The Safety and Efficacy of Microporous Polysaccharide Hemospheres in Terms of the Complication Rates in Total Hip Arthroplasty for Femoral Neck Fractures: A Control-Matched Retrospective Cohort

Olga Pidgaiska; Marcel Niemann; Karl Braun; Andrej Trampuz; Stavros Goumenos; Ulrich Stöckle; Sebastian Meller

doi:10.3390/life14020177

The Safety and Efficacy of Microporous Polysaccharide Hemospheres in Terms of the Complication Rates in Total Hip Arthroplasty for Femoral Neck Fractures: A Control-Matched Retrospective Cohort

Life (Basel). 2024 Jan 25;14(2):177. doi: 10.3390/life14020177.

Authors

Olga Pidgaiska^{1

2}, Marcel Niemann¹, Karl Braun³, Andrej Trampuz¹, Stavros Goumenos¹, Ulrich Stöckle¹, Sebastian Meller¹

Affiliations

¹ 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.
² Sytenko Institute of Spine and Joint Pathology, Academy of Medical Science, Ukraine, Pushkinska Str. 80, 61024 Charkiw, Ukraine.
³ Department of Trauma Surgery, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany.

Abstract

Aims: 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.

Methods: 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.

Results: 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) (p = 0.3). There were no significant differences (p = 0.24) in the haematocrit and red blood cell concentration (p = 0.15). The platelet levels did not significantly differ (p = 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.

Conclusions: 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.

Keywords: complications after total hip arthroplasty; microporous polysaccharide hemospheres; periprosthetic joint infection; postoperative haematoma.

Grants and funding

This research received no external funding.