Abdulsalam Mohammed Aleid¹*, Saud Nayef Salem Aldanyowi¹, Hasan Ali Al Aidarous², Zainab Mohammed Aleid¹, Abdulmajeed Alghamdi³, Mohammad Barnawi⁴, Mohammed Nasser Asiri⁵, Yousef Khalaf A Alghamdi⁶, Abdulwahab Ahmed Alzahrani⁷, Mohammad Al Mohaini⁸, Loai Saleh Albinsaad¹, Mohammed Yousef Alessa¹, Abbas Al Mutair⁹ and Awad Al-Omari¹⁰

¹Department of Surgery, Medical College, King Faisal University, Hofuf, Ahsa, 31982, Saudi Arabia
²Faculty of Medicine, Surgery Department, Al-Baha University, Saudi Arabia
³Assistant Professor of Urology, Unit of Urology, Department of Surgery, Faculty of Medicine, Al-Baha University, Saudi Arabia
⁴Assistant Professor of Anesthesia and ICU, Department of Surgery, Faculty of Medicine, Al-Baha University, Saudi Arabia
⁵Assistant Professor of Plastic Surgery, Department of Surgery, Faculty of Medicine, Al-Baha University, Saudi Arabia
⁶Teaching Assistant, Surgery Department, Faculty of Medicine, Al-Baha University, Saudi Arabia
⁷Associate Professor, Surgery Department, Faculty of Medicine, Al-Baha University, Saudi Arabia
⁸College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Al Ahsa 31982, Saudi Arabia
⁹Department of Medical-Surgical Nursing, College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
¹⁰College of Medicine, Alfaisal University, Riyadh, Saudi Arabia

*Corresponding Author: Abdulsalam Mohammed Aleid, Department of Surgery, Medical College, King Faisal University, Hofuf, Ahsa, 31982, Saudi Arabia.

Received: February 24, 2025; Published: April 03, 2025

Abstract

Background: The increased blood loss in hip arthroplasty has not yet been fully solved and frequently requires pharmacological tools to enhance hemostasis. Carbazochrome can be used in conjunction with tranexamic acid (TXA), and to decrease perioperative blood loss.

Objective: This study aims to compare the efficiency of the combination of Carbazochrome with TXA and only TXA in hip arthroplasty to reduce blood loss and improve surgery.

Methods: The available literature in databases, including PubMed, Scopus, Web of Science, and Cochrane, was studied to uncover pertinent randomized controlled trials assessing the effectiveness of the single TXA and combined use of carbazochrome and TXA in THA. The PRISMA protocol was followed for the selection of studies. A meta-analysis was performed utilizing a random effects model with RevMan software.

Results: This systematic review and meta-analysis included five clinical studies (n = 500 patients) evaluating the efficacy of combining Carbazochrome Sodium Sulfonate (CSS) with TXA in THA. The combination significantly minimized the total blood loss (TBL) (MD = -242.81 mL, 95% CI [-297.95, -187.68], p < 0.00001) and hidden blood loss (HBL) (MD = -241.70 mL, 95% CI [-297.00, -186.39], p < 0.00001) compared to TXA alone. Postoperative pain scores on day 1 were also significantly lower in the CSS+TXA group (MD = -0.36, 95% CI [-0.60, -0.11], p = 0.005). No significant differences were observed in intraoperative blood loss (IBL) (MD = -0.63 mL, 95% CI [-2.89, 1.63], p = 0.58) or operative time (MD = -1.65 minutes, 95% CI [-4.17, 0.87], p = 0.20), highlighting the selective benefits of this combination therapy.

Conclusion: This study concluded that the combination of CSS with TXA in THA enhances the control of perioperative blood loss, particularly by reducing TBL and HBL, while not increasing the consequence of thromboembolic or coagulation events.

Keywords: Carbazochrome; Tranexamic Acid; Hip Arthroplasty; Hemostatic Agents

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Citation

Citation: Abdulsalam Mohammed Aleid., et al. “Combining Carbazochrome with Tranexamic Acid for Hip Arthroplasty: A Systematic Review and Meta-Analysis of Efficacy".Acta Scientific Orthopaedics 8.5 (2025): 02-13.

Copyright

Copyright: © 2025 Abdulsalam Mohammed Aleid., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.