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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Oct 18, 2025; 16(10): 109196
Published online Oct 18, 2025. doi: 10.5312/wjo.v16.i10.109196
Published online Oct 18, 2025. doi: 10.5312/wjo.v16.i10.109196
High efficiency pathway for lower limb orthopedic surgery: A matched historic cohort study
Cheng Lin, Gopakumar S Nair, Kamal Kumar, Department of Anesthesia and Perioperative Medicine, Schulich School of Medicine, Western University, London N6A 5W9, Ontario, Canada
Tripti Nagdev, Department of Anesthesia, McMaster University, Hamilton L8R2K3, Ontario, Canada
Dan Annie Zhu, Department of Anesthesia, Western University, London N6A 5W9, Ontario, Canada
Sonny Cheng, Department of Anesthesia and Perioperative Medicine, Schulich School of Medicine & Dentistry, LHSC/Western University, London N6A 5W9, Ontario, Canada
Co-first authors: Cheng Lin and Kamal Kumar.
Author contributions: Lin C contributed to the conception and design of the study, data analysis and manuscript writing; Nagdev T and Zhu DA assisted in data collection and manuscript reviewing; Cheng S, Nair GS, Kumar K reviewed and revised the final manuscript. Lin C and Kumar K contributed equally to this work as co-first authors.
Institutional review board statement: The study was approved by Health Sciences Research Ethics Board at Western University (ID 113648).
Informed consent statement: Health Sciences Research Ethics Board at Western University (ID 113648) waived the requirement for informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cheng Lin, Associate Professor, FRCPC, Department of Anesthesia and Perioperative Medicine, Schulich School of Medicine, Western University, 800 Commissioners Road East, London N6A 5W9, Ontario, Canada. cheng.lin@lhsc.on.ca
Received: May 8, 2025
Revised: June 12, 2025
Accepted: September 19, 2025
Published online: October 18, 2025
Processing time: 161 Days and 16 Hours
Revised: June 12, 2025
Accepted: September 19, 2025
Published online: October 18, 2025
Processing time: 161 Days and 16 Hours
Core Tip
Core Tip: This study shows that adopting a high-efficiency approach for lower limb orthopedic surgery, by selecting appropriate patients, using standardized instruments, applying regional anesthesia, and bypassing phase one recovery, significantly shortens postoperative recovery time, reduces operating room duration, and decreases total hospital stay. This model provides a practical and scalable way to enhance perioperative care and tackle surgical backlogs in the face of on