Non-drainage versus drainage in tourniquet-free knee arthroplasty: a prospective trial

BackgroundIt is still unknown whether drainage is necessary and non-drainage is safe and acceptable after tourniquet-free total knee arthroplasty (TKA). We aim to investigate whether non-drainage use is accepted in TKA that is performed without a tourniquet. MethodsClinical data of 80 adult patients who did or did not receive drainage in our centres from August 2015 to December 2015 were prospective investigated. ResultsThe drainage group exhibited reduced hidden blood loss (47.643.6mL versus 151.1 +/- 97.1mL, P<0.001), less calf swelling (d1: 3.2% versus 5.2%, P=0.02) and milder knee active pain (d3: 4.9 +/- 1.9 versus 5.9 +/- 1.2, P=0.01; d5: 3.2 +/- 1.6 versus 4.2 +/- 1.5, P=0.003) than the non-drainage group. However, the non-drainage group had higher haemoglobin level (d1: 112.1 +/- 10.6g/dL versus 106.1 +/- 12.4g/dL, P=0.026; d3: 99.5 +/- 9.6g/dL versus 92.7 +/- 13.1g/dL, P=0.011) and less haematopoietic medication usage (42.1% versus 66.6%, P=0.03) in the initial postoperative period following TKA. Earlier postoperative time to ambulation (22.4 +/- 12.3h versus 30.1 +/- 14.6h, P=0.01) and shorter length of stay (5.5 +/- 1.2 days versus 6.3 +/- 1.7 days, P=0.02) were found in the non-drainage group. Conclusion It is practicable to abandon wound drainage in uncomplicated, primary, tourniquet-free TKA.