Evaluation of outcomes of suction drainage in patients with haemophilic arthropathy undergoing total knee arthroplasty

• Published in: Haemophilia : the official journal of the World Federation of Hemophilia 2017-07, Vol.23 (4), p.e310-e315
• Main Authors: Mortazavi, S. M. J., Firoozabadi, M. A., Najafi, A., Mansouri, P.
• Format: Article
• Language: English
• Subjects: Adult; Arthroplasty (knee); Arthroplasty, Replacement, Knee - adverse effects; Blood transfusion; Case-Control Studies; Female; haemophilia; Hematoma; Hemophilia; Hemophilia A - complications; Humans; Joint Diseases - complications; Joint Diseases - surgery; Joint surgery; Knee; Male; Middle Aged; Pain; Postoperative Complications - etiology; Suction - adverse effects; suction drainage; Suctioning; Surgery; Surgical drains; total knee arthroplasty; Wounds
• ISSN: 1351-8216; 1365-2516
• DOI: 10.1111/hae.13224

Introduction Closed suction drainage has been extensively applied for orthopaedic procedures for the sake of avoiding fluid collections around the wound at the operated limb. Aim We believed that without application of suction drainage after total knee arthroplasty (TKA), the risk of infection and haematoma formation will not increase while the need for blood transfusion because of decreased blood loss will be lesser. Methods In a prospective randomized clinical trial from April 2010 to April 2014, 176 patients with haemophilia who underwent TKA were included. The study group consisted of 88 patients (108 knees), in which we did not insert suction drain and the control group included 88 patients (106 knees), in which drain was inserted at the end of the surgery. All patients underwent TKA via anterior knee incision and medial parapatellar approach. Results The mean follow‐up period of study group and control group was 21 ± 11 months vs. 20 ± 9 months consecutively (P = 0.54). The mean hospital stay was 13 ± 8 days vs. 14 ± 8 days in study and control group consecutively (P = 0.40). In both groups, the major part of improvement in clinical knee society score was due to increase in pain subset (mean increase of 42 vs. 39 points consecutively) and to a lesser extent to alleviation of flexion contracture (mean increase of 13 vs. 15 points consecutively). We observed no differences in the mean visual analogue scale (VAS) value between both groups. Average functional outcome in both groups improved during follow‐up visits. Conclusion We can conclude that there is no rationale for the use of drain after primary TKA.