Enhanced Recovery After Orthopaedic Surgery (ERAS)
When facing joint replacement surgery, the journey to recovery can feel daunting. Enhanced Recovery After Surgery (ERAS) protocols however, also known as ‘rapid recovery,’ are designed to help you achieve the best possible outcome from your surgery. It focuses on the steps you can take before your operation to optimise your recovery, reduce complications, and improve your overall experience which is why Dr Martin incorporates the ERAS system in all orthopaedic procedures, including knee and hip replacements.
By following this program, you can actively contribute to your recovery by improving your fitness, diet, and mental health before your operation. This preparation can reduce the physical stress of surgery and help you return to your daily activities sooner. ERAS is not just about what happens in the operating theatre; it is a comprehensive approach that highlights the importance of pre-operative preparation and postoperative care in enhancing your recovery.
THE ERAS PROCESS
Enhanced Recovery After Surgery (ERAS) is a comprehensive, evidence-based program designed to improve your surgical experience and support a faster recovery. Initially developed for major abdominal procedures, ERAS protocols are now widely used in orthopaedic surgery, including hip and knee replacements. These protocols involve a series of coordinated steps that take place before, during, and after your operation, all with the goal of reducing complications, shortening hospital stays, and helping you return to your usual activities sooner. While every patient is different, many find that ERAS helps create a smoother and more comfortable recovery process.
Physical recovery focuses on restoring movement, strength, and joint function as early as possible after surgery. With the support of physiotherapists and your healthcare team, you are encouraged to begin walking, standing, and performing light movements soon after your procedure. This early mobilisation helps reduce the risk of complications such as blood clots, improves muscle function, and supports your return to independence.
Key components include:
Smaller incisions and less invasive methods to reduce tissue damage and support healing.
Multimodal pain relief strategies to enhance comfort and reduce the need for opioids.
Encouraging movement and walking shortly after surgery to promote circulation, reduce complications, and support recovery.
Tailored physiotherapy and rehabilitation programs to address your specific needs and goals.
This involves:
Providing clear and comprehensive information about your procedure to help reduce anxiety and build confidence
Offering guidance and reassurance throughout your recovery to help you feel informed and supported.
Physiological recovery focuses on minimising the impact of surgery on your body’s major systems, including cardiovascular, respiratory, and haematological systems.
Key elements include:
Using advanced techniques like regional anaesthesia to reduce surgical trauma.
Supporting these functions during surgery to enhance recovery.
Limiting the use of these devices to promote early mobility and independence.
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THE POTENTIAL BENEFITS OF THE ERAS SYSTEM
The ERAS system is designed to promote active participation in your recovery and offers several benefits, including:
Reduced Pain and Discomfort: Advanced pain management techniques minimise the need for opioids.
Faster Mobilisation: Many patients begin walking within hours of their procedure.
Lower Risk of Complications: Reduced likelihood of issues such as blood clots, infections, or other surgical risks.
Early Discharge: Many patients can return home after a single overnight stay.
THE 4 STAGES OF THE ERAS SYSTEM
The Enhanced Recovery After Surgery (ERAS) system supports your surgical journey by focusing on four key stages: pre-operative preparations, intra-operative care, post-operative recovery, and discharge planning. Each stage plays an essential role in optimising your recovery and helping you return to your daily life as smoothly as possible.
1. Pre-Operative Preparations
This critical stage ensures you are in the best possible condition for surgery, setting the foundation for a successful recovery.
It includes:
- Optimising your health: Managing any underlying medical conditions, such as diabetes or high blood pressure.
- Preoperative education and nutrition: Learning about the procedure and maintaining a balanced diet to support healing.
- Discharge planning: Organising your home recovery environment and ensuring you have the necessary support.
2. Intra-Operative Care
During surgery, the focus is on minimising the impact on your body to reduce complications and support faster recovery.
This stage involves:
- Minimally invasive surgical techniques: Reducing tissue damage and promoting healing.
- Advanced anaesthesia and pain management: Using modern approaches to minimise discomfort and surgical stress.
- Maintaining stability: Ensuring normal circulation, oxygen levels, and body temperature throughout the procedure.
- Reducing invasive devices: Avoiding the use of systemic morphine, drains, and other devices where possible.
3. Post-Operative Recovery
After surgery, ERAS protocols encourage active recovery strategies to reduce complications and shorten your hospital stay. Key components include:
- Early mobilisation: Encouraging movement and walking soon after surgery to improve circulation and prevent complications.
- Personalised physiotherapy: Beginning rehabilitation to restore strength and mobility.
- Effective pain management: Using oral medications to control pain while reducing reliance on stronger medications.
- Promoting independence: Removing catheters, drips, and drains as soon as possible to support mobility.
4. Discharge Planning
Discharge planning begins as soon as your surgery is scheduled. This stage ensures that you can safely return home with the necessary support for continued recovery. The focus includes:
- Preparing your recovery environment at home.
- Ensuring you have access to any required medical equipment or medications.
- Providing clear instructions for follow-up care and physiotherapy.
By addressing each stage with care and precision, the ERAS system helps you recover faster, reduce the risk of complications, and achieve the best possible outcomes from your surgery.
