Abstract
Background: With the substantially growing trend of the aging populations in China and the rest of the world, the number of total hip and total knee arthroplasty (THA and TKA) cases are increasing dramatically. It’s important to develop practical strategies to improve the quality of healthcare and better outcome for patients undergoing THA and TKA. Enhanced recovery after surgery (ERAS) pathways have been reported to promote earlier recovery and be beneficial for patients. We propose the hypothesis that ERAS pathway could provide better recovery for patients undergoing primary THA or TKA.
Methods/Design: This trial is a prospective, open-labelled, randomized controlled trial that will evaluate the length of stay (LOS) in hospital, and other end points of interest for the patients undergoing ERAS pathway as compared to current non-ERAS clinical practice. A total of 640 patients undergoing primary THA or TKA will be randomly allocated to either ERAS pathway (ERAS group) or conventional care according to individual participating center (non-ERAS group). The primary outcome is the total LOS in hospital, the secondary outcomes include Postoperative LOS, all-cause mortality by 30 days after operation, in-hospital complications, early mobilization, postoperative pain control, total in-hospital cost, and readmission rate by 30 days after discharge from the hospital.
Discussion: This trial is designed to evaluate the superiority of the ERAS pathway to conventional non-ERAS clinical practice in reducing the LOS without increasing the incidence of complications or medical cost. The results will provide new insight into the clinical applications of ERAS pathway for total hip and total knee arthroplasty.
Trial registration: The National Institutes of Health Clinical Trials Registry, NCT03517098. Registered 04, May, 2018. https://register.clinicaltrials.gov/prs/app/action/ SelectProtocol?sid=S0007YV7&selectaction=Edit&uid=U0001B4E&ts=2&cx=97eyz9
Outpatient total hip or knee arthroplasty in ambulatory surgery center versus arthroplasty ward: a randomized controlled trial
