Impact of enhanced recovery after surgery on postoperative blood management following primary total knee arthroplasty: a propensity score-matched analysis.

IF 2 3区 医学 Q2 ORTHOPEDICS
International Orthopaedics Pub Date : 2025-01-01 Epub Date: 2024-10-10 DOI:10.1007/s00264-024-06342-x
Abdullah S Mogalli, Jianbo Zhao, Yang Chen, Xin Qi
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引用次数: 0

Abstract

Purpose: To evaluate the efficacy of blood management in patients underwent unilateral Total Knee Arthroplasty (TKA) under an enhanced recovery after surgery (ERAS) program.

Method: Patients underwent unilateral TKA from January 2019 to October 2023 in a university hospital were retrospectively studied. A total of 200 cases were selected in the analysis. After matching with propensity scoring, 51 patients in each group were included. The postoperative Haemoglobin (Hb), albumin (Alb), C-reactive protein (CRP), total length of stay (LOS), and estimated blood loss after operation were compared between the two groups. Clinical outcomes including Western Ontario and McMaster Universities Arthritis Index (WOMAC), SF-12, and Oxford Knee Score (OKS) were also compared at six week and three month follow-up.

Results: The results showed that the Hb of the ERAS group was significantly higher than those of the non-ERAS group (P < 0.05) on the third postoperative. The mean CRP level was lower, LOS was shorter, and Alb level was higher in the ERAS group compared to that in the non-ERAS group (P < 0.05). The clinical outcomes such as WOMAC and OKS, SF-12 scores were higher in the ERAS group at both follow-up.

Conclusion: ERAS protocol effectively minimizes perioperative blood loss and supports optimal nutrient levels in patients. ERAS management significantly contributes to the postoperative recovery of knee function in patients undergoing primary total knee arthroplasty.

加强术后恢复对初级全膝关节置换术后血液管理的影响:倾向得分匹配分析。
目的:评估在增强术后恢复(ERAS)计划下对单侧全膝关节置换术(TKA)患者进行血液管理的效果:回顾性研究2019年1月至2023年10月在某大学附属医院接受单侧全膝关节置换术的患者。分析共选取了 200 例患者。经过倾向评分匹配后,每组纳入 51 例患者。比较了两组患者的术后血红蛋白(Hb)、白蛋白(Alb)、C反应蛋白(CRP)、总住院时间(LOS)和术后估计失血量。此外,还比较了六周和三个月随访时的临床结果,包括西安大略和麦克马斯特大学关节炎指数(WOMAC)、SF-12 和牛津膝关节评分(OKS):结果:结果显示,ERAS 组的血红蛋白明显高于非 ERAS 组(P 结论:ERAS 方案能有效减少围手术期的风险:ERAS方案有效地减少了围手术期的失血量,并为患者提供了最佳的营养水平。ERAS管理大大有助于初级全膝关节置换术患者术后膝关节功能的恢复。
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来源期刊
International Orthopaedics
International Orthopaedics 医学-整形外科
CiteScore
5.50
自引率
7.40%
发文量
360
审稿时长
1 months
期刊介绍: International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.
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