Is There a Role for Preoperative Iron Supplementation in Patients Preparing for a Total Hip or Total Knee Arthroplasty?

Abstract Background Several treatment modalities exist for the treatment of perioperative anemia. We determined the effect of oral iron supplementation on preoperative anemia, and the use of blood-conserving interventions before total hip arthroplasty (THA) and total knee arthroplasty (TKA). Methods A total of 3435 total joint arthroplasties (1461 THAs and 1974 TKAs) were analyzed during 2 phases of a blood conservation program. The first phase used erythropoietin alfa (EPO) or intravenous (IV) iron for patients at risk for perioperative anemia. The second phase included these interventions, as well as preoperative iron supplementation. The effect on preoperative hemoglobin (Hb) and serum ferritin, as well as EPO and IV iron utilization, was determined. Results Oral iron therapy increased preoperative Hb level by 6 g/L ( P < .001) and 7 g/L ( P < .001) in the hip and knee cohorts, respectively. Serum ferritin level rose by 80 μg/L ( P < .001) and 52 μg/L ( P < .001) in the hip and knee cohorts, respectively. The number of patients with an Hb level