• Wayne Yong Xiang Foo, Jerry Yongqiang Chen, Hee Nee Pang, TayDarren Keng JinDKJDepartment of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Academia, Level 4, Bukit Merah, 169865, Singapore., Seng Jin Yeo, and LiowMing Han LincolnMHLDepartment of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Academia, Level 4, Bukit Merah, 169865, Singapore..
• Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Academia, Level 4, Bukit Merah, 169865, Singapore. yxwayne@gmail.com.
• Arch Orthop Trauma Surg. 2024 May 1; 144 (5): 224922562249-2256.

IntroductionEnhanced recovery after surgery (ERAS) has been increasingly adopted in orthopaedic surgery. Although not an exclusion criterion, patients undergoing total knee arthroplasty (TKA) with preoperative severe varus deformity may be less likely to be enrolled for ERAS. This study aimed to compare the success of ERAS TKA between patients with severe preoperative varus deformities (≥ 15° varus) and the control group (< 15° varus to 14° valgus). Our secondary aim was to compare postoperative complications and functional outcomes between the two groups.Materials & Methods310 TKAs performed from August 2019 to February 2021 were analyzed with a follow-up of 6 months postoperatively. The primary outcome, ERAS TKA success, was defined as length of hospital stay of < 24 h. Other parameters included 30-day postoperative complications and clinical outcomes such as the original Oxford Knee Score (OKS), the Knee Society Knee (KSKS) and Function Score (KSFS), Visual Analog Scale for Pain (VAS-P), 36-Item Short-Form Health Survey (SF-36) Physical Component Summary (PCS) and SF-36 Mental Component Summary (MCS).ResultsThere were 119 patients in the severe deformity group and 191 patients in the control group. There were no significant differences in ERAS success between the severe deformity group and control group, with both groups achieving similarly high rates (> 90%) of ERAS success. There were also no differences in 30-day postoperative complications and 6-month postoperative clinical outcomes.ConclusionPatients with severe preoperative varus deformity undergoing ERAS TKA achieved high ERAS success rates (> 90%). Genu varum is not a contraindication for ERAS TKA.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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