Pidgaiska Olga, Niemann Marcel, Braun Karl, Trampuz Andrej, Goumenos Stavros, Stöckle Ulrich, Meller Sebastian
Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Center for Musculoskeletal Surgery (CMSC), Augustenburger Platz 1, 13353 Berlin, Germany.
Sytenko Institute of Spine and Joint Pathology, Academy of Medical Science, Ukraine, Pushkinska Str. 80, 61024 Charkiw, Ukraine.
Life (Basel). 2024 Jan 25;14(2):177. doi: 10.3390/life14020177.
This study aimed to assess the safety and efficacy of microporous polysaccharide hemospheres (MPSHs) in managing blood loss and reducing the risk of postoperative haematoma and early periprosthetic joint infection (PJI) following total hip arthroplasty (THA) for femoral neck fracture (FNF), in the context of the existing treatment challenges.
A control-matched retrospective analysis of 163 patients undergoing unilateral primary THA for displaced FNF between 2020 and 2023 was performed. The study group consisted of 74 patients who received MPSH administered intraoperatively. The control group consisted of 89 patients who received no topical haemostatics. One-to-one case-control matching between groups was performed. The primary outcome was a perioperative change in the haematologic values (haemoglobin, red blood cell count, haematocrit, platelet concentration) and transfusion rate. The secondary outcomes were the incidence of postoperative local haematoma formation, prolonged wound secretion, surgical site infection (SSI), and PJI within 3 months of surgery.
Our analysis found no statistically significant differences in the haematologic parameters between the control and study cohorts. The changes in the haemoglobin concentration were not significant between the control group (3.18 ± 1.0 g/dL) and the treatment group (2.87 ± 1.15 g/dL) ( = 0.3). There were no significant differences ( = 0.24) in the haematocrit and red blood cell concentration ( = 0.15). The platelet levels did not significantly differ ( = 0.12) between the groups. Additionally, we found no significant discrepancy in the incidence of early PJI or blood transfusion rates between the groups. No adverse effects following MPSH use were recorded in the study group.
Routine use of MPSH in THA for FNF management appears to be safe, with no observed adverse events related to Arista use. Although there was a tendency towards reduced blood loss in the Arista AH group, MPSH did not significantly impact bleeding complications, local haematoma formation, or subsequent PJI.
本研究旨在评估在现有治疗挑战的背景下，微孔多糖微球（MPSHs）在股骨颈骨折（FNF）全髋关节置换术（THA）中控制失血、降低术后血肿风险和早期假体周围关节感染（PJI）的安全性和有效性。
对2020年至2023年间163例行单侧初次THA治疗移位FNF的患者进行对照匹配的回顾性分析。研究组由74例术中接受MPSH治疗的患者组成。对照组由89例未使用局部止血剂的患者组成。两组间进行一对一病例对照匹配。主要结局是血液学指标（血红蛋白、红细胞计数、血细胞比容、血小板浓度）的围手术期变化及输血率。次要结局是术后局部血肿形成、伤口分泌物延长、手术部位感染（SSI）以及术后3个月内PJI的发生率。
我们的分析发现，对照组和研究组的血液学参数无统计学显著差异。对照组（3.18±1.0 g/dL）和治疗组（2.87±1.15 g/dL）之间血红蛋白浓度变化不显著（P = 0.3）。血细胞比容和红细胞浓度无显著差异（P = 0.24），血小板水平在两组间也无显著差异（P = 0.12）。此外，我们发现两组间早期PJI发生率或输血率无显著差异。研究组未记录到使用MPSH后的不良反应。
在THA治疗FNF中常规使用MPSH似乎是安全的，未观察到与Arista使用相关的不良事件。尽管Arista AH组有失血减少的趋势，但MPSH对出血并发症、局部血肿形成或随后的PJI没有显著影响。
