Abstract
INTRODUCTION: According to epidemiological studies, preoperative anemia exerts a pronounced negative effect on the immune system by reducing its cellular activity and is considered one of the major independent risk factors for the development of infectious complications. Despite the active investigation of preoperative anemia, to date there are no unified standards or clinical guidelines for the optimal management of such patients undergoing orthopedic surgery. OBJECTIVE: To evaluate the effectiveness of a preventive perioperative hemocorrection strategy in reducing the incidence of infectious complications in patients undergoing orthopedic surgical procedures. MATERIALS AND METHODS: Between January 2023 and February 2025, 116 patients undergoing elective orthopedic surgery participated in this single-center randomized controlled trial, 58 of whom received preventive therapy (preventive group) with iron carboxymaltose, and 58 received standard treatment (standard group). RESULTS: The application of perioperative hemocorrection in the preventive group significantly reduced the incidence of infectious complications: 1 case (1.7 %) vs. 7 cases (12.1 %) in the standard group (p = 0.032). In addition, patients in the preventive group demonstrated a smaller decrease in hemoglobin levels on postoperative day 3 (92.5 vs. 84.1 g/L), which was accompanied by a reduced rate of allogeneic blood transfusions (6 vs. 25 cases; p < 0.001). CONCLUSIONS: These findings confirm that correction of anemia and restriction of allogeneic transfusions may play an important role in the prevention of periprosthetic joint infection following major orthopedic procedures.