ABSTRACT
BACKGROUND: Minimally invasive total hip arthroplasty is less invasive and has less tissue injury than traditional approach. However, perioperative anemia is still common, affecting hip function recovery and increasing patient burden. OBJECTIVE: To assess the curative effects of recombinant human erythropoietin on hemorrhagic anemia after minimally invasive total hip arthroplasty. METHODS: Clinical data of 35 patients undergoing SuperPATH minimally invasive total hip arthroplasty in the Department of Orthopedic Surgery, the Affiliated Hospital/Clinical Medical College of Chengdu University were collected. The patients were divided into the control group (n=17) and the erythropoietin group (n=18) according to the presence and absence of erythropoietin. The patients in the erythropoietin group were subcutaneously injected with recombinant human erythropoietin 3 days before replacement, once a day, lasting to 8 days after operation, for 12 consecutive days. During erythropoietin administration, iron sucrose was added once a day. Tranexamic acid 1 g was intravenously infused 0.5 hour before replacement, and 1 g for washing medullary cavity during replacement. The patients in the control group only took iron sucrose, once a day, adding tranexamic acid through intravenous infusion 0.5 hour before replacement. Levels of hemoglobin and hematocrit were monitored on the day of admission, the preoperative 3 days, the operation day, the postoperative 4 days and the postoperative 8 days. The operation time, blood loss, Visual Analogue Scale pain score 4 days before and after replacement and Harris hip function score before replacement, 4 and 8 days after replacement were recorded. RESULTS AND CONCLUSION: (1) Baseline data were not significantly different between the two groups (P > 0.05). (2) Visual Analogue Scale pain score significantly decreased 4 days after replacement in both groups (P < 0.05), and was not significantly different between both groups at various time points (P > 0.05). Harris hip score was not significantly different before and 1 day after replacement between the two groups (P > 0.05). At 4 days after replacement, Harris hip score was significantly higher in the erythropoietin group than in the control group (P< 0.05). Mean blood loss and operation time were not significantly different between the two groups (P > 0.05). (3) Levels of hemoglobin and hematocrit were not significantly different on the day of admission and 1 day before replacement (P > 0.05). Levels of hemoglobin and hematocrit were higher in the erythropoietin group than in the control group during emergency examination, 4 and 8 days after replacement (P< 0.05). The changes in levels of hemoglobin and hematocrit were consistent in different groups. The decreased trend was smooth, but the increased trend was relatively steep in the erythropoietin group. (4) Results confirmed that recombinant human erythropoietin combined with iron sucrose combined adding tranexamic acid, can effectively improve the anemia in perioperative period of minimally invasive total hip arthroplasty. Moreover, hemoglobin levels can increase to the stable and normal levels.