Enhanced recovery in lower limb arthroplasty in the Irish setting.

Abstract

In the current economic climate of staff shortages and bed closures, orthopaedic surgeons must look for system efficiencies. Enhanced Recovery Programmes (ERP) have the potential not only to reduce length of stay (LOS) and concurrent costs but also to improve patient outcomes. The aim of this paper is to evaluate the effect of ERP for primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) on length of stay (LOS) in the Irish Setting. A single-surgeon retrospective case-control study was conducted comparing those who underwent primary lower limb arthroplasty before and after the introduction of an ERP. Patient medical and theatre records were used to determine the operation type, gender, age, LOS and readmission rates. Over the 2-year study period, a total of 310 patients underwent either THA (n=244) or TKA (n=66). The mean LOS was 8.79days in the pre-ERP group and 5.1days in the post-ERP group (p<0.001). There was a significant correlation between LOS and age (p<0.001). Gender or procedure type had no bearing on LOS for any of the subgroups (p>0.1). ERP has the potential to significantly reduce overall length of stay after hip and knee arthroplasty and could have a considerable benefit in the Irish setting.