POSTOPERATIVE OUTCOMES OF ENHANCED RECOVERY AFTER SURGERY VERSUS STANDARD CARE IN TOTAL JOINT ARTHROPLASTY: A PROSPECTIVE OBSERVATIONAL STUDY
Description
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.
Files
Steps to reproduce
The data were generated through a prospective observational study conducted at a single specialized orthopaedic center in Kuala Lumpur, Malaysia, between May 2026 and June 2026. Adult patients undergoing elective primary total knee arthroplasty (TKA) or total hip arthroplasty (THA) were recruited consecutively and allocated to either an Enhanced Recovery After Surgery (ERAS) pathway or standard perioperative care according to the routine, established clinical protocol of the attending orthopedic surgeon. A total of 76 participants were included, comprising 38 patients in the ERAS group and 38 patients in the standard care group. Eligibility criteria included patients aged 18 years and above undergoing elective primary TJA, while revision arthroplasty, emergency procedures, and patients with incomplete records were excluded. Data collection was performed prospectively using standardized data collection forms and an institutional ERAS checklist incorporated into the patient's medical record. Demographic and clinical data were extracted from electronic and paper medical records, nursing documentation, medication administration records, physiotherapy notes, and physician progress notes. The ERAS pathway consisted of preoperative patient education, shortened fasting periods, multimodal opioid-sparing analgesia, standardized antiemetic prophylaxis, early oral intake, early mobilization, structured thromboprophylaxis, and predefined discharge criteria. The standard care group received conventional perioperative management according to routine clinical practice. The primary outcome measures included postoperative pain scores, postoperative nausea and vomiting (PONV), venous thromboembolism (VTE), and length of hospital stay (LOS). Pain was measured using the Visual Analog Scale (VAS; 0–10) and recorded at 12, 24, and 48 hours postoperatively by nursing staff as part of routine care. PONV was recorded based on documented episodes of nausea or vomiting occurring within the first 48 postoperative hours. VTE events were identified through clinical diagnosis and confirmed by Doppler ultrasonography for deep vein thrombosis or computed tomography pulmonary angiography for pulmonary embolism. LOS was calculated as the total number of days from hospital admission until discharge. Data were entered into Microsoft Excel and subsequently analysed using IBM SPSS Statistics Version 30.0. Descriptive statistics were used to summarize participant characteristics. Continuous variables were assessed for normality using the Shapiro-Wilk and Kolmogorov-Smirnov tests. Group comparisons were performed using independent samples t-tests or Mann-Whitney U tests for continuous variables and Chi-square or Fisher's exact tests for categorical variables. Statistical significance was established at p < 0.05. The study protocol was approved by the institutional ethics committees, and written informed consent was obtained from all participants before enrolment.