Prevalence of iron deficiency in a total joint surgery population

Iron deficiency without anemia has been associated with decreases in functional work capacity and fatigue. The aim of this study was to determine the prevalence of iron deficiency without anemia in a preoperative cohort of orthopedic patients and to determine if iron deficiency is a condition which warrants inclusion into a prehabilitation program prior to surgery.

One hundred consecutive patients going through preoperative testing for total joint replacement were enrolled in the study. In addition to the standard preoperative complete blood count, a ferritin concentration was also measured before the patients had their surgeries performed. Iron deficiency was defined as a ferritin concentration <50. Patients were then followed for 30 days following their surgical procedure to determine if any complications ensued, or if red blood cell transfusions were required.

The average age of the patients in this study was 65.2 ± 11.8 years and there were 41/100 males. Overall, 16 patients had anemia of which 6 patients also had low ferritin levels. Twenty-two other patients had ferritin levels consistent with iron deficiency but were not anemic. There was no association between iron deficiency and length of stay, complications, and transfusion.

No association was found between simple iron deficiency and any perioperative complications. Only a ferritin level was assessed so other measures of iron deficiency may have revealed a higher prevalence of iron deficiency. A study with a larger sample size is warranted in order to further understand iron deficiency in a preoperative setting.