Research Article
Volume 11 Issue 6 - 2020
Comparison between Closed Suction Drainage and No Drainage Following Primary Total Knee Arthroplasty
M Suhail Amin, Muhammad Khurram Habib* and Aziz Ur Rehman
Combined Military Hospital Rawalpindi ,DHQ Teaching Hospital Faisalabad
*Corresponding Author: Muhammad Khurram Habib, Assistant Professor Orthopedics, DHQ Teaching Hospital Faisalabad, Clinical Fellow Combined Military Hospital, Lahore.
Received: May 28, 2020; Published: June 04, 2020




Abstract

Objective: To compare the early outcome between closed suction drainage and no drainage following primary total knee arthroplasty.

Design of Study: It was a randomized controlled trial.

Study Duration and Settings: This study was carried at the Orthopedic Departments of Combined Military Hospital Lahore and Rawalpindi from Jan 2016 to March 2019.

Methodology: This study involved 236 patients of both genders, aged between 40 - 80 years undergoing primary unilateral total knee arthroplasty for degenerative conditions like osteoarthritis and rheumatoid arthritis. These patients were divided into two treatment groups randomly. Patients in Group-A underwent TKR with closed suction drainage while patients in Group-B underwent TKR without post-operative drainage. A signed written consent was taken from every patient.

Findings: Of the 236 studied patients, there were 49 (20.8%) males and 187 (79.2%) females with a male to female ratio of 1:3.8. The mean age of the patients was 62.5 ± 8.5 years. Both the study groups were similar in terms of mean pre-operative hemoglobin (p-value = 0.737) and mean pre-operative hematocrit (p-value = 0.524). However, the mean post-operative hemoglobin (10.57 ± 1.16 vs. 9.22 ± 1.02 g/dl; p-value < 0.001) and mean post-operative hematocrit (38.30 ± 1.65 vs. 36.54 ± 1.34 %; p-value < 0.001) were significantly higher in the non-drainage group. Similarly, the mean fall in hemoglobin (1.09 ± 1.97 vs. 2.37 ± 1.66 g/dl; p-value < 0.001), mean fall in hematocrit (2.30 ± 1.57 vs. 3.87 ± 2.47; p-value < 0.001), mean estimated blood loss (947.01 ± 218.98 vs. 1282.19 ± 320.59 ml; p-value < 0.001) and mean length of hospital stay (5.27 ± 1.45 vs. 6.25 ± 1.29 days; p-value < 0.001) were all significantly lower in the non-drainage group. Patients without post-operative drain also had significantly lower need for transfusion (32.2% vs. 46.6%; p-value = 0.024) in the post-operative period.

Conclusion: Omission of routine post-operative drainage after primary total knee arthroplasty was found superior to conventional practice of closed suction drainage in terms of decreased blood loss, decreased fall in hemoglobin concentration and lesser need for post-operative transfusion. Therefore, we advocate the drainage after primary TKA to be unnecessary and be avoided as a routine practice.

Keywords: Primary Total Knee Arthroplasty; Post-Operative Drainage; Blood Loss

References

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Citation: Amin MS., et al. “Comparison between Closed Suction Drainage and No Drainage Following Primary Total Knee Arthroplasty”. EC Orthopaedics 11.7 (2020): 07-12.

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