean, 70) years with ER programme were compared with 22 men and 33 women aged 53 to 90 (mean, 73) years without ER programme in terms of the preoperative haemoglobin level, American Association of Anesthesiologists (ASA) physical status grading, body mass index (BMI), and length of hospital stay.
  
  
  RESULTS
  The length of hospital stay was significantly shorter in the ER than non-ER groups in overall patients (6 vs. 7.8 days, p=0.0003), in patients with preoperative haemoglobin level of ≥ 14 g/dl (5.4 vs. 7.7 days, p=0.02), in patients with preoperative haemoglobin level of <14 g/dl (6.2 vs. 7.7 days, p=0.02), in patients with ASA grades 1 and 2 (5.6 vs. 7.6 days, p=0.01), in patients with ASA grade 3 (6.4 vs. 8.2 days, p=0.01), in patients with BMI of <30 kg/m(2) (6 vs. 8.1 days, p=0.0061), and in patients with BMI of ≥ 30 kg/m(2) (5.9 vs. 7.5 days, p=0.0006). Complications were noted in 4 ER patients and 5 non-ER patients.
  
  
  CONCLUSIONS
  ER programmes are readily transferable to patients undergoing TKR and significantly reduced the length of hospital stay.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Yeovil District Hospital, Somerset, United Kingdom.
authors.forename: Amitabh J
authors.initials: AJ
authors.lastname: Dwyer
authors.forename: William
authors.initials: W
authors.lastname: Thomas
authors.forename: Simon
authors.initials: S
authors.lastname: Humphry
authors.forename: Paul
authors.initials: P
authors.lastname: Porter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D015992:Body Mass Index; D005260:Female; D006304:Health Status; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000534:rehabilitation / Q000601:surgery*; D011182:Postoperative Care; D011300:Preoperative Care; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D006454:Hemoglobins
keywords: arthroplasty, replacement, knee; length of
  stay; postoperative care