Does Postoperative Intravenous Ferric Carboxymaltose Hasten the Recovery of Hemoglobin in Patients Post Total Knee Arthroplasty?

Maniar, Adit; Mishra, Amarnath; Sanghavi, Nishant; N, Maniar Rajesh

doi:10.1016/j.arth.2022.02.046

Cited by 5 publications

(7 citation statements)

References 29 publications

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“…Preoperative IV FCM administration in anemic individuals undergoing revision joint arthroplasty was found to be effective in accelerating recovery from surgery-related anemia by improving Hb levels, despite similar actual Hb levels between the groups. IV FCM could be a safe and effective blood management protocol for improving anemia correction, which is supported by the previously reported efficacy of IV iron supplementation [2,17,19]. Moreover, postoperative iron metabolite levels were also improved in patients administered IV FCM, which was effective in replenishing iron, increasing circulation iron, and enhancing iron availability [21,22].…”

Section: Discussionsupporting

confidence: 54%

“…An association between iron supplementation and lower limb total arthroplasty outcomes has been reported [2,17,19,26]. Amato et al evaluated the effect of IV FCM administered four weeks preoperatively on recovery from postoperative anemia after lower limb total arthroplasty and showed a quicker restoration of Hb concentration four weeks postoperatively in an FCM group [26].…”

Section: Discussionmentioning

confidence: 99%

“…Revision joint arthroplasty is technically difficult and requires better management of blood loss than primary joint arthroplasty [12][13][14][15]. Previous studies have demonstrated the effectiveness of perioperative IV FCM after lower limb total arthroplasty [2,[16][17][18][19]; however, few studies have evaluated its role in revision joint arthroplasty.…”

Section: Introductionmentioning

confidence: 99%

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Preoperative Intravenous Ferric Carboxymaltose Improves Recovery from Anemia in Patients Undergoing Revision Joint Arthroplasty: A Randomized Controlled Trial

Yang,

Park,

Shin

et al. 2023

Preprint

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(1) Background: Ferric carboxymaltose (FCM) is an intravenous (IV) high-dose iron that is effective in the treatment of iron deficiency anemia. This study was to determine if preoperative IV FCM administration could improve recovery from postoperative anemia in patients undergoing revision total joint arthroplasty. (2) Methods: This prospective randomized controlled study analyzed 82 patients undergoing revision total joint arthroplasty during a single hospitalization. Patients in the iron group (n = 41) were administered 1000 mg of IV FCM two weeks preoperatively, while those in the control group (n = 41) were not. Moreover, patients with anemia defined as a preoperative suboptimal Hb concentration &lt;13.0 g/dl were compared according to IV FCM administration. The absolute Hb levels and changes in Hb levels, iron profiles, transfusion rate, and EuroQOL 5-dimension (EQ-5D) scores were compared. (3) Results: There were no significant differences in recovery of Hb levels at each timepoint between the two groups; however, the changes in Hb levels from baseline to four weeks postoperatively showed marginally significant differences favoring the iron group (p = 0.052). However, for preoperatively anemic patients, the change in hemoglobin (Hb) levels between baseline and four weeks postoperatively was significantly better in the iron group than in the control group (iron group [n = 26], −0.3 ± 0.7 g/dL vs. control group [n = 27], −0.9 ± 0.8 g/dL; p = 0.040), although the absolute Hb levels, transfusion rates, and patient quality of life were comparable (all p &gt; 0.05). The iron group showed improved iron metabolite levels including serum ferritin and transferrin saturation four weeks postoperatively, and no adverse events associated with IV FCM administration occurred in either group. (4) Conclusions: Preoperative IV FCM in anemic individuals undergoing revision joint arthroplasty was effective in accelerating recovery from surgery-related anemia by improving Hb levels without any adverse events, despite similar actual Hb levels between the groups. Our findings are clinically relevant and can facilitate determination of the suitability of IV FCM as a safe and reliable protocol for iron supplementation for anemia correction.

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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Preoperative Intravenous Ferric Carboxymaltose Improves Recovery from Anemia in Patients Undergoing Revision Joint Arthroplasty: A Randomized Controlled Trial

Yang,

Park,

Shin

et al. 2023

Preprint

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“…Accordingly, 6 studies were finally included in our meta-analysis. [5,6,[12][13][14][15] The characteristics of the studies included in the research also described in Table 2.…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, 2 studies were assessed the risk of bias based on the using and Cochrane collaboration's handbook. These studies had low-risk of bias for random sequence generation, [14] Retrospective Maniar et al (2022) [13] Retrospective FCM 500mg…”

Section: Quality Assessmentmentioning

confidence: 99%

Effects of intraoperative or postoperative administration of intravenous iron supplements on hemoglobin recovery in patients with total knee arthroplasty: A systematic review and meta-analysis

Kwak,

Kwon,

Bae

et al. 2023

Medicine

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Background: The objectives of the researchers are as follows: First, to investigate whether intraoperative or postoperative administration of Intravenous (IV) iron supplements in patients undergoing primary total knee arthroplasty (TKA) can contribute to the hemoglobin recovery during the postoperative period (between 4 and 8 weeks after surgery). Second, to examine whether the administration of IV iron supplements during or immediately after TKA in patients undergoing primary TKA can reduce the need for allogenic blood transfusion during hospitalization. Methods: Articles published between January 1, 1990, and June 30, 2023 were searched in PubMed, Cochrane, and Embase. The population, intervention, comparison, and outcome of this study are as follows; Population: Patients undergoing primary total knee arthroplasty; Intervention: Administration of IV iron supplements during or immediately after surgery; Comparison: Non-administration of IV iron supplements; Outcome: Degree of hemoglobin recovery (between 4 and 8 weeks after surgery) and the need for blood transfusion during hospitalization. Results: There was a statistically significant difference in the amount of change in hemoglobin between iron supplementation group and non-iron supplementation group. The effect size were −0.44 (95% confidence interval: −0.69 to −0.19, P value < .001) in all patients. This means that the amount of change in hemoglobin were significantly reduced in the iron supplementation group than in the non-iron supplementation group. There was a statistically significant difference for post-operative transfusion rate between 2 groups. The effect size were 0.28 (95% confidence interval: 0.10–0.81, P value = .02) in all patients. This means that the post-operative transfusion rate was significantly less in the iron supplementation group than in the non-iron supplementation group Conclusion: The administration of IV iron supplements during or after TKA surgery increases hemoglobin recovery between 4 and 8 weeks after surgery and reduces the need for allogeneic blood transfusion during hospitalization.

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Associations of preoperative anemia and postoperative hemoglobin values with hospital costs in total knee arthroplasty (TKA)

Schatz¹,

Plötz²,

Beckmann³

et al. 2023

Arch Orthop Trauma Surg

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Background Total knee arthroplasty are among the most frequently conducted surgeries, due to an aging society. Since hospital costs are subsequently rising, adequate preparation of patients and reimbursement becomes more and more important. Recent literature revealed anemia as a risk factor for enhanced length of stay (LOS) and complications. This study analyzed whether preoperative hemoglobin (Hb) and postoperative Hb were associated with total hospital costs and general ward costs. Methods The study comprised 367 patients from a single high-volume hospital in Germany. Hospital costs were calculated with standardized cost accounting methods. Generalized linear models were applied to account for confounders, such as age, comorbidities, body mass index, insurance status, health-related quality of life, implant types, incision-suture-time and tranexamic acid. Results Preoperative anemic women had 426 Euros higher general ward costs (p < 0.01), due to increased LOS. For men, 1 g/dl less Hb loss between the preoperative value and the value before discharge reduced total costs by 292 Euros (p < 0.001) and 161 Euros fewer general ward costs (p < 0.001). Total hospital costs were reduced by 144 Euros with 1 g/dl higher Hb on day 2 postoperatively for women (p < 0.01). Conclusion Preoperative anemia was associated with increased general ward costs for women and Hb loss with decreasing total hospital costs for men and women. Cost containment, especially reduced utilization of the general ward, may be feasible with the correction of anemia for women. Postoperative Hb values may be a factor for adjustments of reimbursement systems. Level of evidence Retrospective cohort study, III.

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Does Postoperative Intravenous Ferric Carboxymaltose Hasten the Recovery of Hemoglobin in Patients Post Total Knee Arthroplasty?

Cited by 5 publications

References 29 publications

Preoperative Intravenous Ferric Carboxymaltose Improves Recovery from Anemia in Patients Undergoing Revision Joint Arthroplasty: A Randomized Controlled Trial

Preoperative Intravenous Ferric Carboxymaltose Improves Recovery from Anemia in Patients Undergoing Revision Joint Arthroplasty: A Randomized Controlled Trial

Effects of intraoperative or postoperative administration of intravenous iron supplements on hemoglobin recovery in patients with total knee arthroplasty: A systematic review and meta-analysis

Associations of preoperative anemia and postoperative hemoglobin values with hospital costs in total knee arthroplasty (TKA)

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