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Selecting and optimising patients for total knee arthroplasty

Lachlan F Miles, Kate L Burbury and David A Story
Med J Aust 2019; 211 (6): . || doi: 10.5694/mja2.50304
Published online: 16 September 2019

To the Editor: We read with interest the recent review by Adie and colleagues1 discussing the optimisation of patients planned for total knee arthroplasty (TKA) and the prevention of adverse post‐operative outcomes. However, anaemia, which is a common, major and modifiable risk factor for this patient cohort,2 was not addressed by the authors.


  • 1 Austin Health, Melbourne, VIC
  • 2 Centre for Integrated Critical Care, University of Melbourne, Melbourne, VIC
  • 3 Peter MacCallum Cancer Institute, Melbourne, VIC


Correspondence: lachlan.miles@austin.org.au

Competing interests:

Lachlan Miles, Kate Burbury and David Story are investigators on the NATO (non‐anaemic iron deficiency and treatment outcomes in colorectal cancer surgery) study, which has received partial financial support from Vifor Pharma.

  • 1. Adie S, Harris I, Chaun A, et al. Selecting and optimising patients for total knee arthroplasty. Med J Aust 2019; 210: 135–141. https://www.mja.com.au/journal/2019/210/3/selecting-and-optimising-patients-total-knee-arthroplasty
  • 2. Castano‐Betancourt M, Fruschein Annichino R, de Azevado E Souza Munhoz M, et al. Identification of high‐risk groups for complication after arthroplasty: predictive value of patient's related risk factors. J Orthop Surg Res 2018; 13: 328.
  • 3. Muñoz M, Laso‐Morales MJ, Gómez‐Ramírez S, et al. Pre‐operative haemoglobin levels and iron status in a large multicentre cohort of patients undergoing major elective surgery. Anaesthesia 2017; 72: 826–834.
  • 4. Abdullah HR, Sim YE, Hao Y, et al. Association between preoperative anaemia with length of hospital stay among patients undergoing primary total knee arthroplasty in Singapore: a single‐centre retrospective study. BMJ Open 2017; 7: e016403.
  • 5. Lu M, Sing DC, Kuo AC, Hansen EN. Preoperative anemia independently predicts 30‐day complications after aseptic and septic revision total joint arthroplasty. J Athroplasty 2017; 32: S197–S201.
  • 6. Muñoz M, Gómez‐Ramírez S, Cuenca J, et al. Very short‐term perioperative intravenous iron administration and postoperative outcome in major orthopedic surgery: a pooled analysis of observational data from 2547 patients. Transfusion 2014; 54: 289–299.
  • 7. National Blood Authority. Patient blood management guidelines: module 2 — perioperative. Canberra: National Blood Authority, 2012. http://www.blood.gov.au/system/files/documents/pbm-module-2.pdf (viewed March 2019).

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