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Acta Ortopédica Mexicana

ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología
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2023, Number 1

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Acta Ortop Mex 2023; 37 (1)

Impact of the ''Enhanced Recovery After Surgery'' program in knee arthroplasty at the institutional level

Hernández-Romero C, Martínez-Montiel O, Blanco-Bucio P, Villalobos-Campuzano C, Valencia-Martínez G
Full text How to cite this article 10.35366/112808

DOI

DOI: 10.35366/112808
URL: https://dx.doi.org/10.35366/112808

Language: Spanish
References: 7
Page: 14-18
PDF size: 117.14 Kb.


Key words:

total knee arthroplasty (TKA), knee, impact, recovery, surgery.

ABSTRACT

Introduction: total knee arthroplasty has gained popularity over decreasing pain, restoring mobility and improving patients' quality of life. At the institutional level, there is no multidisciplinary model in the treatment of our patients, and in our environment, physical rehabilitation starts late, making it difficult for patients to reincorporate and attain adequate pain control. Material and methods: a controlled, randomized, prospective and longitudinal study was conducted, 55 patients underwent total knee arthroplasty, assigned to two study groups: the ERAS (enhanced recovery after surgery) group (n = 27) and the usual group (n = 28). Inclusion criteria were patients with Kellgren-Lawrence classification grade 4 gonarthrosis, age between 30-70 years and follow-up for six months. Descriptive statistics were performed using medians and interquartile range, while inferential statistics were performed using the Kruskal-Wallis test. Results: the results obtained at six months showed no statistically significant differences in age (p = 0.327) and gender (p = 0.588). The results obtained in the scales of VAS, WOMAC and IKDC showed statistically significant difference (p = 0.000). The rapid recovery group with a 120° flexion median and the usual group with 90° flexion, both groups with 0° extension. Conclusions: the enhanced recovery after surgery pathway in joint replacement procedures showed good results on pain, function, mobility and complications compared to patients undergoing usual management.


REFERENCES

  1. Jiang HH, Jian XF, Shangguan YF, Qing J, Chen LB. Effects of enhanced recovery after surgery in total knee arthroplasty for patients older than 65 years. Orthop Surg. 2019; 11(2): 229-35.

  2. Zhao D, Ma XL, Wang WL, Zhang L. Effectiveness evaluation between enhanced recovery after surgery and traditional treatment in unilateral total knee arthroplasty. Zhonghua Yi Xue Za Zhi. 2018; 98(7): 519-23.

  3. Chughtai M, Shah NV, Sultan AA, Solow M, Tiberi JV, Mehran N, et al. The role of prehabilitation with a telerehabilitation system prior to total knee arthroplasty. Ann Transl Med. 2019; 7(4): 68.

  4. Edwards PK, Mears SC, Lowry Barnes C. Preoperative education for hip and knee replacement: never stop learning. Curr Rev Musculoskelet Med. 2017; 10(3): 356-64.

  5. Rutherford RW, Jennings JM, Dennis DA. Enhancing recovery after total knee arthroplasty. Orthop Clin North Am. 2017; 48(4): 391-400. doi: 10.1016/j.ocl.2017.05.002.

  6. Deng QF, Gu HY, Peng WY, Zhang Q, Huang ZD, Zhang C, et al. Impact of enhanced recovery after surgery on postoperative recovery after joint arthroplasty: results from a systematic review and meta-analysis. Postgrad Med J. 2018; 94(1118): 678-93. doi: 10.1136/postgradmedj-2018-136166.

  7. Stowers MD, Manuopangai L, Hill AG, Gray JR, Coleman B, Munro JT. Enhanced Recovery After Surgery in elective hip and knee arthroplasty reduces length of hospital stay. ANZ J Surg. 2016; 86(6): 475-9. doi: 10.1111/ans.13538.



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Acta Ortop Mex. 2023 Ene-Feb;37