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: This study prospectively analyzes 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 a treatment group or control group. Patients in the treatment group will receive EPO for ten days combined with iron sucrose injection for three 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 in the control group. There were no significant statistical differences in descriptive characteristics of the population between the two groups. The results indicated that the anemic rate of the treatment group was significantly lower than the control group after treatment (67.4%vs93.5%, P=0.001). The hematological index also has a significant difference in the two groups, such as Postoperative Hb, RBC count, Hct. The treatment group, perioperative blood loss, was significantly lower than the control group (587.69±340.81ml vs. 812.72±329.7ml, P=0.002). The treatment group showed a better HSS score and WOMAC score (HSS score: P=0.007; WOMAC score: P=0.001), HSS score improved 3.37 points, and WOMAC scores improved 12.08 points after the operation than the 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 costs on the hospitalization expenses. Patients who receive erythrocyte mobilization treatment can significantly accelerate erythropoiesis after surgery and promote the hemoglobin level to normal more quickly. The patients after treatment show an advantage in HSS score and WOMAC score.