Closed Suction Drainage Is Not Necessary for Total Knee Arthroplasty: A Prospective Study on Simultaneous Bilateral Surgeries of a Mean Follow-Up of 5.5 Years

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• 作者：Toshifumi Watanabe ; MD ; PhD^a ; ^{watanabe.orj@tmd.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Takeshi Muneta ; MD ; PhD^a ; Kazuyoshi Yagishita ; MD ; PhD^a ; Kenji Hara ; MD ; PhD^b ; Hideyuki Koga ; MD ; PhD^a ; Ichiro Sekiya ; MD ; PhD^a
• 关键词：total knee arthroplasty ; results ; management ; suction drainage ; blood loss
• 刊名：The Journal of Arthroplasty
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：31
• 期：3
• 页码：641-645
• 全文大小：261 K

文摘

Closed suction drainage has been widely used for orthopedic surgeries including total knee arthroplasty (TKA) to prevent fluid collections at the operative site such as blood around the wound. However, it is still controversial whether suction drainage is necessary for TKA. The present study aimed to clarify the need for suction drainage by assessing short-term and long-term clinical outcomes of simultaneous bilateral TKA.

Methods

Our subjects were 63 patients (126 knees) who underwent simultaneous bilateral TKA using a cemented posterior stabilized prosthesis, classified into 3 groups: 20 patients with a closed suction drain on both sides (bilateral group), 22 patients with a closed suction drain on one side and no drain on the other side (unilateral group), and 21 patients with no drain (no-drainage group). Short- and long-term clinical outcomes were evaluated.

Results

Mean hemoglobin drop on the day after surgery was significantly greater in the bilateral group (2.2 g/dL, P = .038) and unilateral group (2.2 g/dL, P = .045) compared with the no-drainage group (1.5 g/dL). The incidence of short-term and long-term complications was not significantly different between knees with drainage and those without drainage. In side-to-side comparisons, no significant differences were found in knee extension, flexion, or circumference in the unilateral group. In group comparisons, we found no significant differences in clinical outcomes between the bilateral group and no-drainage group, either.

Conclusion

These findings suggest closed suction drainage is not necessary after TKA with cemented posterior-stabilized prostheses.