Table of Contents
Advances in Orthopedic Surgery
Volume 2016, Article ID 9846910, 5 pages
Research Article

Enhanced Recovery Protocol Reduces Transfusion Requirements and Hospital Stay in Patients Undergoing an Elective Arthroplasty Procedure

1Department of Orthopaedic Surgery, Leighton Hospital, Crewe CW1 4QJ, UK
2Department of Anaesthetics, Leighton Hospital, Crewe CW1 4QJ, UK

Received 30 December 2015; Accepted 17 March 2016

Academic Editor: Padhraig O’Loughlin

Copyright © 2016 Kirsten Juliette de Burlet et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Enhanced recovery (ER) for elective total hip or total knee replacement has become common practice. The aim of this study is to evaluate the impact of ER on transfusion rates and incidence of venous thromboembolism (VTE). Methods. A comprehensive review was undertaken of all patients who underwent primary hip or knee arthroplasty surgery electively between January 2011 and December 2013 at our institution. ER was implemented in August 2012, thus creating two cohorts: the traditional protocol (TP) group and the ER group. Outcome measurements of length of stay, postoperative transfusion, thromboembolic complications, and number of readmissions were assessed. Main Findings. 1262 patients were included. The TP group contained a total of 632 patients and the ER group contained 630 patients. Postoperative transfusion rate in the ER group was reduced with 45% (). There was no statistical difference in postoperative VTE complications. The length of stay was reduced from 5.5 days to 4.8 days (). Conclusions. There was no difference in the number of readmissions. ER has contributed to a significant decrease in transfusions after elective arthroplasty surgery, with no increase in the incidence of thromboembolic events. Furthermore, it has significantly reduced inpatient length of stay.