title: Review article: Perioperative care in enhanced recovery for total hip and knee arthroplasty.
abstract: Enhanced recovery pathways for total hip and knee arthroplasty can reduce length of hospital stay and perioperative morbidity. 22 studies were reviewed for identification of perioperative care interventions, including preoperative (n=4), intra-operative (n=8), and postoperative (n=4) care interventions. Factors that improve outcomes included use of pre-emptive and multimodal analgesia regimens to reduce opioid consumption, identification of patients with poor nutritional status and provision of supplements preoperatively to improve wound healing and reduce length of hospital stay, use of warming systems and tranexamic acid, avoidance of drains to reduce operative blood loss and subsequent transfusion, and early ambulation with pharmacological and mechanical prophylaxis to reduce venous thromboembolism and to speed recovery.
authors.affiliation: Department of Surgery, South Auckland Clinical School, Middlemore Hospital, University of Auckland, Auckland, New Zealand.
authors.forename: Marinus D J
authors.initials: MD
authors.lastname: Stowers
authors.affiliation: Department of Surgery, South Auckland Clinical School, Middlemore Hospital, University of Auckland, Auckland, New Zealand.
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Lemanu
authors.affiliation: Department of Orthopaedic Surgery, Middlemore Hospital, Auckland, New Zealand.
authors.forename: Brendan
authors.initials: B
authors.lastname: Coleman
authors.affiliation: Department of Surgery, South Auckland Clinical School, Middlemore Hospital, University of Auckland, Auckland, New Zealand.
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Hill
authors.affiliation: Department of Orthopaedic Surgery, Auckland City Hospital, University of Auckland, Auckland, New Zealand.
authors.forename: Jacob T
authors.initials: JT
authors.lastname: Munro
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation; D003289:Convalescence; D019091:Critical Pathways / Q000592:standards*; D006801:Humans; D019990:Perioperative Care / Q000592:standards*
keywords: arthroplasty, replacement, hip; arthroplasty, replacement, knee; perioperative care