Evidence mapPaperPMID 42001126Full record

ArticleJournal of orthopaedic surgery and research2026

Low-dose erythropoietin in anemic arthroplasty patients within contemporary patient blood management pathways.

Hervé Hourlier, Guillaume Fricault, Peter Fennema

Abstract read
In one paragraph

Article in Journal of orthopaedic surgery and research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Hervé HourlierDepartment of Orthopaedic Surgery, Polyclinique de la Thiérache, Wignehies, France.
Guillaume FricaultDepartment of Orthopaedic Surgery, CHU de La Réunion, Saint-Pierre Site, Avenue François Mitterrand, 97448, Saint-Pierre, La Réunion, France.
Peter FennemaAMR Advanced Medical Research, Hofenstrasse 89b, 8708, Männedorf, Switzerland. peter.fennema@amr-cro.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPreoperative anemia remains a major determinant of transfusion risk in total joint arthroplasty (TJA), even within contemporary patient blood management (PBM) pathways. Although erythropoietin (EPO) increases preoperative hemoglobin (Hb) levels, its role in modern low-transfusion arthroplasty practice remains debated. This study evaluated the real-world effectiveness of a selective, low-dose preoperative EPO protocol in anemic patients undergoing TJA within a comprehensive PBM program.

methodsWe retrospectively analyzed 2462 primary TJA procedures performed between 2013 and 2024 and identified 188 patients with baseline Hb < 12 g/dL. Of these, 80 received low-dose EPO and 108 served as controls. The EPO regimen consisted of two weekly subcutaneous injections of 20,000 IU administered preoperatively, combined with oral iron supplementation. All patients were managed under a standardized PBM protocol. The primary outcome was the bleeding index at postoperative day 7 (BI-7), defined as the sum of Hb decline between admission and postoperative day 7 and the number of transfused red-blood-cell units.

resultsPatients receiving EPO had lower baseline Hb levels than controls (10.9 vs. 11.5 g/dL). EPO treatment increased preoperative Hb by a mean of 1.3 g/dL and resulted in higher Hb levels at hospital admission, postoperative day 1, and postoperative day 7. No blood transfusions were administered during the observation period. BI-7 values were low and comparable between groups (2.1 vs. 2.3; p = 0.30). No thromboembolic events were observed.

conclusionsWithin a contemporary PBM framework, selective low-dose preoperative EPO safely optimized perioperative Hb levels and was associated with a transfusion-free perioperative course despite higher baseline hematologic risk. These findings suggest that modern low-transfusion PBM strategies can be effectively extended to selected anemic arthroplasty patients by improving preoperative Hb reserve.

Indexed as

AnemiaArthroplasty, ReplacementBlood TransfusionErythropoietinPreoperative CareAgedArthroplasty, Replacement, HipBlood Loss, SurgicalFemaleHemoglobinsHumansMaleMiddle AgedRetrospective StudiesErythropoietinHemoglobinsBleeding indexErythropoietinHemoglobin optimizationPatient blood managementPreoperative anemiaTotal joint arthroplastyTransfusion avoidance

Identifiers

PMID42001126
PMCPMC13274152

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.