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Open Orthop J. 2013;7:47-50. doi: 10.2174/1874325001307010047. Epub 2013 Feb 22.

Should We Use Preoperative Epoetin-α in the Mildly Anemic Patient Undergoing Simultaneous Total Knee Arthroplasty?

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1
Department of Orthopedics, Kingsbrook Jewish Medical Center, Brooklyn, NY 11203, USA.

Abstract

Simultaneous knee arthroplasty is associated with significant blood loss. To prevent transfusion, three preoperative doses of epoetin-α were offered to mildly anemic simultaneous knee arthroplasty patients. A retrospective review, using ICD-9 codes, identified twenty patients from 2007-2009. Epoetin-α increased hemoglobin levels preoperatively (12.6 to 13.9, p<0.01). Twenty patients who did not receive epoetin-α were matched to study patients. Study patients were transfused less (55% vs 95%, p=0.012) and had similar inpatient length of stay. The average blood loss without transfusion was 4.6g/dL. The mildly anemic patient is at high-risk for packed red cell transfusion during simultaneous knee arthroplasty. Three preoperative doses of epoetin-α in the mildly anemic patient decreased total transfusions; however, it did not affect inpatient length of stay.

KEYWORDS:

Single stage bilateral total knee arthroplasty; anemia.; degenerative joint disease; epoetin-α; pain; simultaneous total knee arthroplasty; tranexamic acid

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