Combining enhanced recovery and short-stay protocols for hip and knee joint replacements: the ideal solution

Combining enhanced recovery and short-stay protocols for hip and knee joint replacements: the ideal solution

Can J Surg 2021;64(1):E66-E68 | PDF

Pascal-André Vendittoli, MD, MSc; Karina Pellei, PTH, MSc; Carla Williams, MHSM, CPPS; Claude Laflamme, MD, MHSc


Pressure to reduce health care costs, limited hospital bed availability as well as improvements in surgical techniques and perioperative care motivated many health care centres to implement short-stay protocols for patients undergoing hip or knee arthroplasty. To improve patient outcomes and maintain care safety, we strongly believe the best way to implement a successful outpatient program would be to embrace the principles of Enhanced Recovery After Surgery (ERAS), and to improve patient recovery to a level such that the patient could leave the hospital sooner. Enhanced Recovery Canada and the Canadian Patient Safety Institute support the development of ERAS pathways for orthopedic procedures. The goal is to provide patients, health care providers and leaders with helpful tools and resources to effectively implement and sustain ERAS protocols. Reducing the rate of adverse events while reducing the length of hospital stays to less than 24 hours is a winning situation for everyone.

Accepted March 17, 2020

Affiliations: From the Department of Surgery, University of Montréal, Montréal Que. (Venditolli); the Department of Surgery, Maisonneauve-Rosemont Hospital, Montréal Que. (Vendittoli, Pellei); Canadian Patient Safety Institute, St. John’s, NL (Williams); and Sunnybrook Health Sciences Centre, Toronto, Ont. (Laflamme).

Competing interests: P.-A. Vendittoli reports grants and personal fees from Stryker and Johnson and Johnson, grants from Zimmer and from Smith and Nephew, and royalties from Microport, outside the submitted work. C. Williams is a senior program manager at the Canadian Patient Safety Institute and organizational lead for Enhanced Recovery Canada. No other competing interests are declared.

Contributors: All authors contributed substantially to the conception, writing and revision of this article and approved the final version for publication.

Content licence: This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) licence, which permits use, distribution and reproduction in any medium, provided that the original publication is properly cited, the use is noncommercial (i.e., research or educational use), and no modifications or adaptations are made. See:

DOI: 10.1503/cjs.019519

Correspondence to: P.-A. Vendittoli, Hôpital Maisonneuve-Rosemont, 5415 Boul L’Assomption, Montréal QC H1T 2M4,