Total Knee Arthroplasty (Replacement)
Conditions
Keywords
Enhanced Recovery After Surgery, Total Knee Arthroplasty, Older Adults, Pain, Knee Function, Physical Resilience
Brief summary
With the advent of an aging society, the demand for total knee arthroplasty (TKA) continues to increase. Postoperative recovery is influenced not only by the surgical procedure itself but also by pain control, joint function, and physical resilience. Enhanced Recovery After Surgery (ERAS) promotes postoperative recovery through multidisciplinary integrated care; however, related research in Taiwan remains limited, particularly studies that simultaneously examine pain, joint function, and physical resilience. This study aims to investigate the effects of the Enhanced Recovery After Surgery (ERAS) care model on changes in postoperative pain, knee function, and physical resilience among older adults undergoing total knee arthroplasty. A quasi-experimental study with convenience sampling will be conducted. Participants will be allocated to either the ERAS group or the routine care group according to the care model received. Outcome measurements will be obtained preoperatively, on postoperative day 1, postoperative day 3, and two weeks after discharge. Pain will be assessed using the Numeric Rating Scale (NRS), knee function using the Chinese version of the Knee Injury and Osteoarthritis Outcome Score (KOOS), and physical resilience using the Physical Resilience Instrument for Older Adults (PRIFOR). Clinical recovery indicators, including vital signs, length of hospital stay, and time to first ambulation, will also be collected. The ERAS care model is expected to improve postoperative pain, promote recovery of knee function, enhance physical resilience, shorten the length of hospital stay, and facilitate earlier ambulation. The findings of this study are expected to provide evidence for optimizing perioperative care and supporting the implementation of ERAS for older adults undergoing total knee arthroplasty.
Interventions
OTHEREnhanced Recovery After Surgery (ERAS) Care Pathway
A standardized multidisciplinary perioperative care pathway including preoperative multidimensional assessment, preoperative education, nutritional assessment, multimodal pain management, intraoperative temperature maintenance, early oral intake, early ambulation, early rehabilitation, and discharge care.
Usual perioperative care according to the hospital's current care pathway, including routine preoperative education, preoperative assessment, postoperative pain care, wound care, rehabilitation guidance, and discharge education.
Sponsors
China Medical University Hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
Participants choose either ERAS care or usual perioperative care after receiving information from the attending physician and are enrolled into the corresponding group. The study uses a non-randomized parallel-group design.
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Adults aged 65 years or older. Scheduled to undergo primary unilateral total knee arthroplasty (TKA). Able to understand the study information and complete the study questionnaires. Willing to participate and provide written informed consent
Exclusion criteria
Undergoing revision total knee arthroplasty. Undergoing bilateral total knee arthroplasty. Cognitive impairment or communication difficulties that prevent completion of the study questionnaires
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain Intensity Assessed by the Numerical Rating Scale (NRS) | Preoperative day, postoperative day 1, postoperative day 3, and 2 weeks after discharge | Pain intensity will be assessed using the Numerical Rating Scale (NRS), with scores ranging from 0 to 10. Higher scores indicate greater pain intensity. Changes in pain scores will be compared between the ERAS group and the usual care group across the study time points. |
| Knee Function Assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS) | Preoperative day, postoperative day 1, postoperative day 3, and 2 weeks after discharge | Knee-related outcomes will be assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS), which includes five subscales: Symptoms, Pain, Activities of Daily Living, Sport and Recreation Function, and Knee-related Quality of Life. Higher scores indicate better knee-related health status. |
| Physical Resilience Assessed by the Physical Resilience Instrument for Older Adults (PRIFOR) | Preoperative day, postoperative day 1, postoperative day 3, and 2 weeks after discharge | Physical resilience will be assessed using the 16-item Physical Resilience Instrument for Older Adults (PRIFOR). Changes in physical resilience scores will be compared between the ERAS group and the usual care group across the study time points. |
Contacts
CONTACTLin Tung-Chieh Lin Tung-Chieh, Principal Investigator
Outcome results
None listed