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June 1, 2026Formosan Journal of Musculoskeletal Disorders0 citationsOpen Access

Does Enhanced Recovery after Surgery Protocol Improve Outcomes in Elderly Patients of Advanced Age Undergoing Primary Total Joint Replacement Surgery? A Preliminary Report

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TYTzu-Hua YangPSPei-Hung ShenCWChih‐Chien Wang

Key Points

  • This study evaluates the effects of the Enhanced Recovery after Surgery (ERAS) protocol on elderly patients undergoing total joint replacements.
  • Retrospective review of patients undergoing primary THA and TKA at a single tertiary center.
  • Comparison of outcomes between standard care and ERAS protocol groups.
  • Assessment of length of stay, morbidity, and readmission rates.
  • In the non-ERAS group (N=56), mean length of stay was 7.61 days with 12.5% morbidity and no readmissions.
  • In the ERAS group (N=14), length of stay was reduced to 7 days with no morbidity or readmissions reported.
  • Non-ERAS TKA and THA had longer stays (7.36 and 8.5 days) and higher morbidity rates (11% and 17%).

Abstract

Background: Enhanced recovery after surgery (ERAS) protocols have been increasingly adopted in joint reconstruction surgeries to reduce costs, improve efficiency, and optimize outcomes. Objectives: This study evaluates the preliminary effects of ERAS in elderly patients (>80 years) undergoing primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) on hospital length of stay (LOS), morbidity, and readmission rates. Materials and Methods: Patients who received elective TKA or THA from a single tertiary center were retrospectively reviewed. Two groups were compared: patients treated with standard care in 2023 and those recruited in the ERAS protocol from June to December 2024. Outcomes assessed contained mean age, LOS, morbidity, and 30-day readmission rates. Results: Among 56 patients in the non-ERAS group (mean age 84.1), the overall LOS was 7.61 days with 7 morbidity cases (12.5%) and no readmissions. In the ERAS group ( n = 14, mean age 83.2), LOS decreased to 7 days and no morbidity or readmissions were observed. For non-ERAS TKA and THA, LOS was longer (7.36 and 8.5 days, respectively) with higher morbidity rates (11% and 17%). Conclusions: Preliminary results suggest that ERAS ameliorate perioperative outcomes in elderly patients receiving joint replacement surgery, although the findings are exploratory and not definitive. Additional large-scale research is needed to confirm these findings and to clearly demonstrate the advantages of ERAS in Taiwan.

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Cite This Study

Yang et al. (2026) studied this question.

synapsesocial.com/papers/6a1d221f02fbce9130637dedhttps://doi.org/10.4103/fjmd.fjmd-d-25-00044
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