[Drainage versus non-drainage in total knee arthroplasty]

To compare the clinical outcome of total knee arthroplasty with or without wound drainage.

A comparative study involving 56 patients who were accepted primary unilateral total knee arthroplasty, divided into two groups. Group 1 included 27 patients with wound drainage; group 2 included 29 patients without any drainage. All operations were performed by a single surgeon, and all patients were recovered under the same programs. The mean blood loss, hidden blood loss, volume of transfusion, transfused rate of two groups were compared. Meanwhile, the clinical results of two groups, including pain, swelling, hematoma, infection, range of motion, deep venous thrombosis, and wound healing, were evaluated.

The average blood loss in group 1 was (1250 ± 487) ml, which was significantly higher than that of group 2, (932 ± 332) ml (t = 2.877, P = 0.006). The volume of transfusion was (933 ± 487) ml in group 1 compare to (510 ± 443) ml in group 2 (t = 3.406, P = 0.001). Blood transfusion was required in 88.9% of 27 patients managed with a drain compared with 62.1% of 29 managed without a drain (χ² = 5.364, P = 0.021). There was no statistical difference in the hidden blood loss, pain score, swelling, or the range of motion, or in the incidence of deep venous thrombosis, infection, hematoma, and wound problems.

According to our study, the use of wound drainage provides no apparent advantages after total knee arthroplasty. The blood loss and the need for blood transfusion may decrease significantly in patients without wound drainage after total knee arthroplasty, meanwhile, there were no significant differences in other clinical results between two groups. However, large-scale randomized controlled clinical trials were needed to verify the conclusion.