Use of erythropoietin in two-stage reimplantation total hip arthroplasty

This study was done to quantify the effect of epoetin alfa on the transfusion requirements of patients having two-stage reimplantation for infected total hip arthroplasties. This prospective study included 30 consecutive patients treated with a two-stage reimplantation procedure during a 2-year period at one institution. Each patient received a standard dose of epoetin alpha (40,000 units) subcutaneous in the interval between resection and reimplantation. Transfusions were administered only when warranted by clinical symptoms and were not governed by predetermined hemoglobin levels. When compared with a control group of similar patients, the hemoglobin levels before reimplantation were significantly higher (14.0 g/dL versus 11.8 g/dL) and the median allogeneic blood requirements were significantly lower (0 units/patient [range, 0-6] versus 4.3 units per patient [range, 0-9]). Epoetin alfa used in the interval between the resection and reimplantation stage significantly increased the hemoglobin levels and decreased the rate of transfusion for patients having two-stage reimplantation total hip arthroplasty.