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Outcome in primary cemented total knee arthroplasty with or without drain: A prospective comparative study
Rafał Kęska1, T Przemysław Paradowski2, Dariusz Witoński1
1Department of Reconstructive Surgery and Arthroscopy of the Knee Joint, Medical University of Łódź, 91-002 Łódź, 75 Drewnowska, Poland.
Indian Journal of Orthopaedics
|August 22, 2014
Summary
Routine suction drains after total knee arthroplasty (TKA) are unnecessary. Omitting drains reduces opioid use and dressing changes without impacting outcomes or complications, simplifying postoperative care.
Area of Science:
- Orthopedic Surgery
- Arthroplasty
- Surgical Drainage
Background:
- Suction drains are common post-arthroplasty to prevent hematoma, but evidence is conflicting.
- Concerns exist regarding limited drainage efficacy, infection risk, and delayed rehabilitation.
- The study investigated drain use impact on postoperative pain and analgesia in total knee arthroplasty (TKA).
Purpose of the Study:
- To evaluate the clinical outcome, specifically postoperative pain and analgesic intake.
- To compare TKA patients who received a postoperative drain versus those who did not.
Main Methods:
- Prospective comparative study of 108 consecutive patients (121 knees).
- Two groups: no drainage (59 knees) vs. drain insertion (62 knees).
- Groups were comparable preoperatively; TKA indications were osteoarthritis and rheumatoid arthritis.
Main Results:
- Patients without drains had lower opioid needs and fewer dressing changes.
- Higher blood loss was observed on day 1 in the no-drain group.
- No significant differences in total blood loss, transfusion rates, ROM, hospital stay, or complications were found.
Conclusions:
- The use of drains after primary TKA lacks clinical rationale.
- Omitting drains offers benefits: reduced opioid consumption, less early blood loss, and fewer dressing reinforcements.
- No long-term clinical outcome differences were observed between groups after one year.