Survival curve and factors related to drainage during the first 24 h after total knee arthroplasty

Ares-Rodriguez, Oscar; Martínez, A; Fernandez, Alberto Hernandez; Castellet, Enric; Quilis, Antonio

doi:10.1007/s00167-008-0512-3

Cited by 7 publications

(7 citation statements)

References 19 publications

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“…Therefore, drainage tube could be removed after 24 hours. Ares-Rodriguez et al 21 found that the drains used in TKA can be removed within the first 18 hours with a high degree of safety and low risk of persistent bleeding by using a survival study, which was further confirmed in the same study by Ares et al 22 In our study, there was no statistically significant difference in the volume of total blood loss and Hb levels preoperatively and on POD1, POD3 in the three groups, the decrease of Hb between preoperative and POD1, POD3 as well. No patient received a blood transfusion.…”

Section: Discussionmentioning

confidence: 99%

Early Removal of Drainage Tube after Fast-Track Primary Total Knee Arthroplasty

Zhang

Huang

et al. 2016

J Knee Surg

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There is no consensus as to whether drainage tube should be used and how long it should remain in use after primary total knee arthroplasty (TKA). As fast-track (FT) program has been implemented in TKA, whether drainage tube could be removed early, and the ideal timing for removal after FT primary TKA has been a new topic. The purpose of this prospective cohort study was to evaluate the safety and feasibility of early removal of drainage tube when FT program was implemented in primary TKA. A total of 101 patients undergoing FT primary TKA were prospectively allocated into three groups. Patients in group A (31 patients) indwelled wound drainage tube for 6 hours after surgery while group B (34 patients) for 12 hours and group C (36 patients) for 18 hours. The knee circumference, resting and moving visual analogue score (VAS), hemoglobin (Hb), hematocrit, white blood count (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), interleukin-6 (IL-6), the volume of blood loss and drainage, and postoperative length of stay (LOS) among three groups were recorded and compared. There was no statistically significant difference in the volume of total and hidden blood loss among three groups ( > 0.05), but as the time of drainage prolonged, total volume of drainage and dominant blood loss increased gradually ( < 0.01). The knee circumference, the mean of resting and moving VAS, Hb, WBC, ESR, CRP, and IL-6 of three groups were similar preoperatively and on postoperative day 1 and 3 ( > 0.05), the decrease of Hb in the perioperative period and postoperative LOS as well. Early removal of wound drainage tube could drain the hematocele and reduce the risk of infection, and it doesn't increase the sense of pain, inflammatory reaction, limb swelling, and total blood loss. It's safe and feasible to remove the drainage tube within 6 to 12 hours after FT primary TKA.

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Section: Discussionmentioning

confidence: 99%

Early Removal of Drainage Tube after Fast-Track Primary Total Knee Arthroplasty

Zhang

Huang

et al. 2016

J Knee Surg

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“…In the present study, bleeding survival curves were used to assess the time at which drainage ceases to be productive (0 mL) and 0 mL during the next hour. 17 Bleeding survival curves define the hourly risk of bleeding until it ceases.…”

Section: Methodsmentioning

confidence: 99%

“…No drainage was maintained for more than 24 hours due to the previous studies regarding the survival curve of bleeding, which concluded that the drains ceased being productive beyond 16 hours. 17 Patients were 24 hours in recovery room where the same nursing staff performed the measurements at 1, 12, and 24 hours. To avoid bleeding bias between cemented arthroplasties, noncemented, or hybrids, 18 only patients with a cemented arthroplasty were included in the study.…”

Section: Methodsmentioning

confidence: 99%

Bleeding in Knee Arthroplasty: Age, Drained Volume, and Ischemia Time

et al. 2014

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Drainages in primary knee arthroplasty remain unclear. Our aim is to analyze variables that may affect bleeding in knee arthroplasty (age, drained volume, and ischemia time). We included 188 knee arthroplasties, divided into three groups: conventional approach for total knee arthroplasty (TKA), minimally invasive total knee arthroplasty (MIS), and unicompartmental knee arthroplasty (UNI). Main variables analyzed for the present study were age, drained volume, and ischemia time. Other recorded variables were operated knee, pre- and postoperative hematocrit, diagnosis, comorbidities, and transfusions required. No relationship between age and drained volume was observed. However, patients younger than 70 years presented a major rate of survival curve bleeding. A statistically significant difference was found between drained volume in UNI in contrast to TKA and MIS. There was a significant relationship between time and bleeding at 24 hours postoperative, observing that the greater the bleeding, the longer it would keep bleeding (log-rank, p < 0.001). No statistically significant difference was observed between ischemia time during surgery and a variation in the survival curve. In conclusion, there is a significant relationship between drained volume and time (24 hours). No relationship was found between age or ischemia time and drained volume.

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“…Moreover, blood loss is a surgical complication that should be especially aware of in at-risk patients such as those with cardiovascular or anemic problems. Although blood loss itself has been described in other orthopedic procedures, such as knee replacement or hip fractures [ 9 - 11 ], to our knowledge, the present manuscript is the first to describe its impact within hip arthroscopy.…”

Section: Introductionmentioning

confidence: 98%

“…Our hypothesis was that significant blood loss occurred following hip arthroscopy, described as a loss in hemoglobin and hematocrit values, as it has been described in other orthopedic procedures [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Pre- and Postoperative Hemoglobin and Hematocrit Levels in Hip Arthroscopy

Seijas¹,

Espinosa²,

Sallent³

et al. 2015

TOORTHJ

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Purpose : to assess the loss in hematocrit and hemoglobin, if any, 24 hours after hip arthroscopy.Methods : thirty-five patients were included. Laboratory tests including complete blood count and white blood cells were performed one week prior to surgery and 24 hours after. Surgical time, volume of saline perfusion and pump perfusion was also recorded.Results : mean preoperative hematocrit was 42.01% (4.63 SD), whereas mean postoperative hematocrit at 24 h decreased to 36.78% (SD 5.11) (p <0.021.). Mean preoperative hemoglobin was 14.23 g/dL (1.73 SD), and mean postoperative hemoglobin at 24 h decreased to 12.40 g/dL (SD 1.92) (p =0.03.). Platelets and white blood cells, as well as the remaining biochemical parameters showed no significant difference between preoperative and postoperative samples. Lost blood volume worked out with the logarithmic method for estimated blood loss was which 0.78 liters (SD 0.45). Lost blood volume taking into account, the red blood cell mass was also 0.78 liters (SD 0.45).Conclusion : a significant decrease in hemoglobin and hematocrit after hip arthroscopy was observed. Although patients did not show clinical signs of anemia or bleeding, blood loss should be considered when planning a hip arthroscopy, especially in patients at risk of anemia. According to our results, we recommend a postoperative control analysis at 24 h.Level of Evidence : level II, Diagnostic Study.

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Survival curve and factors related to drainage during the first 24 h after total knee arthroplasty

Cited by 7 publications

References 19 publications

Early Removal of Drainage Tube after Fast-Track Primary Total Knee Arthroplasty

Early Removal of Drainage Tube after Fast-Track Primary Total Knee Arthroplasty

Bleeding in Knee Arthroplasty: Age, Drained Volume, and Ischemia Time

Comparison of Pre- and Postoperative Hemoglobin and Hematocrit Levels in Hip Arthroscopy

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