Effectiveness and Safety of Oxidized Regenerated Cellulose for Hemostasis in Joint Arthroplasty: A Systematic Review and Meta-Analysis

Background Oxidized regenerated cellulose (ORC) is a topical hemostatic agent, but its efficacy and safety in arthroplasty remain inconclusive. This meta-analysis aimed to comprehensively assess its role in this procedure. Methods We systematically searched multiple databases up to July 30, 2025, for cohort studies and randomized controlled trials investigating the use of ORC in arthroplasty. Study quality was assessed using standard tools, and data were analyzed using Stata software. Results A total of 33 articles were retrieved. After removing 27 duplicates, six high-quality studies involving 684 participants were included in the analysis. The analysis revealed that ORC significantly reduced total blood loss (WMD = −102.50 mL, 95% CI: −201.75, −3.26, I 2 = 69.9%) and hemoglobin drop (WMD = −3.99 g/L, 95% CI: −6.19, −1.79, I 2 = 39.8%) compared with the control group. No significant differences were found in other secondary outcomes, such as intraoperative blood loss, risk of thrombosis, operative time, or wound complications. Conclusion ORC is an effective and safe hemostatic agent that reduces total blood loss and hemoglobin drop during arthroplasty. Future research should focus on determining the optimal timing of ORC and long-term functional outcomes.