Comparing outcomes between enhanced recovery after surgery and traditional protocols in total hip arthroplasty: a retrospective cohort study

  • Editorial Office
  • R J Immelman University of Pretoria
  • J N De Vos Wilgers Hospital
  • J H Venter Wilgers Hospital
Keywords ERAS;, enhanced recovery, rapid recovery, total hip replacement, arthroplasty


Background: Traditionally, hip replacement surgery was associated with prolonged recovery and rehabilitation in a hospital setting. Prolonged stay is causing growing concern internationally, where there is an increased drive to cost-effective practice and a realisation that prolonged hospitalisation is not required and may be detrimental. Enhanced Recovery After Surgery (ERAS) protocols address this problem by advocating evidence-based multidisciplinary peri-operative management pathways associated with rapid recovery, without compromising safety. Despite proven efficacy, these protocols are not being implemented in most South African orthopaedic practices.
Methods: Data from two cohorts (80 patients) undergoing elective primary total hip arthroplasty were included. One group was rehabilitated according to a prolonged stay protocol and the other according to ERAS. Cohorts were matched according to demographics and comorbidities. The functional outcome was compared using the Oxford Hip Score. The 30-day readmission rate was compared to assess the safety of early discharge, and the length of stay of patients was compared. 
Results: The readmission rate and Oxford Hip Scores showed no clinically significant difference between the cohorts. The length of stay was markedly decreased in the ERAS group. 
Conclusion: ERAS protocols can decrease the length of stay in elective total hip replacement without compromising patient safety or functional outcome.
Level of evidence: Level 4

Author Biographies

R J Immelman, University of Pretoria


Registrar in Orthopaedic Surgery

University of Pretoria

J N De Vos, Wilgers Hospital

MBChB(Pret) MMed Orth(Pret)

Orthopaedic Surgeon

Wilgers Hospital


J H Venter, Wilgers Hospital

MBChB(Pret) MMed Int(Pret)

Specialist Physician

Wilgers Hospital


How to Cite
OFFICE, Editorial et al. Comparing outcomes between enhanced recovery after surgery and traditional protocols in total hip arthroplasty: a retrospective cohort study. South African Orthopaedic Journal, [S.l.], p. 11-16, may 2018. ISSN 2309-8309. Available at: <>. Date accessed: 23 jan. 2019.

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