Suction drainage in total knee replacement does not influence early functional outcomes or blood loss: a randomized control trial

Abstract

Introduction The use of wound drainage following total knee arthroplasty (TKA) remains controversial. The purpose of this study was to evaluate the impact of suction drainage on early postoperative outcomes in patients who underwent TKA with concomitant administration of intravenous tranexamic acid (TXA). Method One hundred forty-six patients undergoing primary TKA with systematic intravenous TXA were prospectively selected and randomly divided into two groups. The first "Study group" (n = 67) received no suction drain and the second "Control" group (n = 79) had a suction drain. Perioperative hemoglobin levels, blood loss, complications, and length of hospital stay were assessed in both groups. Preoperative and postoperative range of motion and Knee Injury and Osteoarthritis Outcome Scores (KOOS) were also compared at a 6-week follow-up. Results The study group was found to have higher hemoglobin levels preoperatively and during the first two days following surgery, and no difference was found between the groups on the third day. No significant discrepancies at any time were found between groups in terms of blood loss, length of hospitalization, knee range of motion, and KOOS score. Complications requiring further treatment were observed in one patient from the study group and ten patients from the control group. Conclusion The use of suction drains after TKA with TXA did not alter early postoperative outcomes.

The Effects of Drainage Tube on Pain and Functional Recovery After Unicompartmental Knee Arthroplasty

“…However, patients without the drainage tube were more likely to experience blood stasis, tissue swelling, and blood extravasates. Anton et al 11 conducted a randomized controlled study on 146 patients 12 with total knee arthroplasty, and found no significant difference in blood loss, length of hospitalization, knee ROM, and KOOS score among patients with drainage tube placement. However, the value of a drainage tube after the UKA operation remains a controversy at present.…”

The emerging role of tranexamic acid and its principal target, plasminogen, in skeletal health

“…The results showed that the average fall of hemoglobin levels in the group treated by TXA treatment without drainages was less compared to the other two groups (8.0%, 14.4% and 10.9%, respectively) 59 . Therefore, currently drainages appear to be not necessary when TXA is administered in selected orthopedic surgeries including proximal fractures of the femur 58 , 59 and knee arthroplasty 60 , 61 . However, as TXA in orthopedic and emergency trauma surgeries is still applied off-label in most cases, its use, particularly systemically, must for now be limited to indications where excessive bleeding is expected to lead to clinical complications, and contraindications such as an acquired or genetic increased risk for thromboembolic events must be taken into consideration carefully on a case-to-case basis.…”

Early Biofilm Formation on the Drain Tip after Total Knee Arthroplasty Is Not Associated with Prosthetic Joint Infection: A Pilot Prospective Case Series Study of a Single Center

“…Conversely, the authors observed that drains were associated with a greater complication rate: infection and knee stiffness. Therefore, they concluded that the usage of a suction drain may not provide any benefit and may have adverse effects in the TKA procedure [6].…”