POSTOPERATIVE OUTCOMES OF ENHANCED RECOVERY AFTER SURGERY VERSUS STANDARD CARE IN TOTAL JOINT ARTHROPLASTY: A PROSPECTIVE OBSERVATIONAL STUDY

This study evaluated whether implementation of the Enhanced Recovery After Surgery (ERAS) protocol resulted in improved postoperative outcomes compared with standard perioperative care among patients undergoing total joint arthroplasty (TJA).

The following hypotheses were tested:

H1: There is a significant difference in the incidence of postoperative nausea and vomiting (PONV) between patients managed using ERAS and those receiving standard perioperative care.

H2: There is a significant difference in postoperative pain scores between patients managed using ERAS and those receiving standard perioperative care.

H3: There is a significant difference in the incidence of venous thromboembolism (VTE) between patients managed using ERAS and those receiving standard perioperative care.

H4: There is a significant difference in length of hospital stay (LOS) between patients managed using ERAS and those receiving standard perioperative care.

Description of the Dataset

The dataset was collected prospectively from adult patients undergoing elective primary total joint arthroplasty at a single specialized orthopaedic center in Kuala Lumpur, Malaysia. Allocation to the ERAS pathway or standard perioperative care was not determined by the research team but rather by the routine, established clinical protocol of the attending orthopaedic surgeon. This pragmatic design was chosen to reflect real-world clinical decision-making and perioperative pathway implementation.

A total of 76 participants were included, consisting of:

ERAS group: 38 patients
Standard care group: 38 patients

Data were obtained through:

Medical record review.
Nursing documentation.
ERAS pathway checklist.
Postoperative nursing assessments.
Clinical investigations and physician documentation.

The dataset included both demographic and clinical outcome variables.

Demographic Variables
Age
Gender
Surgical diagnosis
Treatment group (ERAS or standard care)
Clinical Outcome Variables
Pain score at 12 hours postoperatively
Pain score at 24 hours postoperatively
Pain score at 48 hours postoperatively
Presence or absence of PONV
Presence or absence of VTE
Length of hospital stay

Pain scores were measured using the Visual Analog Scale (VAS), with scores ranging from 0 (no pain) to 10 (worst imaginable pain).

PONV and VTE were recorded as binary variables:

1 = Present
2 = Absent

Length of stay was recorded as the total number of hospitalization days.