countries standard practice is discharge to home instead. The optimal technique of rehabilitation needs evaluation, since present data even with immediate strength training have been disappointing and where all data have documented a reduction of muscle function for several weeks postoperatively. Although patient-reported outcomes are fashionable and important, further studies to compare these with objectively measured function and activity are required, since initial data are disappointing and showing a gap between the positive patient-reported outcomes vs the rather disappointing objective recovery data. Finally, a very large number of publications on ERAS cohorts often has an insufficient interpretation compared with global literature, and a lack of balanced discussion on international experiences and consequences in different health care systems. In summary, despite an obvious success of ERAS in THA and THA to reduce LOS and morbidity, several challenges lie ahead to improve postdischarge recovery. n References Aasvang EK, Luna IE, Kehlet H. Challenges in postdischarge function and recovery: the case of fasttrack hip and knee arthroplasty. Br J Anaesth 2015; 115:861-866.Cyriac J, Garson L, Schwarzkopf R, Ahn K, Rinehart J, Vakharia S, Cannesson M, Kain Z. Total joint replacement perioperative surgical home program: 2-year follow-up. Anesth Analg 2016; 123:51-62. Artz N, Elvers KT, Lowe CM, Sackley C, Jepson P, Beswick AD. Effectiveness of physiotherapy exercise following total knee replacement: systematic review and meta-analysis. BMC Musculoskelet Disord 2015; 16:15. Cyriac J, Garson L, Schwarzkopf R, Ahn K, Rinehart J, Vakharia S, Cannesson M, Kain Z. Total joint replacement perioperative surgical home program: 2-year follow-up. Anesth Analg 2016; 123:5162. Fragiadakis GK, Gaudilliere B, Ganio EA, Aghaeepour N, Tingle M, Nolan GP, Angst MS. Patient-specific immune states before surgery are strong correlates of surgical recovery. Anesthesiology 2015; 123:12411255. Hossain FS, Konan S, Patel S, Rodriguez-Merchan EC, Haddad FS. The assessment of outcome after total knee arthroplasty: are we there yet? Bone Joint J 2015; 97-B:3-9. Jans O, Kehlet H. Postoperative orthostatic intolerance: a common perioperative problem with few available solutions. Can J Anaesth 2016 (Epub). Jorgensen CC, Petersen MA, Kehlet H. Preoperative prediction of potentially preventable morbidity after fast-track hip and knee arthroplasty: a detailed descriptive cohort study. BMJ Open 2016; 6:e009813. Kehlet H, Jorgensen CC. Rapid Recovery After Hip and Knee Arthroplasty--A Transatlantic Gap? J Arthroplasty 2015; 30:2380. Kehlet H, Jorgensen CC. Advancing surgical outcomes research and quality improvement within an enhanced recovery program framework. Ann Surg 2016; 264:237-238. Kjellberg J, Kehlet H. A nationwide analysis of socioeconomic outcomes after hip and knee replacement. Dan Med J 2016; 63:A5257.Pitter FT, Jorgensen CC, Lindberg-Larsen M, Kehlet H. Postoperative morbidity and discharge destinations after fast-track hip and knee arthroplasty in patients older than 85 years. Anesth Analg 2016; 122:18071815. Pitter FT, Jorgensen CC, Lindberg-Larsen M, Kehlet H. Postoperative morbidity and discharge destinations after fast-track hip and knee arthroplasty in patients older than 85 years. Anesth Analg 2016; 122:18071815. Thienpont E, Lavand’homme P, Kehlet H. The constraints on day-case total knee arthroplasty: the fastest fast track. Bone Joint J 2015; 97-B:40-44. FASTER RECOVERY, FEWER COMPLICATIONS, PROMOTING CHANGE Comitted to Improving Patient Care ASER Member Benefits Become an ASER member today! For further information and to apply one line visit aserhq.org/membership ASER ALERT • VOLUME 1, ISSUE 1 • aserhq.org • Implementation Consultation and Guidance • Practice Guidelines and Ongoing Research • Hospital and Patient Educational Materials • Networking • Professional Development and Education • Research Grant Opportunities • Membership Discount to Attend Annual Congress 5
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