Clinical Case Database / Category: Case Based Discussion
Enhanced recovery after orthopaedic surgery
Dr Som Sarkar MB, ChB, MAcad, MEd, FRCA, EDIC, FFICM, Mr Shivan Jassim MSc, MBBS, MRCS, Dr David Hewson BSc, PGCertEd, FHEA, MBBS, MRCS, FRCA
Foundation Years Journal, volume 9, issue 9, p.15 (123Doc Education, London, October 2015)
A 77 year-old man presents for elective major joint surgery. He has concerns that major surgery will not be feasible due to the disruption it will cause to his caring responsibilities for his wife, who suffers from severe dementia. His perioperative pathway is described and the principles of enhanced recovery after orthopaedic surgery are explained. These give him the best chance to return to optimal function as soon as practicable within current perioperative practice.
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Dr Som Sarkar MB, ChB, MAcad, MEd, FRCA, EDIC, FFICM
Consultant in Anaesthesia and Intensive Care Medicine
Kings Mill Hospital, Mansfield Road
Sutton-in-Ashfield, NG17 4JL
Mr Shivan Jassim MSc, MBBS, MRCS
ST5 Trauma and Orthopaedics Registrar
Watford General Hospital
Watford, WD18 0HB
Dr David Hewson BSc, PGCertEd, FHEA, MBBS, MRCS, FRCA (Corresponding author)
ST5 Anaesthetic Registrar
Queens Medical Centre
Derby Road, Nottingham, NG7 2UH
1. Kehlet H. Fast-track colorectal surgery. Lancet 2008; 371: 791-3.
2. Delivering Enhanced Recovery. NHS Enhanced Recovery Partnership Programme. DH, London, March
2010 (www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@ dh/@en/@ps/documents/
3. Hansen TB, Bredtoft HK, Larsen K. Preoperative physical optimization in fast-track hip and knee
arthroplasty. Dan Med J 2012; 59: A4381.
4. Preoperative tests. The use of routine preoperative tests for elective surgery. NICE clinical guideline
3, June 2003 (www.guidance.nice.org.uk/cg3).
5. Andersen KV, Pfeiffer-Jensen M, Haraldsted V, Søballe K. Reduced hospital stay and narcotic
consumption, and improved mobilization with local and intra-articular infiltration after hip arthroplasty.
Acta Orthop 2007; 78: 180–6.
6. Macfarlane AJ, Prasad GA, Chan VWS, Brull R. Does regional anaesthesia improve outcome after total
hip arthroplasty? A systematic review. Anaesthesia 2009; 103: 335–45.
7. den Hertog A, Gliesche K, Timm J et al. Pathway-controlled fast-track rehabilitation after total
knee arthroplasty: a randomized prospective clinical study evaluating the recovery pattern, drug
consumption, and length of stay. Arch Orthop Trauma Surg 2012; 132: 153–163.
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About the Clinical Cases Database
The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
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