Hemostatic Effect of Oxidized Regenerated Cellulose in Simultaneous Bilateral Total Knee Arthroplasty: A Retrospective Study

Background Oxidized regenerated cellulose (ORC) is a biodegradable hemostatic agent widely used in surgical practice. However, its efficacy and safety in total knee arthroplasty (TKA), particularly in simultaneous bilateral procedures, remain underreported. Methods This retrospective study included patients who underwent simultaneous bilateral TKA at our institution. A total of 49 patients were analyzed and divided into two groups: the ORC group (n=21), in which ORC was used intraoperatively, and the non-ORC group (n=28). Perioperative hemoglobin (Hb) and hematocrit (Ht) levels were compared between groups, along with estimated blood loss (EBL) on postoperative days 4 and 7, calculated using the Gross formula. Transfusion rates and postoperative complications were also evaluated. Statistical analyses were performed using the Wilcoxon rank-sum test and chi-squared test. Results No significant preoperative differences in Hb or Ht values were observed between groups. However, both postoperative Hb/Ht levels and EBL on postoperative days 4 and 7 were significantly lower in the ORC group (p<0.05). No significant difference in transfusion rate was found between groups. Importantly, no postoperative complications directly related to ORC use were identified. Conclusion ORC demonstrated effective and safe hemostasis in simultaneous bilateral TKA, contributing to reduced postoperative blood loss without increasing complications. ORC may be a valuable adjunct for blood loss management in TKA.