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Preoperative Intravenous Ferric Carboxymaltose versus Oral Ferrous Sulfate in Total Knee Arthroplasty: Effects on
Hyeon-Joon Lee1, Doo-Ho Lim2, Chae-Chil Lee1
1Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, 25 Daehakbyeongwon-Ro, Dong-Gu, Ulsan, 44033 Republic of Korea.
Background:
This retrospective case-control study aimed to determine the effectiveness of preoperative intravenous ferric carboxymaltose (FCM) administration compared to oral ferrous sulfate (FS) supplementation in patients undergoing primary unilateral total knee arthroplasty (TKA).
Methods:
This retrospective comparative cohort study included a total of 183 patients with 87 in the FCM group receiving 1000 mg FCM 2 weeks before TKA and 96 in the FS group receiving 1024 mg FS daily for 4 weeks preoperatively. Hemoglobin (Hb) levels were measured at baseline and postoperatively. The primary endpoint was the change in Hb levels relative to baseline. The secondary outcomes were the transfusion rate and volume. Subgroup analysis was performed for patients without preoperative anemia.
Results:
At all postoperative time points, the Hb levels were significantly higher in the FCM group than in the FS group. The FCM group demonstrated a significantly lower transfusion rate (1.1 vs. 9.4%, P = 0.01) and mean transfusion volume (3.7 vs. 34.5 cc, P = 0.01). Among the patients without preoperative anemia, the FCM-A group had significantly higher Hb levels and lower Hb changes postoperatively than the FS-A group.
Conclusion:
Preoperative intravenous FCM can help restore postoperative Hb levels and reduce transfusion requirements in patients undergoing primary unilateral TKA, even in those without preoperative anemia.
