Effect of Drain Placed in the Donor Site in the Early Postoperative Period after Arthroscopically Assisted Anterior Cruciate Ligament Reconstruction with Quadrupled Hamstring Tendons

Karahan, Mustafa; Erol, Bülent; Bekiroğlu, Nural; Uyan, Derya

doi:10.1177/0363546504271503

Cited by 15 publications

(12 citation statements)

References 24 publications

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“…Patients receiving a postoperative drain reported significantly higher VAS scores in one trial, 30 significantly lower VAS scores in another trial, 60 and no significant differences in VAS scores or analgesic consumption in a third trial 80 when compared to no drain. All 3 studies reported no complications associated with the use of drains.…”

Section: Surgical Technique (Table 8)mentioning

confidence: 90%

Pain Management After Outpatient Anterior Cruciate Ligament Reconstruction

et al. 2016

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Section: Surgical Technique (Table 8)mentioning

confidence: 90%

Pain Management After Outpatient Anterior Cruciate Ligament Reconstruction

et al. 2016

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“…5,6 Usually bleeding in case of ACL reconstruction occurs at intraarticular site as well as the graft donor site (hamstring or Bone patellar bone tendon graft) which adds to the formation of the knee effusion post operatively. 7 Various ways of reducing the bleeding and formation of effusion involves use of tourniquet, drains, or antifibrinolytic chemotherapeutic agents like Inj Tranexamic acid (TXA).…”

Section: Introductionmentioning

confidence: 99%

Assessing the effect of per operative intravenous injection of tranexamic acid in patients undergoing arthroscopic anterior cruciate ligament reconstruction

Pande¹,

Bhaskarwar²

2019

Int J Res Orthop

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Background: Anterior cruciate ligament (ACL) tear is a common injury sustained during contact games hampering performance of the sportsmen and thus requires promt management. Arthroscopic ACL reconstruction is commonly associated with postoperative knee effusion which affects the functional recovery. Various treatment modalities are available for managing effusion after ACL reconstruction, which are associated with various grades of success and side effects.Methods: This prospective interventional study was carried out at tertiary care Orthopaedic centre. It involved 48 Young male athletes with ACL tear managed subsequently by arthroscopic ACL reconstruction. Subjects were divided into Injection group and non injection group by randomization and blinding was ensured. Postoperative rehabilitation, prophylactic antibiotic and chemoprophylaxis for DVT was kept standardised for all patients. Patients were assessed for pain at operative site by visual analogue scale, effusion of knee by classification of Coupens and Yates and Lysholm knee scoring at 2nd, 6th and 12th week postoperatively.Results: During follow ups it was found that Injection group was having significant less incidence of effusion as compared with Non injection group; which also has reflected in functional recovery.Conclusions: It can be concluded that use of inj tranexamic acid preoperative dose in case of patients undergoing ACL reconstruction is efficient to reduce the knee effusion.

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“…5 Two common bleeding sources were identified mainly from intra-articular femoral or tibial tunnels and harvested graft sites. 6 Some surgeons advocate placing a drain at the surgical site prior to skin closure but multiple randomised controlled trials (RCTs) have proven this technique to be ineffective in the reduction of haemarthrosis in ACLR surgery. [6][7][8][9] Tranexamic acid (TXA) is a synthetic analogue of lysine, which acts as a competitive inhibitor at the plasminogen lysine-binding site to reduce postoperative bleeding.…”

Section: Introductionmentioning

confidence: 99%

“…6 Some surgeons advocate placing a drain at the surgical site prior to skin closure but multiple randomised controlled trials (RCTs) have proven this technique to be ineffective in the reduction of haemarthrosis in ACLR surgery. [6][7][8][9] Tranexamic acid (TXA) is a synthetic analogue of lysine, which acts as a competitive inhibitor at the plasminogen lysine-binding site to reduce postoperative bleeding. 10 It is believed that the use of TXA reduced postoperative blood loss and incidence of severe haemarthrosis in patients undergoing ACLR surgery.…”

Section: Introductionmentioning

confidence: 99%

Effect of tranexamic acid in arthroscopic anterior cruciate ligament repair: A systematic review and meta-analysis of randomised clinical trials

Tan

Lim

et al. 2021

J Orthop Surg (Hong Kong)

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Purpose: Perioperative blood loss remains a major challenge to surgeons in anterior cruciate ligament reconstruction (ACLR) surgery, despite of the introduction of minimally invasive approach. Tranexamic acid (TXA) is believed to reduce blood loss, which may minimise the complication of postoperative haemarthrosis with insufficient evidence on its effectiveness in ACLR. The primary aim of this study was to examine the effect of TXA on postoperative blood loss and other secondary outcomes in patients undergoing arthroscopic ACLR surgery. Method: PUBMED, EMBASE, MEDLINE and CENTRAL database were systematically searched from its inception until November 2020. All randomised clinical trials (RCTs) comparing TXA (intravenous or intra-articular) versus placebo in the arthroscopic ACLR surgery were included. Case series, case report and editorials were excluded. Results: Five RCTs comprising of a total of 580 patients (291 in TXA group, 289 in control group) were included for qualitative and quantitative meta-analysis. In comparison to placebo, TXA group was significantly associated with lower postoperative blood loss (mean difference (MD): −81.93 ml; 95% CI −141.80 to −22.05) and lower incidence of needing knee aspiration (odd ratio (OR): 0.19; 95% CI 0.08 to 0.44). Patients who randomised to TXA were also reported to have better range of movement (MD: 2.86; 95% CI 0.54 to 5.18), lower VAS Pain Score (MD: −1.39; 95% CI −2.54 to −0.25) and higher Lysholm Score (MD: 7.38; 95% CI 2.75 to 12.01). Conclusion: In this meta-analysis, TXA reduced postoperative blood loss with lesser incidence of needing knee aspiration along with better range of knee movement and Lysholm score in patients undergoing arthroscopic ACLR surgery.

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Effect of Drain Placed in the Donor Site in the Early Postoperative Period after Arthroscopically Assisted Anterior Cruciate Ligament Reconstruction with Quadrupled Hamstring Tendons

Abstract: Drain placement at the donor site after anterior cruciate ligament reconstruction gives more comfort to the patient and provides better flexion within the first week.

Cited by 15 publications

References 24 publications

Pain Management After Outpatient Anterior Cruciate Ligament Reconstruction

Pain Management After Outpatient Anterior Cruciate Ligament Reconstruction

Assessing the effect of per operative intravenous injection of tranexamic acid in patients undergoing arthroscopic anterior cruciate ligament reconstruction

Effect of tranexamic acid in arthroscopic anterior cruciate ligament repair: A systematic review and meta-analysis of randomised clinical trials

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