title: Enhanced recovery protocol and hidden blood loss in patients undergoing total knee arthroplasty.
abstract: BACKGROUND
  Perioperative blood loss and postoperative pain following total knee arthroplasty prevent early mobilisation of patients. The Enhanced Recovery Protocol (ERP) followed for patients in our institute aims at reducing post operative pain, blood loss and length of stay.
  
  
  METHODS
  50 consecutive patients that underwent ERP following total knee arthroplasty with another group of 70 patients that underwent the same surgery without ERP were compared in terms of hidden blood loss and length of hospital stay. Hidden blood loss was calculated according to previously described method.
  
  
  RESULTS
  Reduction in blood loss was found in both males (305 ml) and females (150 ml) following ERP. Length of stay reduced by 1.5 days in both genders. Regression analysis showed a significant correlation between body weight and blood loss in females.
  
  
  CONCLUSIONS
  Enhanced recovery protocol could be a useful tool to reduce patient morbidity and reduce length of inpatient stay.
authors.affiliation: Department of Arthroplasty, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, SY10 7AG, UK.
authors.forename: Rohit
authors.initials: R
authors.lastname: Dhawan
authors.affiliation: Department of Arthroplasty, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, SY10 7AG, UK.
authors.forename: Harshadkumar
authors.initials: H
authors.lastname: Rajgor
authors.affiliation: Department of Arthroplasty, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, SY10 7AG, UK.
authors.forename: Rathan
authors.initials: R
authors.lastname: Yarlagadda
authors.affiliation: Department of Anaesthesia, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, SY10 7AG, UK.
authors.forename: John
authors.initials: J
authors.lastname: John
authors.affiliation: Department of Arthroplasty, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, SY10 7AG, UK.
authors.forename: Niall M
authors.initials: NM
authors.lastname: Graham
keywords: Arthroplasty; Enhanced recovery programme; blood loss; hidden blood loss; knee; replacement; surgical; total knee arthroplasty