Perioperative Patient Blood Management in Primary Knee and Hip Arthroplasty-Nonsense or Necessity?

Background/Objectives: The perioperative management of a patient's blood values involves the optimization of anemia management in the pre-, intra-, and postoperative periods to avoid blood transfusions. The purpose of this study was to determine the prevalence of pre- and postoperative anemia in patients undergoing elective knee and hip arthroplasty, and explore the change in hemoglobin levels in transfused and non-transfused patients over the course of their hospital stay. Methods: In this retrospective study, data on anemia-influencing factors were collected and examined using multiple regression analysis (OLS model) to determine if they are associated with the average hemoglobin change in 801 patients who underwent a primary knee or hip arthroplasty. The study group was screened for the prevalence of preoperative anemia, and the incidence of postoperative anemia was examined. Results: A total of 801 patients were retrospectively investigated. The length of stay for the two different procedures was significantly different (p < 0.001). There was a markedly higher transfusion rate in the cases requiring longer-than-usual hospital stays. In total, 37 patients (5%) received perioperative erythrocyte transfusions. Total hip replacement (THR) was associated with significantly more erythrocyte transfusions (8%) in comparison with total knee replacement (TKR) (2%) (p < 0.001). Conclusions: Satisfactory results for the prevalence and incidence of anemia in the context of primary knee or hip arthroplasties were obtained in this study. The collected values indicate the need for better implementation and awareness of the importance of adequate patient blood management.