scholarly journals Preoperative optimisation in fast-track and enhanced recovery after surgery (ERAS) programs for total hip and knee joint replacement: a systematic review protocol

2021 ◽  
Author(s):  
Wei-Ju Chang ◽  
Justine Naylor ◽  
Victor Liu ◽  
Masiath Monuja ◽  
Sam Adie
Keyword(s):  
Systematic Review ◽  
Hospital Readmission ◽  
Patient Reported Outcomes ◽  
Fast Track ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Risk Of Bias ◽  
Total Hip ◽  
Patient Reported ◽  
Meta Analyses

ABSTRACTIntroductionEmerging evidence suggests that fast-track and enhanced recovery after surgery (ERAS) targeting modifiable risk factors reduce complications after total hip (THR) and knee replacement (TKR). However, what constitutes an effective preoperative optimisation protocol for THR and TKR remains unclear. The aims are to: (1) describe pre-operative optimisation protocols for THR and TKR; (2) evaluate the effects of pre-operative optimisation protocols for THR and TKR on morbidity, and patient-reported outcomes.Methods and analysisSystematic review and meta-analysis. Electronic databases will be searched using pre-determined search terms to identify relevant studies and evaluate the study eligibility and risks of bias. Two independent reviewers will select the eligible studies and any disagreement will be resolved through a third reviewer. We will include studies investigated pre-operative optimisation protocols administered prior to participants receiving primary THR or TKR to improve post-operative outcomes. Primary outcomes are hospital readmission, complications and patient-reported pain and function. Risk of bias will be assessed using the Cochrane RoB 1 tool and strength of evidence will be examined using the GRADE approach. Pre-operative optimisation protocols will be summarised qualitatively. Meta-analyses on the effects of included protocols will be conducted if appropriate.Ethics and disseminationThis systematic review does not require ethics approval. The findings will be disseminated in a peer-reviewed journal and presented at relevant conferences.RegistrationThis protocol has been submitted to the International Prospective Register of Systematic Reviews on 30 August 2021.ARTICLE SUMMARYStrength and LimitationsThis systematic review aims to describe pre-operative optimisation protocols for total hip and knee replacement and to synthesise evidence for the effects of pre-operative optimisation protocols on hospital readmission, complications and patient-reported outcomes.Two independent reviewers will conduct study selection, data extraction and risk of bias assessment.Meta-analyses, sub-group and sensitivity analyses will be performed where appropriate.

Enhanced Recovery Experience After Orthopaedic Surgery: A Systematic Review of Patient-Reported Outcomes

2019 ◽  
pp. 108-112
Author(s):  
Muath Alturkistani ◽  
Ali Alahmari ◽  
Hussam Alhumaidi ◽  
Mohammed Alharbi ◽  
Alhanouf Alqernas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Orthopaedic Surgery ◽  
Patient Reported Outcomes ◽  
Enhanced Recovery ◽  
Patient Reported

scholarly journals A Systematic Review and Meta-Analysis to Assess Patient-Reported Outcomes after Lung Cancer Surgery

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Sayf Gazala ◽  
Jean-Sébastien Pelletier ◽  
Dale Storie ◽  
Jeffrey A. Johnson ◽  
Demetrios J. Kutsogiannis ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Patient Reported Outcomes ◽  
Meta Analysis ◽  
Lung Cancer Surgery ◽  
Risk Of Bias ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related

The main objective of this review was to systematically review, assess, and report on the studies that have assessed health related quality of life (HRQOL) after VATS and thoracotomy for resection of lung cancer. We performed a systematic review of six databases. The Downs and Black tool was used to assess the risk of bias. Five studies were included. In general, patients undergoing VATS have a better HRQOL when compared to thoracotomy; however, there was a high risk of bias in the included studies. The consistent use of a lung cancer specific questionnaire for measuring HRQOL after surgery is encouraged.

Meniscus repair failure risk does not differ by sex: a systematic review

2020 ◽  
Vol 5 (2) ◽  
pp. 98-102
Author(s):  
Christopher Hamilton ◽  
David C Flanigan ◽  
Kishan H Patel ◽  
Nathaniel Lundy ◽  
Ryan Blackwell ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Reported Outcomes ◽  
Meniscus Repair ◽  
Published Data ◽  
Level Of Evidence ◽  
Female Patients ◽  
Failure Risk ◽  
Significant Difference ◽  
Patient Reported ◽  
Meta Analyses

ImportanceMeniscus tears are common knee pathologies that are frequently treated with meniscus repair with a variety of techniques. Regardless of technique and implant choice, it is critical to understand and consider patient factors, including patient sex, which can influence outcome.ObjectiveWe sought to determine if there is an effect of sex on failure risk following meniscus repair.Evidence reviewA systematic review of the literature was undertaken to identify studies that reported failure risk independently for male and female patients. Meta-analyses were performed to identify the effect of patient sex on meniscus repair failure risk. Differences in patient-reported outcomes by sex were reported qualitatively.FindingsA total of 886 patients analysed were included in the 11 identified studies, including 556 males and 330 females. Meniscus repair failure was reported in 192 patients (21.7%). The failure risk was 21.1% in males and 21.5% in females. Meta-analyses demonstrated no significant difference in meniscus repair failure risk based on sex in neither the three studies that assessed repair success arthroscopically (p=0.66) nor the eight studies in which failure was defined with clinical assessment or as the need for repeat surgery (p=0.92).Conclusions and relevanceThere are no significant differences in meniscus repair failure risk in male versus female patients in the existing literature. More published data are needed to evaluate patient-reported outcomes of meniscus repair based on sex.Level of evidenceIV, systematic review.

scholarly journals The impact of enhanced recovery after surgery on total joint arthroplasty: A protocol for systematic review and meta-analysis (Preprint)

2020 ◽  
Author(s):  
Siddharth Rele ◽  
Cade Shadbolt ◽  
Chris Schilling ◽  
Nicholas F Taylor ◽  
Michelle M Dowsey ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Service ◽  
Knee Arthroplasty ◽  
Total Joint Arthroplasty ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Meta Analysis ◽  
Joint Arthroplasty ◽  
Total Hip ◽  
Hip And Knee Arthroplasty

BACKGROUND The number of total joint arthroplasty 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 formulation of enhanced recovery for 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 total joint arthroplasty. OBJECTIVE This study outlines the protocol for a systematic review and meta-analysis that aims to assess the utility of enhanced recovery after surgery programs on patient, health services and economic outcomes for primary, elective total hip and knee arthroplasty. METHODS A systematic search will be conducted in Medline (OVID), EMCARE (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, total knee and hip arthroplasty 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. RESULTS The search terms have been finalized, and the final primary database search will be completed in November 2020. The results of this systematic review will be disseminated in a peer-reviewed journal. CONCLUSIONS This protocol will guide a systematic review assessing outcomes associated with ERAS surgery in primary, total hip and knee arthroplasty CLINICALTRIAL Open Science Framework. Doi: 10.17605/OSF.IO/Y4BHS

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