Intravenous FCM administration reduces the need for transfusions in TKA patients: study

Dr Supreeth  D R

Intravenous FCM administration reduces the need for transfusions in TKA patients: study

Written By : Dr Supreeth D R Published On 2026-09-14T21:00:47+05:30 | Updated On 14 Sept 2026 9:01 PM IST

Approximately 80% of patients who do not have anemia before surgery may develop anemia after elective knee and hip surgery. Effective perioperative iron supplementation can reduce the incidence of postoperative anemia and allogeneic blood transfusion, thereby improving early functional outcomes.

Hyeon-Joon Lee et al conducted a retrospective case–control study aimed to determine the effectiveness of preoperative intravenous ferric carboxymaltose (FCM) administration compared to oral ferrous sulfate (FS) supplementation in patients undergoing primary unilateral total knee arthroplasty (TKA). The article has been published in ‘Indian Journal of Orthopaedics.’

This retrospective comparative cohort study included a total of 183 patients with 87 in the FCM group receiving 1000 mg FCM 2 weeks before TKA and 96 in the FS group receiving 1024 mg FS daily for 4 weeks preoperatively. Hemoglobin (Hb) levels were measured at baseline and postoperatively. The primary endpoint was the change in Hb levels relative to baseline. The secondary outcomes were the transfusion rate and volume. Subgroup analysis was performed for patients without preoperative anemia.

The key findings of the study were:

• At all postoperative time points, the Hb levels were signifi cantly higher in the FCM group than in the FS group.

• The FCM group demonstrated a significantly lower transfusion rate (1.1 vs. 9.4%, P = 0.01) and mean transfusion volume (3.7 vs. 34.5 cc, P = 0.01).

• Among the patients without preoperative anemia, the FCM-A group had significantly higher Hb levels and lower Hb changes postoperatively than the FS-A group.

The authors concluded – “Preoperative IV FCM administration can help restore postoperative Hb levels and reduce the need for transfusions in patients undergoing primary unilateral TKA. A single injection of FCM 1000 mg 2 weeks before TKA can help maintain a stable hemodynamic status during the acute postoperative period.”

For further details on the article refer to:

Preoperative Intravenous Ferric Carboxymaltose versus Oral Ferrous Sulfate in Total Knee Arthroplasty: Effects on Hemoglobin Levels and Transfusion Rates

Hyeon-Joon Lee et al

Indian Journal of Orthopaedics (2026) 60:1365–1373

https://doi.org/10.1007/s43465-026-01694-5

Total knee arthroplastyHemoglobinPreoperativeIntravenous ironFerric carboxymaltoseOral ironTransfusion

Source : Indian Journal of Orthopaedics

Dr Supreeth D R

MBBS, Dip. Ortho, DNB ortho, MNAMS

Dr Supreeth D R (MBBS, Dip. Ortho, DNB ortho, MNAMS) is a practicing orthopedician with interest in medical research and publishing articles. He completed MBBS from mysore medical college, dip ortho from Trivandrum medical college and sec. DNB from Manipal Hospital, Bengaluru. He has expirence of 7years in the field of orthopedics. He has presented scientific papers & posters in various state, national and international conferences. His interest in writing articles lead the way to join medical dialogues. He can be contacted at editorial@medicaldialogues.in.

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