Journal
ANZ JOURNAL OF SURGERY
Volume 87, Issue 12, Pages 1048-1052Publisher
WILEY
DOI: 10.1111/ans.14183
Keywords
drainage; perspective randomized controlled trial; total knee arthroplasty; tourniquet
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Funding
- Health Industry Special Scientific Research Projects of China - The safety and effectiveness evaluation of arthroplasty [201302007]
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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.
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