Key result
The Enhanced Recovery After Surgery (ERAS) pathway will be evaluated to determine if it reduces the length of hospital stay compared to conventional care in 640 patients undergoing primary hip or knee arthroplasty.
Why the study?
With dramatic increases in total hip and knee arthroplasty cases, practical strategies are needed to improve healthcare quality and outcomes, testing whether enhanced recovery after surgery pathways reduce hospital length of stay.
RCT (n=640)
Open-label
Central Randomization System (CRS)
Yes
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 reduce the length of stay (LOS)in hospital for patients undergoing primary THA or TKA. Methods/Design:This trial is a prospective, open-labelled, multi-centered, randomizedcontrolledtrial that will test the superiority of ERAS pathway in term of LOS in hospital for the patients undergoing primary THA or TKAas 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 rateby 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.The results may 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
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Li et al. (2019) conducted an RCT in End-stage osteoarthritis requiring primary total hip or knee arthroplasty (n=640). Enhanced recovery after surgery (ERAS) pathway vs. Conventional non-ERAS clinical practice was evaluated on Total length of stay (LOS) in hospital. The Enhanced Recovery After Surgery (ERAS) pathway will be evaluated to determine if it reduces the length of hospital stay compared to conventional care in 640 patients undergoing primary hip or knee arthroplasty.
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