Effects Of Erythropoietin And Iron In Total Hip Arthroplasty Of Steroid-induced Osteonecrosis Of Femoral Head

ObjectiveTo assess the effects of erythropoietin(EPO)combined with iron on anemia,blood transfusion rate and hip function in patients with steroid-induced femoral head necrosis(SONFH)after total hip arthroplasty(THA).MethodsThe present clinical study was designed as a randomized controlled clinical trial.A total of 100 patients with SONFH who met the inclusion and exclusion criteria in Linyi People’s Hospital from September 2018 to September 2020 were randomly divided into observation group and control group with the ratio of 1:1.Both groups were routinely treated with tranexamic acid(TXA)during the operation,while the observation group was treated with EPO and iron during the perioperative period.Patients in both groups were undertaken with the accelerated rehabilitation surgery(ERAS)during the perioperative period.General data of the patients were collected as follows: gender,age,body mass index(BMI),operative time,intraoperative blood loss,ARCO stage,ASA grade,preoperative Hb,Hct,Harris score,the perioperative hemoglobin(Hb),hematocrit(Hct),Harris score and blood transfusion rate.These data was compared between the two groups.ResultsNo statistical significance was observed in the baseline between the two groups(P＞0.05).One day after surgery,there was no significant difference in Hb between the observation group and the control group(P＞0.05).At 3 days after operation,the Hb of the observation group(97.36±9.00)g/L was higher than that of the control group(92.92±9.94)g/L,and the difference was statistically significant(P(27)0.05).At 7 days after operation,Hb in the observation group(106.62±8.17)g/L was higher than that in the control group(99.52±9.98)g/L,and the difference was statistically significant(P(27)0.05).One day after surgery,there was no significant difference in Hct between the observation group and the control group(P(27)0.05).Three days after operation,the Hct of the observation group was(32.11±4.74)% higher than that of the control group(29.43±4.38)%,and the difference was statistically significant(P(27)0.05).At 7 days after operation,the Hct of the observation group was(33.61±4.41)% higher than that of the control group(31.47±4.38)%,and the difference was statistically significant(P(27)0.05).Harris score in the observation group(73.06±8.16)was higher than that in the control group(68.1±8.62)2 weeks after surgery,and the difference was statistically significant(P(27)0.05).There was no statistically significant difference in Harris score between the two groups 12 weeks after surgery(P＞0.05).The blood transfusion rate in the observation group(2.00%)was lower than that in the control group(16.67%),and the difference was statistically significant(P(27)0.05).There was no significant difference in postoperative complications between the two groups(P＞0.05).ConclusionFor SONFH patients undergoing THA for the first time,perioperative application of EPO and iron can promote postoperative Hb and Hct recovery,reduce postoperative blood transfusion rate,and improve early postoperative hip function,which is conducive to the early recovery with safety.