Norwich Enhanced Recovery Programme vs. non-enhanced recovery following hip and knee replacement: A matched-cohort study

This study compared the early clinical outcomes and safety of the Norwich Enhanced Recovery Programme (NERP) and a non-enhanced recovery programme following Total Hip Replacement (THR) and Total Knee Replacement (TKR). The NERP programme is a multi-componented nursing and multidisciplinary pre- and peri-operative recovery programme which harnesses elements of managing patient expectation with education, pain control and early intensive rehabilitation. This new programme was compared with an age- and gender-matched cohort who followed the recovery pathway provided prior to the NERP regime. A total of 192 patients were reviewed. The results indicated that for THR and TKR hospital length of stay and requirement for in-patient rehabilitation was significantly lower following the NERP regime (p < 0.01). There was no significant difference between the groups in peri-operative complications. These results provide encouraging findings that this nursing and multidisciplinary enhanced recovery following THR or TKR may provide a more efficient post-operative pathway restoring independence earlier to people compared to non-enhanced recovery.