Advanced blood management strategies for elective joint arthroplasty

There is a high prevalence of anemia detected in the preoperative work-up of elective surgical patients preparing for total joint replacement. The impact of anemia in this population has significant implications due to elevations in postoperative morbidity and mortality. By using current clinical guidelines and medical evidence, clinicians can improve outcomes for these patients by employing a three-phase approach, focused on preoperative assessment, intraoperative hemostasis, and postoperative blood product management. Strategies to optimize preoperative hemoglobin levels, reduce intraoperative blood losses, and decrease postoperative transfusion rates can independently and collectively improve overall patient care and surgical outcomes following lower extremity total joint arthroplasty.