Clinical Effectiveness of Perioperative EPO combine with Iron sucrose Treatment in Total Knee Arthroplasty Surgery：Not blinded， prospective randomized clinical trial of efficacy and safety

Abstract Trial design: The purpose of this study was prospectively analyzing the effect of EPO combined with Iron sucrose on postoperative anemia prevention and prognosis of patients with TKA. Methods Participants in this study will be randomly assigned to treatment group or control group. Patients in the treatment group will perioperatively receive EPO for 10 days combined with iron sucrose injection for 3 days preoperative. The general data, hematological indexes, transfusion rate, total blood loss and knee joint function score will be analyzed. Results 92 patients met the inclusion criteria, including 46 patients in the treatment group and 46 patients in the control group. There were no significant statistical differences in descriptive characteristics of the population between two groups. The results indicated that the anemic rate of the treatment group was significantly lower than control group after treatment (67.4%vs93.5%, P = 0.001). The hematological index also has significantly difference in two group. Such as Postoperative Hb, RBC count, Hct. The treatment group perioperative blood loss was significantly lower than control group (587.69 ± 340.81ml vs. 812.72 ± 329.7ml, P = 0.002). The treatment group shows better in HSS score and WOMAC score (HSS score: P = 0.007; WOMAC score: P = 0.001), HSS score improved 3.37 points and WOMAC score improved 12.08 points after operation than control group. No postoperative blood transfusion and postoperative complications occurred in the study period. Conclusions According to our study, we found that perioperative treatment of erythrocyte mobilization in patients with TKA can improve postoperative hemoglobin level, reduce postoperative total blood loss, and reduce postoperative anemic rate without increased drug cost on the hospitalization expenses. Patients received erythrocyte mobilization treatment can significantly accelerate the erythropoiesis after surgery, promote the hemoglobin level return to normal more quickly. The patiens after treatment shows advantage at HSS score and WOMAC score.