What is the

program?

OrthoADVANCE

OrthoADVANCE™ is a structured program designed to optimise the care of patients undergoing hip and knee replacement. It combines evidence-based prehabilitation, perioperative protocols, and postoperative rehabilitation to deliver safe, consistent, and patient-focused care through your arthritis journey.

GET READY, GET STRONG, RECOVER WELL

What is ERAS

“ERAS® is a multimodal perioperative care pathway designed to achieve early recovery for patients undergoing major surgery.

ERAS® represents a paradigm shift in perioperative care in two ways. First, it re-examines traditional practices, replacing them with evidence-based best practices when necessary. Second, it is comprehensive in its scope, covering all areas of the patient’s journey through the surgical process.”

Reference: https://erassociety.org/ - 30/9/2025

Why is it important?

Hip and knee osteoarthritis is one of the leading causes of disability worldwide. Joint replacement is highly effective, but outcomes can vary depending on preoperative optimisation and perioperative care.

Enhanced Recovery After Surgery (ERAS®) principles have optimised arthroplasty care, emphasising early mobilisation and aiming to improve patient satisfaction and outcome measures.

By integrating these evidence-based principles with locally tailored programs throughout the entire patient journey, OrthoADVANCE™ aims to proactively address modifiable risk factors, establish clear expectations, optimise physiotherapy pathways, and support patients' recovery using local providers in your region.

OrthoADVANCE™ Philosophy

GET READY, GET STRONG, RECOVER WELL

The OrthoADVANCE™ motto reflects the three stages of care:

Get Ready: Preoperative optimisation through exercise, nutrition, and education.

Get Strong: Intra-hospital care with modern anaesthesia, surgical precision with advanced technology, and immediate mobilisation after surgery.

Recover Well: Structured, evidence-based rehabilitation for return to independence.

START Protocol ...

Safe (Physiotherapy) Therapy And Rapid ambulation after Theatre

The START Protocol is part of the OrthoADVANCE™ program, focused on early, safe and supervised mobilisation immediately after joint replacement surgery. Patients are guided to sit, stand and walk under supervision to recovery.

OrthoADVANCE™

guiding principles

Awareness of surgical

process and medical

preparation

Diet and nutrition optimisation
(e.g. protein, vitamin D, weight, blood sugars)

Value-based care approach
(tailored, patient-centred planning)

Activity planning (prehabilitation exercises, mobility goals, smoking cessation)

Navigation of the surgical journey (education, expectations)

Communication with care team (GP, surgeon, allied health provider)

Engagement of patient and medical professionals in shared decision-making

Intra-Operative

Pre-Operative

Post-Operative

Prehab

Anaesthesia preparation

Anaemia screening

Diet / nutrition optimisation

Education & awareness

Multi-modal opiod sparing analgesia

Surgical techniques to minimise trauma

Strategies to prevent blood loss

Manage nausea & vomiting

Antimicrobial prophylaxis

Normothermia maintenance

Early return to normal activities & diet

Early mobilisation

Aim to discharge to home in 1-2 days

Formal rehab program

Optimising your health – OrthoADVANCE™

Risk Factors

BMI: > 40
Smoking
Diabetes: HBA1C > 7.5
Anaemia:

< 130g/dL Male, <1206g/dL Female

Other Comorbidities

GP Assessment

Optimisation

Weight loss
Diabetes control
Anaemia correction
Smoking cessation
Optimising other conditions

Treatment & Recovery

Optimising your health is a key component of the OrthoAdvance™ “Prehab” program and involves support from your GP.

Reference: Queensland Health. Infection prevention in elective total hip and knee arthroplasty surgery: guideline [Internet]. Brisbane: Queensland Health; 2025 Mar 20
[cited 2025 Sep 12]. Report No.: QH-GDL-478. Available from: https://www.health.qld.gov.au

Ready to get started with the

OrthoADVANCE™ program?

Dr. Aidan Cleary is an Australian-trained orthopaedic surgeon based in Hervey Bay, Queensland, with a special interest in hip and knee conditions.

Dr. Cleary is the founder of Fraser Coast Orthopaedics and has completed a fellowship in hip and knee joint replacement surgery, with a special interest in robotic-assisted, minimally invasive, muscle-sparing procedures.

Passionate about improving patient outcomes, Dr. Cleary integrates evidence-based protocols into his practice. He developed the OrthoADVANCE™ program to optimise patient outcomes by combining prehabilitation, chronic disease management, nutritional screening, multidisciplinary collaboration, and evidence-based intra-operative techniques – intending to help patients achieve recoveries tailored to their individual needs.

To learn more about Dr. Cleary and the OrthoADVANCE™ program, please visit Fraser Coast Orthopaedics or speak with your GP or healthcare provider.