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Introduction Closed suction drainage is an established procedure in arthroscopic surgery. It is intended to reduce the retention of wound and irrigation fluids, which form the basis for postoperative swelling, pain, and infection. However, currently, there is no scientific review of the actual benefit of this procedure. Methods Between 2020 and 2021, 84 patients (53 males, 31 females; mean age: 42 years) were prospectively randomised into this study. The patients underwent arthroscopic surgery of the ankle joint with (group A) or without (group B) insertion of a closed suction drain (42 patients per group). Assessments included upper ankle swelling using the figure-of-eight-20 method, pain preoperatively and 48 h postoperatively, and unexpected events within 6 weeks postoperatively. ResultsThe measurements performed 48 h postoperatively showed a mean circumferential increase of 1.38 cm (1.48 and 1.28 cm in groups A and B, respectively; p > 0.05) in all patients. The mean pain at rest, assessed using the visual analogue scale (maximum 10 points), was 2.7 and 2.4 in groups A and B, respectively (p > 0.05). Overall, two minor complications occurred: residual swelling in group A and persistent limitation of movement in group B. The average length of hospital stay was 2.4 days (p > 0.05). Conclusions Based on the available data, the routine insertion of a closed suction drainage at the upper ankle does not offer any objective benefit and must be considered obsolete. From both a medical and an economic point of view, the decision to conduct this procedure should be justified on an individual basis. Level of evidence Level I, prospective randomised trial.

A systematic clinical examination of the shoulder joint, including a structured medical history, is essential for the diagnosis of shoulder pathologies. Complex clinical situations that are accompanied by pain, restriction of movement, loss of strength, or instability have to be considered in accordance with the functional interaction between the cervical spine, the shoulder girdle, and the glenohumeral joint. Only accurate diagnosis allows us to apply successful therapeutic interventions. In order to achieve this, the physician needs to use standardized clinical tests and signs combined with a profound knowledge of the anatomy and the possible underlying pathologies. To ensure a structured approach as well as a complete documentation of results, a shoulder assessment form should be used. The information obtained from the history, examination, and collected data form the basis for further diagnostic imaging.

Eine systematische klinische Untersuchung des Kniegelenks einschlie?lich ausf?hrlicher Anamnese ist f?r die Diagnostik der Funktionsst?rungen und Schmerzen des Kniegelenks essenziell. Es empfiehlt sich, eine begrenzte Anzahl der vielen unten aufgef?hrten, bew?hrten klinischen Untersuchungstests f?r sich auszusuchen und diese bei jeder Knieuntersuchung zu pr?fen, um die Sicherheit und entsprechende Routine sowohl bei der Durchf?hrung als auch bei der Bewertung zu erlangen. Um ein strukturiertes Vorgehen sowie eine l?ckenlose Dokumentation der Untersuchungsergebnisse zu gew?hrleisten, sollte ein Knieuntersuchungsbogen verwendet werden. Die durch Anamnese und klinische Untersuchung gewonnenen Erkenntnisse und erhobenen Daten bilden die Basis, an die sich eine gezielte bildgebende Diagnostik anschlie?t. Die ?radiologischen Untersuchungsverfahren sind in einem ?eigenen Beitrag im folgenden Heft thematisiert (Brkic et al. 2013).