Joint Center, Cheil Orthopedic Hospital, Gangnam-gu, Seoul, Republic of Korea.
Department of Orthopedic Surgery, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Dongjak-gu, Seoul, Republic of Korea.
J Arthroplasty. 2020 Sep;35(9):2444-2450. doi: 10.1016/j.arth.2020.04.086. Epub 2020 May 4.
We determined whether postoperative intravenous (IV) iron supplementation could reduce transfusion rate in patients undergoing staged bilateral total knee arthroplasty (TKA). Furthermore, we examined whether hemoglobin (Hb) levels and iron profile differed between patients with and without postoperative IV iron supplementation.
This retrospective, comparative cohort study included 126 patients who underwent primary staged bilateral TKA during a single hospitalization. The second TKA was performed at a week's interval. Group iron (n = 65) received IV iron immediately after each surgery, while patients in group no-iron (n = 61) received no iron after surgery. Transfusion rate, change in Hb levels, and iron profile including serum iron, ferritin, total iron binding capacity, and transferrin saturation were evaluated preoperatively; on postoperative days 1, 2, and 4 after the first TKA; and postoperative days 1, 2, 4, and 7, 6 weeks, and 3 months after the second TKA.
There were no significant differences in Hb levels and transfusion rate following staged bilateral TKA between patients with and without postoperative IV iron supplementation although serum iron profiles were improved in patients with IV iron supplementation.
Postoperative IV iron supplementation immediately after acute blood loss caused by TKA was not effective in improving the transfusion rate. Therefore, surgeons should use protocols other than postoperative IV iron supplementation for reducing the transfusion rate in patients undergoing staged bilateral TKA in a single hospitalization.
III.
我们旨在确定分期双侧全膝关节置换术（TKA）后静脉（IV）补铁是否可以降低输血率。此外，我们还研究了接受和未接受术后 IV 补铁的患者之间的血红蛋白（Hb）水平和铁状态是否存在差异。
本回顾性、比较队列研究纳入了 126 例在单次住院期间接受分期双侧初次 TKA 的患者。第二期 TKA 在一周的间隔内进行。补铁组（n=65）在每次手术后立即接受 IV 补铁，而不补铁组（n=61）在手术后不接受铁剂。评估了术前、第一次 TKA 后第 1、2 和 4 天以及第二次 TKA 后第 1、2、4、7、6 周和 3 个月的输血率、Hb 水平变化以及包括血清铁、铁蛋白、总铁结合能力和转铁蛋白饱和度在内的铁状态。
尽管接受 IV 补铁的患者血清铁状态得到改善，但分期双侧 TKA 后 Hb 水平和输血率在接受和未接受术后 IV 补铁的患者之间无显著差异。
TKA 急性失血后立即进行术后 IV 补铁对于改善输血率没有效果。因此，对于在单次住院期间接受分期双侧 TKA 的患者，外科医生应使用除术后 IV 补铁以外的方案来降低输血率。
III。
