Oxidized regenerated cellulose powder reduces perioperative bleeding and thigh swelling in total hip arthroplasty: a prospective interventional study
Bibliographic record
Abstract
BACKGROUND: Total hip arthroplasty (THA) is an effective treatment for hip osteoarthritis; however, perioperative blood loss and postoperative thigh swelling are significant challenges that can delay recovery and increase patient discomfort. Minimally invasive THA and pharmacological interventions, such as tranexamic acid, have mitigated some complications; however, achieving localized hemostasis, particularly in cancellous bones, remains problematic. We aimed to evaluate the efficacy of oxidized regenerated cellulose (ORC) powder in reducing perioperative blood loss and postoperative thigh swelling following THA. METHODS: This prospective interventional study included 152 patients who underwent primary unilateral THA via the direct anterior approach. The patients were divided into ORC (n = 74) and non-ORC (n = 78) groups. ORC powder was applied to three critical surgical sites: the acetabulum, femoral medullary canal, and the surrounding soft tissue. The estimated total blood loss (eTBL), postoperative blood loss (ePBL), thigh swelling, and hematologic parameters (hemoglobin, hematocrit, D-dimer, creatine kinase, and C-reactive protein) were assessed. Clinical outcomes were evaluated using the modified Harris Hip Score (mHHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and University of California, Los Angeles (UCLA) activity score at 3 months postoperatively. RESULTS: The ORC group exhibited significantly lower eTBL and ePBL, smaller reductions in hemoglobin levels, and higher hematocrit levels up to postoperative day 7. Postoperative thigh swelling was significantly reduced in the ORC group, particularly on day 1, with a trend toward reduced swelling at all time points. However, there were no significant differences in the clinical scores between the groups at 3 months postoperatively. CONCLUSIONS: The ORC powder application during THA effectively reduced perioperative blood loss and postoperative thigh swelling. Powdered ORC has the potential to maximize efficacy in THA because of its ability to be applied to hemispherical acetabular surfaces and deep femoral medullary canals, effectively addressing bleeding from both soft tissue and cancellous bone. TRIAL REGISTRATION: This prospective interventional study was reviewed and approved by the Ethics Committee of Shizuoka Red Cross Hospital (Approval No: 2023-36) and was designed and conducted according to the rules of the Declaration of Helsinki. Written informed consent was obtained from patients or their families.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".