A Comparison of the Postoperative Complications between Two Drainage Methods after Total Knee Arthroplasty

Abstract

Background: The role of wound drainage after total knee arthroplasty is still considered controversial as although<br />closed drainage systems have been believed to be effective in decreasing the post-operative complications, they could<br />also facilitate the bleeding and increase the rate of transfusion and infection. We have conducted the current study to<br />compare the outcomes superficial subcutaneous, one deep, and two deep drain techniques after total knee arthroplasty.<br />Methods: Between 2014 and 2015 sixty consecutive patients were prospectively selected and underwent primary<br />total knee arthroplasty. Patients randomized to receive one superficial, one deep and two deep drains at the end of<br />operation. Tourniquet was used and opened at the end of the surgery after dressing. Patients were studied for volume<br />of blood loss, hemoglobin drop, number of transfusion, and any complications. Knee range of motion and diameter<br />were measured and compared with contralateral side in all cases at the end of the third day.<br />Results: There was no statistical difference regarding red blood cell volume loss, Hb drop, and transfusion rate between<br />groups. Patients in one superficial group had the most sever post-operative ecchymosis. Knee flexion and swelling<br />were the same in all groups. Patients in one superficial drain group had the worst VAS for the pain. Need for early<br />blood transfusion was significantly higher in two deep drain group. In one deep drain group returned back to operating<br />room for sever hemarthrosis and wound dehiscence was occurred in a patient. One patient in one deep group had also<br />developed mild thrombo-emboli.<br />Conclusion: Regarding the blood volume loss after total knee arthroplasty there is no difference between<br />superficial drainage and even more effective intra-articular techniques. Outcome and complication rates are the<br />same.