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Utility of postoperative drainage in total hip arthroplasty. A systematic review
C Moreno-Benet1, P Castells-Ayuso2, I Miranda3
1Facultad de Ciencias de la Salud, Universidad Católica de Valencia, Valencia, España.
Insights
Eliminating drainage in total hip arthroplasty (THA) shows no increased risk of complications. This systematic review suggests routine drainage is unnecessary for THA patients, potentially improving outcomes.
Area of Science:
- Orthopedic Surgery
- Surgical Innovation
- Patient Outcomes
Background:
- Drainage is commonly used in primary total hip arthroplasty (THA).
- The necessity and benefits of routine drainage in THA remain debated.
- Investigating drainage's role is crucial for optimizing surgical protocols.
Purpose of the Study:
- To evaluate the advantages of using drainage versus no drainage in primary THA.
- To determine if routine drainage can be safely discontinued in THA procedures.
- To test the hypothesis that eliminating drainage does not increase postoperative complications.
Main Methods:
- A systematic review adhering to PRISMA guidelines was conducted.
- Searches were performed in PubMed and Cochrane Library databases using specific keywords.
- The Joanna Briggs Institute quality assessment tool evaluated study quality.
Main Results:
- Sixteen clinical trials comparing drainage versus no drainage in THA were included.
- No significant differences were found in infection rates or hematoma occurrence.
- Some studies indicated increased transfusion rates and hospital stays with drainage use.
Conclusions:
- Routine drainage in THA offers no discernible advantages over not using drainage.
- Clinical evidence supports the discontinuation of routine drainage in THA.
- Omitting drainage may reduce complications and shorten hospital stays.
Aim And Hypothesis:
To investigate the advantages associated with the use of drainage in primary total hip arthroplasty (THA) versus not using drainage and to determine if drainage can be systematically discontinued. The starting hypothesis was that eliminating the use of drainage systematically in THA does not significantly increase the risk of postoperative complications.
Materials And Methods:
A systematic review was carried out following the PRISMA guidelines in the PubMed and Cochrane Library databases. The search was conducted on February 15, 2024, by entering the terms ("suction drainage") AND ("total hip arthroplasty"). The Joanna Briggs Institute quality assessment tool was used to assess the quality of the included studies.
Results:
Sixteen clinical trials comparing the use of drainage with no drainage in THA were included. No differences were observed in terms of infection rate or haematoma. Some authors find that the use of drainage increases the percentage of patients requiring transfusion and the length of hospitalisation. Of 16 studies, 13 recommend not to use drainage routinely in THA.
Conclusions:
The use of drainage in THA has no advantage over no drainage. The results of the clinical trials reviewed suggest that drainage should not be used routinely in THA.
