Transfusion Incidence and Functional Outcome Post Bilateral Total Knee Arthroplasty:
Can Preoperative Intravenous Iron Supplementation Make a Difference?
Janam Yatin Merchant1* and Jinal Subhash Tanna2
1Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India
2Clinical Associate, P. D. Hinduja Hospital and Medical Research Centre, Marvela,
Mumbai, Maharashtra, India
*Corresponding Author: Janam Yatin Merchant, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India.
August 01, 2023; Published: September 14, 2023
Introduction: This prospective study examines the correlation between intravenous iron supplementation's effects on transfusion rates, Hb and PCV levels in the early postoperative period, and treatment outcomes. Additionally, we provide functional post operative outcome by TUG test, knee ROM test, and New KSS score.
Methods: The 19 patients in group B served as the study group, while the 15 patients in group A served as the control group for the study. On the first postoperative day, patients in the control group (group A) received intravenous iron. Patients in Group B were split into B1 (4 weeks), B2 (3 weeks), and B3 (2 weeks). On the day of surgery, on postoperative days 1, 3, and 14, as well as six weeks later, HB and PCV levels were measured. Day 4 and 14 TUG score and Knee ROM measured. After 90 days, a new KSS score was recorded.
Results: HB and PCV levels were shown to be greatly improved by IV iron supplementation four weeks prior to surgery, with reduced day 1 reductions. Two weeks before surgery, IV iron supplementation demonstrated a substantial increase in their haematocrit level and a decrease in day 1 decline. On days 4 and 14, Group A's TUG test and ROM were higher, although this difference was not statistically significant. Compared to no transfusion, Group B1 had a greater success rate, although this difference was not statistically significant.
Although it was less than in group A, the percentage of transfused patients in groups B1, B2, and B3 was not statistically significant. Furthermore, while this was not statistically significant, earlier preoperative intravenous iron supplementation was associated with a better success rate. Studies using a larger sample size and iron supplements at high doses may highlight the difference.
Keywords: Total Knee Arthroplasty; IV Iron Supplementation; Transfusion Incidence; Functional Outcome; Ferric Carboxy Maltose; Haemoglobin; Preoperative; PCV
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