Journal of Rehabilitation Medicine 51-10 | Page 72

792
K. Sisak et al.
preoperative class may provide additional benefits to
high-risk patients undergoing hip or knee replacement
surgery (41).
Retrospective analyses are limited by threats to
both internal and external validity (42). As the current
study utilized existing clinical data, data collection was
secondary and therefore lacks reliability. In addition,
the current study is limited by the fact that both pa-
tient groups received a procedure-specific information
booklet containing information that is also covered in
the education class. This may have produced a smaller
effect size than if the comparison group received no
preoperative education at all. Likewise, the standardi-
zed discharge arrangements used in the ERAS pathway
(23) may have limited between-group variations.
In conclusion, this study highlights that the inclusion
of a preoperative education session in an ERAS path­
way may be most beneficial for patients undergoing
knee replacement, and who are identified as being at
high risk of an extended length of stay. Future work
should focus on identifying high-risk patients and
subsequently personalizing their education class to
meet their biopsychosocial needs.
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