Toshifumi Watanabe1, Takeshi Muneta2, Kazuyoshi Yagishita2, Kenji Hara3, Hideyuki Koga2, Ichiro Sekiya2. 1. Department of Orthopaedic Surgery, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan. Electronic address: watanabe.orj@tmd.ac.jp. 2. Department of Orthopaedic Surgery, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan. 3. Department of Orthopaedic Surgery, Kameda Medical Center, Kamogawa, Chiba, Japan.
Abstract
BACKGROUND: 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.
BACKGROUND: 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.
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