Preoperative optimisation of anaemia for primary total hip arthroplasty: a systematic review.

The 2009 NHS Blood and Transplant national comparative audit on blood use following primary total hip arthroplasty (THR) highlighted that preoperative anaemia was common and undertreated. They recommended that hospitals have a written policy for treating anaemia preoperatively. In our centre, we found that preoperative optimisation of anaemia, significantly reduced blood transfusion rate to <5%. The 2015 national audit showed that even though 48% of patients received tranexamic acid, 85% of patients required transfusion. By conducting a systematic review of literature on blood management for preoperative anaemia in primary THR; we aimed to validate the recommendations of the national audit and increase its awareness in the orthopaedic community.