Back

A Novel Way to Reduce Blood Transfusions before Total Joint Surgery

Did you know you can donate your own blood beforehand for use during a hip or knee replacement? This is called predonation. Since blood loss is a problem with replacement operations, blood transfusion is often needed. There are some problems with predonations. Scheduling conflicts is a big one. So is a limited shelf life for the blood. And if you're almost anemic and you give blood, you could end up with a full-blown case of anemia.

There's a new way to help cut your losses all the way around. It's called
erythropoietin (EPO). EPO is a hormone produced by the kidney and released into the bloodstream. Its sole function is to increase red blood cells. EPO is already being used to treat kidney patients. It's been tested and used with some kinds of anemia and during chemotherapy for cancer. Now it's being tried for joint replacements.

In this study, patients getting a knee or hip replacement were divided into three groups. The first group received EPO and predonated blood. The blood was taken from the patient and given back before the operation. Group two had only EPO before the surgery. Group three predonated blood but didn't receive any EPO.

The authors found the best results in group one. Getting both EPO and blood before the operation resulted in far fewer blood transfusions during the operation. The EPO actually increased the amount of available predonated blood. Together these two steps reduced the risk of anemia later.

The rate of transfusion increased quite a bit in patients who had both hips or both knees replaced at the same time. All three groups reported similar increases. The same was true for revision surgery (when the first joint replacement has to be done over).

This study shows a novel way to reduce blood transfusions for total hip and total knee joint patients. The patient gets his or her own blood before the operation while also taking EPO.

References: Hari P. Bezwada, MD, et al. Preoperative use of Recombinant Human Erythropoietin before Total Joint Arthroplasty. In The Journal of Bone and Joint Surgery. September 2003. Vol. 85-A. No. 9. Pp. 1795-1800.

Back