Abstract
BackgroundThe number of total joint arthroplasties (TJAs) being performed is increasing worldwide. To match this increasing demand, there has been focus on hastening patients’ recovery of function. This effort has culminated in the formulation of enhanced recovery after surgery (ERAS) strategies. However, with evolving ERAS programs and new recommendations, a review of current evidence is required to provide clinicians with up-to-date information about its effect on outcomes for TJA.ObjectiveThe objective of this study is to assess the utility of ERAS programs on patient, health service, and economic outcomes for primary, elective total hip arthroplasty (THA) and total knee arthroplasty (TKA).MethodsA systematic search will be conducted in Medline (Ovid), EMCARE (Ovid), EMBASE (Ovid), Web of Science, CINAHL, National Health Service Economic Evaluations Database, and the Cochrane Library. Analytical, observational, and experimental designs will be included in this systematic review. Only studies including patients undergoing primary TKA and THA comparing ERAS programs with conventional surgery and postoperative care will be included. Data related to patient outcomes, health service outcomes, safety, and economic evaluation will be extracted.ResultsThe search terms and primary database searches have been finalized. Findings will be reported in narrative and tabular form. Where appropriate, random effects meta-analyses will be conducted for each outcome, and heterogeneity quantified with Cochran Q test and I2 statistic. Measures of effect or mean differences will be reported with 95% confidence intervals. The results of this systematic review will be disseminated in a peer-reviewed journal.ConclusionsThis protocol will guide a systematic review assessing outcomes associated with ERAS surgery in primary THA and TKA.Trial RegistrationOpen Science Framework osf.io/y4bhs; https://osf.io/y4bhsInternational Registered Report Identifier (IRRID)PRR1-10.2196/25581
Highlights
The number of total joint arthroplasty (TJA) performed worldwide is increasing [1,2,3,4]
The objective of this study is to assess the utility of enhanced recovery after surgery (ERAS) programs on patient, health service, and economic outcomes for primary, elective total hip arthroplasty (THA) and total knee arthroplasty (TKA)
With these considerations in mind, the proposed systematic review and meta-analysis aims to assess the utility of ERAS programs on patient, health service, and economic outcomes for primary, elective THA, and TKA
Summary
The number of total joint arthroplasty (TJA) performed worldwide is increasing [1,2,3,4]. The limited scope of prior systematic reviews leaves us without a comprehensive picture of the potential risks associated with ERAS pathways—and with an incomplete understanding of the necessary features of a safe and effective ERAS pathway for patients undergoing arthroplasty. With these considerations in mind, the proposed systematic review and meta-analysis aims to assess the utility of ERAS programs on patient, health service, and economic outcomes for primary, elective THA, and TKA. Objective: The objective of this study is to assess the utility of ERAS programs on patient, health service, and economic outcomes for primary, elective total hip arthroplasty (THA) and total knee arthroplasty (TKA). Trial Registration: Open Science Framework osf.io/y4bhs; https://osf.io/y4bhs International Registered Report Identifier (IRRID): PRR1-10.2196/25581
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