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Comparative study of carbazochrome sodium sulfonate and tranexamic acid in reducing blood loss and inflammatory response following direct anterior total hip arthroplasty: a prospective randomized controlled trial

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A Letter to the Editor to this article was published on 29 July 2023

Abstract

Purpose

Carbazochrome sodium sulfonate (CSS) is a haemostatic agent. However, its hemostatic and anti-inflammatory effects in patients undergoing total hip arthroplasty (THA) via a direct anterior approach (DAA) are unknown. We investigated the efficacy and safety of CSS combined with tranexamic acid (TXA) in THA using DAA.

Methods

This study enrolled 100 patients who underwent primary, unilateral THA through a direct anterior approach. Patients were randomly divided into two groups: Group A used a combination of TXA and CSS, while Group B used TXA only. The primary outcome was total perioperative blood loss. The secondary outcomes were hidden blood loss, postoperative blood transfusion rate, inflammatory reactant levels, hip function, pain score, venous thromboembolism (VTE), and incidence of associated adverse reactions.

Results

The total blood loss (TBL) in group A was significantly lower than in group B. The levels of inflammatory reactants and the rate of blood transfusion were also significantly lower. However, the two groups had no significant differences in intraoperative blood loss, postoperative pain score, or joint function. There were no significant differences in VTE or postoperative complications between the groups.

Conclusion

As a haemostatic agent, CSS combined with TXA can reduce postoperative blood loss in patients undergoing THA via DAA and seems to have an anti-inflammatory effect. Moreover, it did not increase the incidence of VTE or its related complications.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Acknowledgements

We want to express our sincere appreciation for all the patients that joined this study.

Funding

This study was funded by 1.3.5 Project of Sichuan University West China Hospital, grant no. ZYJC18040.

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Author notes

  1. Shuwei Ye and Maojia Chen contributed equally to this work and should be regarded as first co-authors.

Authors and Affiliations

  1. Department of Orthopaedics surgery, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu, 610041, China

    Shuwei Ye, Yue Luo, Chengcheng Zhao, Qianhao Li & Pengde Kang

  2. Animal Experimental Center, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu, 610041, China

    Maojia Chen

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Contributions

YSW and CMJ were responsible for data collection, data analysis and manuscript writing. LY, ZCC, and LQH were responsible for data collection. KPD was responsible for the study design and correspondence. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Pengde Kang.

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The study was approved by the Clinical Trials and Biomedical Ethics Committee of West China Hospital.

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The authors declare no competing interests.

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Ye, S., Chen, M., Luo, Y. et al. Comparative study of carbazochrome sodium sulfonate and tranexamic acid in reducing blood loss and inflammatory response following direct anterior total hip arthroplasty: a prospective randomized controlled trial. International Orthopaedics (SICOT) 47, 2553–2561 (2023). https://doi.org/10.1007/s00264-023-05853-3

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