Kaneko Taizo, Hayakawa Kentaro, Miyazaki Tsuyoshi
Department of Orthopaedic Surgery, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Sakae-cho 35-2, Itabashi-ku, Tokyo 173-0015, Japan.
SICOT J. 2025;11:36. doi: 10.1051/sicotj/2025036. Epub 2025 Jul 16.
Perioperative blood loss remains a challenge in total hip arthroplasty (THA). Although tranexamic acid (TXA) is widely used for hemostasis, the efficacy of oxidized regenerated cellulose (ORC) powder as an adjunct in blood management for THA via the direct anterior approach (DAA) remains underexplored. This study aimed to evaluate the effects of ORC powder on perioperative blood loss, hematological parameters, and clinical outcomes in direct anterior THA.
A total of 133 patients who underwent primary THA via the DAA were enrolled in the study. The patients were divided into two groups: the ORC powder group (combination of ORC powder and topical TXA, n = 53) and the control group (topical TXA alone, n = 80). The demographic and clinical information, operative time, intraoperative bleeding volume, estimated total blood loss (eTBL), hidden blood loss (HBL), trends in hemoglobin, hematocrit, postoperative pain scores using a numeric rating scale (NRS), and adverse events were analyzed. Clinical outcomes were assessed using the Japanese Orthopedic Association score.
The ORC powder group had significantly lower eTBL (679.1 ± 230.1 mL vs. 875.8 ± 292.9 mL, p < 0.0001) and HBL (424.1 ± 194.5 mL vs. 558.6 ± 264.2 mL, p = 0.002). Postoperative pain scores at postoperative day 7 were lower in the ORC powder group (1.9 ± 1.6 vs. 2.9 ± 2.2, p = 0.009). The clinical outcomes were excellent, and no significant differences were observed in complication rates between the groups.
ORC powder effectively reduced perioperative blood loss in THA via the DAA without increasing complication rates. ORC powder has the potential to be a valuable adjunct in optimizing blood management strategies in THA.
全髋关节置换术（THA）围手术期失血仍是一个挑战。尽管氨甲环酸（TXA）被广泛用于止血，但氧化再生纤维素（ORC）粉末作为THA直接前路（DAA）血液管理辅助手段的疗效仍未得到充分研究。本研究旨在评估ORC粉末对直接前路THA围手术期失血、血液学参数和临床结局的影响。
本研究共纳入133例通过DAA进行初次THA的患者。患者分为两组：ORC粉末组（ORC粉末与局部TXA联合使用，n = 53）和对照组（仅局部使用TXA，n = 80）。分析人口统计学和临床信息、手术时间、术中出血量、估计总失血量（eTBL）、隐性失血量（HBL）、血红蛋白、血细胞比容变化趋势、采用数字评分量表（NRS）的术后疼痛评分以及不良事件。使用日本骨科协会评分评估临床结局。
ORC粉末组的eTBL显著更低（679.1±230.1 mL对875.8±292.9 mL，p < 0.0001），HBL也更低（424.1±194.5 mL对558.6±264.2 mL，p = 0.002）。ORC粉末组术后第7天的术后疼痛评分更低（1.9±1.6对2.9±2.2，p = 0.009）。临床结局良好，两组间并发症发生率无显著差异。
ORC粉末有效减少了DAA THA的围手术期失血，且未增加并发症发生率。ORC粉末有可能成为优化THA血液管理策略的有价值辅助手段。
