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Does drainage affect development of heterotopic ossification after total hip arthroplasty?
Congcong Wei1, Meng Yang2, Kun Chu2
1Department of Joint Surgery, No. 215 Hospital of Shaanxi Nuclear Industry, Xianyang, Shaanxi, P.R. China.
Insights
Drainage after total hip arthroplasty (THA) increases the risk of heterotopic ossification (HO). No drainage is recommended for primary THA as it offers no added advantage and may reduce HO incidence.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Heterotopic ossification (HO) is a potential complication following total hip arthroplasty (THA).
- The role of surgical drainage in influencing HO development and other outcomes after THA remains debated.
Purpose of the Study:
- To investigate the impact of surgical drainage on HO formation after THA.
- To compare postoperative complications and joint function in patients with and without drainage following THA.
Main Methods:
- Retrospective cohort study of THA patients (2017-2019).
- Patients categorized into drainage and non-drainage groups.
- Radiographic HO assessment and analysis of clinical indicators including range of motion and Harris Hip Score (HHS).
Main Results:
- Higher incidence of HO in the drainage group (32.0%) compared to the non-drainage group (16.3%).
- Significant difference in severe HO (Brooker grade III/IV) between groups.
- Early ROM was lower in the non-drainage group, but final ROM and HHS were comparable.
Conclusions:
- Surgical drainage significantly affects HO rate and severity after THA.
- Closed suction drainage provides no additional benefit for primary THA and is associated with increased HO.
Objective:
To investigate the effect of drainage on heterotopic ossification (HO) after total hip arthroplasty (THA) and to evaluate other postoperative complications and joint dysfunction between patients with and without drainage.
Methods:
In this retrospective cohort study, the medical records of patients who underwent THA from 2017 to 2019 were reviewed. The patients were divided into a drainage group and non-drainage group. Standard preoperative anteroposterior and lateral radiographs were assessed by senior radiologists for HO analysis. Clinical indicators included the hemoglobin concentration, superficial infection, blood transfusion, hematoma formation, hip range of motion (ROM), erythrocyte sedimentation rate, C-reactive protein concentration, dressing changes, visual analogue scale score, and Harris Hip Score (HHS).
Results:
The incidence of HO was significantly higher in the drainage than non-drainage group (32.0% vs. 16.3%). The presence of severe HO (Brooker grade III or IV) was also different between the groups. Patients in the non-drainage group had smaller ROM early after surgery, but the final ROM and HHS did not differ significantly between the groups.
Conclusions:
The rate and degree of HO after THA were significantly different between patients with and without drainage. There is no added advantage of closed suction drainage over no drainage in primary THA.
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