To investigate the impact of the enhanced recovery after surgery (ERAS) protocols under the collaboration of a clinical multidisciplinary team (MDT) on unilateral total knee arthroplasty (TKA).

From September 2018 to December 2021, the patients who were diagnosed as terminal knee osteoarthritis and underwent unilateral total knee arthroplasty in the orthopedic department of Jinjiang Municipal Hospital were enrolled. Exclusion criteria: history of knee surgery, concurrent infection or tumor, or chronic pain disease, and inability to cooperate with trial assessment. A total of 102 patients were enrolled, including 21 males and 81 females, aged from 40 to 89 years. Patients were randomly assigned into an ERAS-MDT treatment group (ERAS-MDT group, n=51) and a conventional treatment group (routine group, n=51) by random number table. The following data were collected: baseline data, visual analogue scale (VAS) scores for kinesalgia at eight hours, and 24, 48, and 72 h, active range of motion (AROM) of knee and the Hospital for Special Surgery (HSS) knee score on the second and fifth days after surgery, C-reactive protein (CRP) on the first day after surgery, transfusion rate, and postoperative complication rate. Independent t test, repeated measures ANOVA, Mann-Whitney test, chi square test and Fisher exact test were performed for data analysis.

VAS scores at eight hours, and 24, 48, 72 h in ERAS-MDT group were significantly lower than those in routine group(t=-2.945, -4.894, -5.676, -5.055, all P<0.05). Knee AROM in the ERAS-MDT group was (68.8±19.1)° and (93.9±14.0)° on the second and fifth days after surgery, both significantly higher than those in the routine group (59.8±21.6)° and (86.2±14.0)°(t=2.223, 2.786, both P<0.05). HSS scores on the postoperative second and fifth days in ERAS-MDT group were (46.8±6.5), (59.8±6.8), which were higher than those in the routine group (43.4±6.8), (52.8±5.8)(t=2.620, 5.575, both P<0.05). CRP level on the day after surgery showed no statistically significant difference between ERAS-MDT group and routine group(Z=-0.400, P>0.05). No statistically significant difference was found in terms of transfusion rate and postoperative complication rate between the two groups(both P>0.05).

Compared with the traditional treatment protocols, the ERAS-MDT protocols can offer more postoperative pain relief and improve joint function in unilateral TKA patients, hence to promote a rapid recovery.