A meta-analysis and systematic review evaluating the use of erythropoietin in total hip and knee arthroplasty

25 randomized controlled trials were included in this meta-analysis which assessed results related to transfusion rate, hemoglobin levels, and venous thromboembolism rate associated with erythropoietin (EPO) administration in orthopaedic surgery. Comparisons included EPO to inactive control treatment, EPO to active control treatment with preoperative autologous blood donation, and the combination of EPO with PABD compared to PABD. Transfusion rate and Hb levels at 24-48 hours, 3-5 days, and at discharge significantly favoured EPO groups compared to both inactive control and PABD. In combination with PABD, EPO was also associated with significantly lower transfusion rate and increased Hb level at discharge compared to PABD alone. All analyses of the incidence of venous thromboembolism demonstrated no significant increase with the use of EPO.