Expert Consensus on the Significance of Intravenous Iron using Ferric Carboxymaltose Perioperatively and in Elective Major Orthopedic Surgeries
Authors:   Department of Orthopedics, Seth G.S Medical College and KEM Hospital, Mumbai, Maharashtra, India,, Desai Mohan , Jain Punit ,   [2] Department of Hematology Oncology and Stem Cell Transplant, Apollo Hospitals, Navi Mumbai, Maharashtra, India, [3] HematCare-Speciality Hematology Clinic, Powai, Mumbai, India,, Bava Surendar Singh ,   Department of Orthopedics, Seth G.S Medical College and KEM Hospital, Mumbai, Maharashtra, India,, Samanta Swarnendu ,   Department of Orthopedics, Peerless Hospital, Kolkata, West Bengal, India,, Kumar K R Prathap ,   Department of Orthopedics, Sunrise Group of Hospitals, Kochi, Kerala, India,, Galagali Anand ,   Department of Orthopedics Surgery Manipal Hospital, Bengaluru, Karnataka, India,, Shetty Santhosh ,   Department of Arthroplasty and Joint Replacement, Surana Group of Hospitals, Malad, Mumbai, Maharashtra, India,, Panghate Atul ,   Department of Orthopedics, Seth G.S Medical College and KEM Hospital, Mumbai, Maharashtra, India,, Arbat Ashish ,   [8] Department of Joint Replacement Surgery, Jehangir Hospital, Pune, Maharashtra, India, [9] Department of Orthopedics, Oyster and Pearl Hospital, Pune, Maharashtra, India,, Sonar Satish ,   SportsMed Arthroscopy and Shoulder Surgery Centre, Nagpur, Maharashtra, India,, Vasdev Attique ,   Department of Orthopaedics, Institute of Musculoskeletal Disorder Orthopaedics, Medanta – The Medicity, Gurugram, Haryana, India,, Tonape Prashant ,   Department ofArthroscopy and Joint Replacement Surgery, Sterling Multispeciality Hospital, Nigadi, Pradhikaran, Pune, Maharashtra, India,, Sheth Miten ,   The Knee Clinic, Mumbai, Maharashtra, India,, Shaikh Ashraf ,   Department of Orthopedics, Seth G.S Medical College and KEM Hospital, Mumbai, Maharashtra, India,, Suryawanshi Sachin ,   Medical Services, Emcure Pharmaceuticals Ltd, Mumbai, Maharashtra, India,, Kulkarni Ketan ,   Medical Services, Emcure Pharmaceuticals Ltd, Mumbai, Maharashtra, India,
Published: June 2024

Anemia has emerged as a significant healthcare crisis in India and often remains undiagnosed, with broad implications across all age groups. Iron deficiency remains the most important and correctable cause of anemia in our country. It often leads to significant morbidity during major operative procedures such as hip and knee arthroplasties, due to the substantial intraoperative bleeding associated with these procedures. To address this challenge and mitigate complications related to blood transfusions, peri-operative iron therapy, notably parenteral iron therapy, has become common practice. Nevertheless, there is a lack of consensus on managing peri-operative anemia and the role of ferric carboxymaltose (FCM) in pre-operative and post-operative orthopedic surgeries in India. A group of 14 experts, primarily orthopedic surgeons and an hematologist in India, convened an in-person expert group meeting. Their primary focus was on the approach of FCM in managing anemia in elective orthopedic surgeries within the diverse landscape of the Indian healthcare system. The consensus strongly advocated using FCM as a rapid and adequate source of iron replacement, especially in cases of significant pre-operative and post-operative anemia in patients undergoing elective orthopedic surgery. Keywords: Pre-operative, post-operative, orthopedic surgery, anemia, ferric carboxymaltose.