Preoperative use of epoietin beta in total hip replacement: a prospective study.
OBJECTIVE
Epoietin (EPO) effectively decreases perioperative blood transfusion requirements. We evaluated the feasibility of using EPO beta to increase haemoglobin levels before total hip replacement (THR) and reduce transfusion.


METHODS
One hundred and seventy-one patients undergoing primary THR were included in this prospective observational study. Patients with initial haemoglobin level <130 g l−1 received EPO beta subcutaneously in a four-dose regimen. Haemoglobin levels were measured at baseline, before surgery, and at postoperative days 1 and 5.


RESULTS
Twenty-eight patients received EPO beta preoperatively, 143 were not treated including 42 with initial haemoglobin level <130 g l−1. Haemoglobin increased by 29 ± 9 g l−1 in the low Hb + EPO group versus 2 ± 1 g l−1 for the other patients. In the low Hb + EPO group 3.6% were transfused, in the low HB group 45.2% (P = 0.001) and in the normal Hb group 11.9% (P = 0.2).


CONCLUSIONS
Preoperative EPO beta increases haemoglobin level and reduces transfusion frequency in anaemic patients before total joint replacement. It could play a major role in the management of perioperative blood loss in orthopaedic surgery.
Laffosse
Jean-Michel
JM
Service de Chirurgie Orthopédique et Traumatologique, CHU de Rangueil, TSA 50032, 1, avenue Jean Poulhès, 31059 Toulouse Cedex 9, France. jean-michel.laVosse@wanadoo.fr
Minville
Vincent
V
Chiron
Philippe
P
Colombani
Aline
A
Gris
Claude
C
Pourrut
Jean-Claude
JC
Eychenne
Bernard
B
Fourcade
Olivier
O