**9. Enhanced recovery after surgery (ERAS)**

ERAS is one of the leading examples of pathway-based perioperative care (**Figure 6**). It provides a structured mechanism to improve the quality of care, reduce variation in surgical care, minimize complications, and improve outcomes of surgeries [28]. ERAS also controls perioperative physiology to optimize the patient by minimizing the stress response to surgery and anesthesia [29, 30]. The key elements of ERAS protocol include patient education, expectation setting, aggressive optimization of comorbidities, standardized anesthetic and surgical techniques, early mobilization, early oral nutrition, early discharge, and effective pain management using MMA. ERAS decreases postoperative complications and costs, shortens hospital stay, and enhances patient satisfaction [31]. Rapid recovery in knee surgeries is possible because of less invasive surgical procedures, more selective soft tissue balancing, improved patient education, meticulous instrumentation, selecting suitable implant design, and improved analgesia options.

#### **Figure 6.**

*Enhanced recovery after surgery protocol. (DVT: Deep venous thrombosis, PONV: Postoperative nausea and vomiting, NG: Nasogastric).*
