Can the introduction of Enhanced Recovery After Surgery (ERAS) reduce the variation in length of stay after total ankle replacement surgery?

Thomas W Wainwright; Tikki Immins; Johannes H A Antonis; Heath Taylor; Robert G Middleton

doi:10.1016/j.fas.2017.12.005

Can the introduction of Enhanced Recovery After Surgery (ERAS) reduce the variation in length of stay after total ankle replacement surgery?

Foot Ankle Surg. 2019 Jun;25(3):294-297. doi: 10.1016/j.fas.2017.12.005. Epub 2017 Dec 21.

Authors

Thomas W Wainwright¹, Tikki Immins², Johannes H A Antonis³, Heath Taylor⁴, Robert G Middleton⁵

Affiliations

¹ Orthopaedic Research Institute, Bournemouth University, 6th Floor, Executive Business Centre, 89 Holdenhurst Road, Bournemouth, BH8 8EB, UK; Orthopaedic Department, The Royal Bournemouth Hospital, Castle Lane, Bournemouth, BH7 7DW, UK. Electronic address: [email protected].
² Orthopaedic Research Institute, Bournemouth University, 6th Floor, Executive Business Centre, 89 Holdenhurst Road, Bournemouth, BH8 8EB, UK. Electronic address: [email protected].
³ Orthopaedic Research Institute, Bournemouth University, 6th Floor, Executive Business Centre, 89 Holdenhurst Road, Bournemouth, BH8 8EB, UK; Orthopaedic Department, The Royal Bournemouth Hospital, Castle Lane, Bournemouth, BH7 7DW, UK. Electronic address: [email protected].
⁴ Orthopaedic Department, The Royal Bournemouth Hospital, Castle Lane, Bournemouth, BH7 7DW, UK. Electronic address: [email protected].
⁵ Orthopaedic Research Institute, Bournemouth University, 6th Floor, Executive Business Centre, 89 Holdenhurst Road, Bournemouth, BH8 8EB, UK; Orthopaedic Department, The Royal Bournemouth Hospital, Castle Lane, Bournemouth, BH7 7DW, UK. Electronic address: [email protected].

PMID: 29409177
DOI: 10.1016/j.fas.2017.12.005

Abstract

Background: Enhanced Recovery After Surgery (ERAS) has been successfully adopted across a range of procedures. This study explores whether there is scope to improve length of stay (LOS) for total ankle replacement surgery (TAR) in the UK by implementing ERAS pathways.

Methods: Hospital Episode Statistics (HES) data (April 2015/March 2016) on LOS for TAR were analysed. A literature search was then carried out to examine whether there were any publications on outpatient TAR and/or the use of ERAS protocols.

Results: Mean observed LOS was 3.3days (range 0-17.3) days. Case mix-adjusted expected LOS range was 2.0-5.7 days. It is likely that the wide observed LOS range is due to differences in local processes and pathways. Two papers were found by the literature search.

Conclusions: TAR should aim to be outpatient surgery as the literature, and data demonstrating scope for improvement in LOS, suggest this should be possible.

Keywords: ERAS; Enhanced Recovery After Surgery; Length of stay; Total ankle replacement.

MeSH terms

Arthroplasty, Replacement, Ankle / rehabilitation*
Humans
Length of Stay*
Postoperative Complications
Recovery of Function
United Kingdom