Peri-operative interventions producing better functional outcomes and enhanced recovery following total hip and knee arthroplasty: an evidence-based review

• Published in: BMC medicine Vol. 11; no. 1; p. 37
• Main Authors: Ibrahim, Mazin S, Khan, Muhammad A, Nizam, Ikram, Haddad, Fares S
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 13-02-2013; BioMed Central
• Subjects: Anemia; Anxiety; Arthroplasty; Arthroplasty, Replacement, Hip - methods; Arthroplasty, Replacement, Knee - methods; Body mass index; Care and treatment; Electromagnetic fields; Evidence-based medicine; Homeopathy; Hospitals; Humans; Infections; Injuries; Intervention; Joint replacement surgery; Knee; Length of Stay; Malnutrition; Materia medica and therapeutics; Methods; Nutritional status; Pain; Patient care planning; Patient education; Patient outcomes; Patient satisfaction; Postoperative Care - methods; Preoperative Care - methods; Prosthesis-Related Infections - prevention & control; Recovery (Medical); Rehabilitation; Review; Sports injuries; Surgeons; Surgical Procedures, Operative - methods; Therapeutics; Treatment Outcome; United Kingdom; United Kingdom > UK
• ISSN: 1741-7015; 1741-7015
• DOI: 10.1186/1741-7015-11-37

The increasing numbers of patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA), combined with the rapidly growing repertoire of surgical techniques and interventions available have put considerable pressure on surgeons and other healthcare professionals to produce excellent results with early functional recovery and short hospital stays. The current economic climate and the restricted healthcare budgets further necessitate brief hospitalization while minimizing costs.Clinical pathways and protocols introduced to achieve these goals include a variety of peri-operative interventions to fulfill patient expectations and achieve the desired outcomes.In this review, we present an evidence-based summary of common interventions available to achieve enhanced recovery, reduce hospital stay, and improve functional outcomes following THA and TKA. It covers pre-operative patient education and nutrition, pre-emptive analgesia, neuromuscular electrical stimulation, pulsed electromagnetic fields, peri-operative rehabilitation, modern wound dressings, standard surgical techniques, minimally invasive surgery, and fast-track arthroplasty units.