By: Clinique Orthopédique Duval

Dr. Vendittoli, who has been working as an orthopedic surgeon at Duval for more than 15 years, has led an interdisciplinary task force to improve all aspects of the arthroplasty procedure. This collaborative work has taken place over the last few years and has improved how doctors and other health care professionals are approaching joint replacement surgery across the country. This practice is called Enhanced Recovery After Surgery (ERAS).

What is Enhanced Recovery After Surgery (ERAS)?

ERAS aims at providing optimized care by modifying several aspects of perioperative care. This requires the involvement of a multidisciplinary team (patients, anesthesiologists, surgeons, nurses, and physiotherapists) who commit to specifically designed, evidence-based protocols in perioperative care. Let’s take a look at the main aspects of ERAS.

Preoperative patient optimization
Preoperative education is an essential part of a patient’s preparation for surgery. It is designed to improve the patient’s knowledge, expectations, behavior, and health. Our experts also take the opportunity to optimize modifiable risk factors, such as smoking and alcohol cessation, improved nutrition, and coaching the patient on pre and postoperative exercises.

Pain control and the reduction of postoperative adverse events
To improve a patient’s wellbeing, ERAS seeks to minimize post-operative pain and reduce the use of opioids to minimize adverse side-effects like drowsiness, nausea, vomiting, and constipation. The ERAS multimodal approach also includes an improved pre-surgery feeding protocol and the use of prophylactic drugs to reduce nausea and vomiting. Patients are encouraged to eat as early as desired after surgery.

Early ambulation motor function
Early postoperative function and mobilization are key factors of an ERAS program. Our experts use an anesthesia technique that reduces muscle weakness and other side effects. This process avoids complete motor block, which enables patients to move their feet during the surgical procedure. Once the deep sedation has ceased, patients can mobilize their lower limbs while in bed, stand, and walk 2-3 hours after surgery.

Blood conservation
Total hip and knee replacement surgeries carry the risks of significant perioperative blood loss. To mitigate these risks, our experts optimize preoperative hemoglobin and perioperative drug administration. For a total knee arthroplasty, we use a careful surgical technique that keeps the knee flexed for 3 hours post-operation. This helps to minimize blood loss and may also help avoid the need for a blood transfusion.

Wound care
An interesting ERAS option is to seal the wound with medical glue, instead of using metallic staples. This helps to prevent discharge, spontaneous evacuation of blood, soiling of the dressing and also provides relief to a patient that is worried about hemorrhages. Closing the skin with glue reduces nursing care time as well as enables patients to shower and heal more quickly.

The key elements of our protocol were selected to optimize patient recovery, minimize complications, reduce unwanted events and improve the patient experience.

Over the years, Duval Clinic has helped thousands of people recover from debilitating joint pain. From consultation to surgery and recovery, all our services are available in our state-of-the-art surgical clinic.

If you have any questions or concerns about joint replacement surgery or any other procedure, please contact us here: