[Comparative study of one stage bilateral total knee arthroplasty with or without drainage]

To compare the impact of rehabilitative process of placing drainage versus no drainage during total knee arthroplasty (TKA).

A prospective study was performed in 30 osteoarthritic patients who underwent one-stage bilateral TKA between October 2007 and December 2008. For every patient, drainage was randomly placed intra-operatively only on one knee side. Pain VAS scores, extremity swelling, incision healing, recovery of knee joint flexion and extension function and early postoperative complications were compared statistically as a self-control study.

All patients were followed up for at least one month. Comparing drainage side with non-drainage side, the mean pain VAS scores at Day 3 post-operation were 4.7 +/- 1.8 and 4. 9 +/- 1.9 respectively; the mean extremity swelling differences of supra patellar (infra patellar) perimeter at Day 6 post-operation were 1.8 +/- 1.7 (0.7 +/- 1.0) cm and 1.7 +/- 1.3 (1.0 +/- 1.0) cm respectively; the mean flexion (extension) differences at Day 30 post-operation were 12.5 +/- 21.6 (4.4 +/- 6.9) degrees and 11.7 +/- 23.9 (4.2 +/- 6.4) degrees respectively. There was no obvious statistical difference between placing drainage and no drainage in all the above aspects (paired t-test, P > 0.05). There was also no statistical difference of early postoperative complications between two groups (exact Fisher test, P > 0.05).

For unsophisticated TKA, placing drainage had no effect upon reducing the pain, extremity swelling and incision exudation. It also had no effect upon reducing the incidence of hematoma to prevent early infections and promoting rehabilitation. Comparing with no drainage, placing drainage had no obvious advantage. On the contrary, it might complicate the surgical steps and increase the chances of post-operative hemorrhage and retrograde infections. Thus no drainage is recommended in such a kind of operation.