Influence of wound drainage in primary total knee arthroplasty without tourniquet

Although it remains the golden standard, several authors have questioned the role of pneumatic tourniquets in primary knee arthroplasty in recent studies. An intra-articular wound drainage is widely used in the field of total knee arthroplasty although the benefit of postoperative wound drainage is controversial in the literature. This study questioned whether the use of an intra-articular drain is an advance over the lack of a drain in total knee arthroplasty which is performed without a tourniquet.

We documented the ROM, the knee circumference at the upper patellar pole pre-operatively and on days two, four and six postoperatively. The blood volume and loss was calculated. As surrogate parameter for wound healing we counted the number of days until no residual secretion was observed via the wound/drainage site.

The results of our investigation showed a significantly better wound healing without the use of a drain. All other parameters revealed no significant differences.

The data of this study demonstrate a faster wound healing without the use of a postoperative wound drain in primary total knee arthroplasty which is performed without a tourniquet. Other parameters could not show any significant differences thus indicating that a postoperative wound drain has no significant advantage and the risk of a retrograde bacterial colonisation is well documented. Based on these data we recommend performing a primary total knee arthroplasty without a postoperative drain if the procedure is done without a tourniquet.