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Erschienen in: International Orthopaedics 4/2015

01.04.2015 | Review Article

The use of postoperative suction drainage in total knee arthroplasty: a systematic review

verfasst von: Mark Quinn, Andrea Bowe, Rose Galvin, Peter Dawson, John O’Byrne

Erschienen in: International Orthopaedics | Ausgabe 4/2015

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Abstract

Purpose

The purpose of this systematic review and meta-analysis of randomised controlled trials is to assess the effectiveness of no drainage when compared to drainage in total knee arthroplasty, in terms of recovery of knee flexion, reduction in swelling, length of hospital stay and haemoglobin levels following TKA.

Methods

Six randomised controlled trials were included.

Results

There is no significant difference between the individuals who receive a drain and those who do not across any of the measures examined (p < 0.05). This analysis demonstrates no statistical difference in ROM [mean difference 0.03° (95 %CI −1.51 to 1.45, p = 0.64, I2 = 0 %)].
, nor in knee circumference [mean difference 1.63 cm (95 % CI −1.07 – 4.34 cm, p = 0.34), [I2 = 0.12].

Conclusion

The finding raises the possibility that drains are not required to assist in recovery following TKA.
Literatur
1.
Zurück zum Zitat Mahomed NN, Barrett J, Katz JN, Baron JA, Wright J, Losina E (2005) Epidemiology of total knee replacement in the United States Medicare population. J Bone Joint Surg (Am) 87:1222–1228CrossRef Mahomed NN, Barrett J, Katz JN, Baron JA, Wright J, Losina E (2005) Epidemiology of total knee replacement in the United States Medicare population. J Bone Joint Surg (Am) 87:1222–1228CrossRef
3.
Zurück zum Zitat NIH (2003) NIH consensus statement on total knee replacement. NIH Consensus Statements. Dec 8–10;20(1):1–34 NIH (2003) NIH consensus statement on total knee replacement. NIH Consensus Statements. Dec 8–10;20(1):1–34
4.
Zurück zum Zitat Waugh TB, Stinchfield FE (1961) Suction drainage of orthopaedic wounds. J Bone Joint Surg Am 43-A:939–946PubMed Waugh TB, Stinchfield FE (1961) Suction drainage of orthopaedic wounds. J Bone Joint Surg Am 43-A:939–946PubMed
5.
Zurück zum Zitat Parker MJ, Livingstone V, Clifton R, McKee A (2007) Closed suction surgical wound drainage after orthopaedic surgery. Cochrane Database Syst Rev (3):CD001825 Parker MJ, Livingstone V, Clifton R, McKee A (2007) Closed suction surgical wound drainage after orthopaedic surgery. Cochrane Database Syst Rev (3):CD001825
6.
Zurück zum Zitat Minnema B, Vearncombe M, Augustin A, Gollish J, Simor AE (2004) Risk factors for surgical-site infection following primary total knee arthroplasty. Infect Control Hosp Epidemiol 25(6):477–480CrossRefPubMed Minnema B, Vearncombe M, Augustin A, Gollish J, Simor AE (2004) Risk factors for surgical-site infection following primary total knee arthroplasty. Infect Control Hosp Epidemiol 25(6):477–480CrossRefPubMed
7.
Zurück zum Zitat Overgaard S, Thomsen NO, Kulinski B, Mossing NB (1993) Closed suction drainage after hip arthroplasty. Prospective study of bacterial contamination in 81 cases. Acta Orthop Scand 64(4):417–420CrossRefPubMed Overgaard S, Thomsen NO, Kulinski B, Mossing NB (1993) Closed suction drainage after hip arthroplasty. Prospective study of bacterial contamination in 81 cases. Acta Orthop Scand 64(4):417–420CrossRefPubMed
8.
Zurück zum Zitat Corpe RS, Gallentine JW, Young TR, Steflik DE, Rectinwald EJ, Kusuma S (2000) Complications in total knee arthroplasty with and without surgical drainage. J South Orthop Assoc Fall 9(3):207–212 Corpe RS, Gallentine JW, Young TR, Steflik DE, Rectinwald EJ, Kusuma S (2000) Complications in total knee arthroplasty with and without surgical drainage. J South Orthop Assoc Fall 9(3):207–212
9.
Zurück zum Zitat Omonbude D, El Masry MA, O’Connor PJ, Grainger AJ, Allgar VL, Calder SJ (2010) Measurement of joint effusion and haematoma formation by ultrasound in assessing the effectiveness of drains after total knee replacement: A prospective randomised study. J Bone Joint Surg (Br) 92(1):51–55CrossRef Omonbude D, El Masry MA, O’Connor PJ, Grainger AJ, Allgar VL, Calder SJ (2010) Measurement of joint effusion and haematoma formation by ultrasound in assessing the effectiveness of drains after total knee replacement: A prospective randomised study. J Bone Joint Surg (Br) 92(1):51–55CrossRef
10.
Zurück zum Zitat Esler CN, Blakeway C, Fiddian NJ (2003) The use of a closed-suction drain in total knee arthroplasty. A prospective, randomised study. J Bone Joint Surg (Br) 85(2):215–217CrossRef Esler CN, Blakeway C, Fiddian NJ (2003) The use of a closed-suction drain in total knee arthroplasty. A prospective, randomised study. J Bone Joint Surg (Br) 85(2):215–217CrossRef
11.
Zurück zum Zitat Jenny J-Y, Boeri C, Lafare S (2001) No drainage does not increase the complication risk after total knee prosthesis implantation: a prospective, comparative, randomised study. Knee Surg Sports Traumatol Arthrosc 9:299–301CrossRefPubMed Jenny J-Y, Boeri C, Lafare S (2001) No drainage does not increase the complication risk after total knee prosthesis implantation: a prospective, comparative, randomised study. Knee Surg Sports Traumatol Arthrosc 9:299–301CrossRefPubMed
12.
Zurück zum Zitat Adalberth G, Byström S, Kolstad K, Mallmin H, Milbrink J (1998) Postoperative drainage of knee arthroplasty is not necessary: a randomized study of 90 patients. Acta Orthop Scand 69(5):475–478CrossRefPubMed Adalberth G, Byström S, Kolstad K, Mallmin H, Milbrink J (1998) Postoperative drainage of knee arthroplasty is not necessary: a randomized study of 90 patients. Acta Orthop Scand 69(5):475–478CrossRefPubMed
13.
Zurück zum Zitat Kim YH, Cho SH, Kim RS (1998) Drainage versus nondrainage in simultaneous bilateral total knee arthroplasties. Clin Orthop Relat Res 347:188–193PubMed Kim YH, Cho SH, Kim RS (1998) Drainage versus nondrainage in simultaneous bilateral total knee arthroplasties. Clin Orthop Relat Res 347:188–193PubMed
14.
Zurück zum Zitat Holt BT, Parks NL, Engh GA, Lawrence JM (1997) Comparison of closed-suction drainage and no drainage after primary total knee arthroplasty. Orthopedics 20(12):1121–1124, discussion 1124–5PubMed Holt BT, Parks NL, Engh GA, Lawrence JM (1997) Comparison of closed-suction drainage and no drainage after primary total knee arthroplasty. Orthopedics 20(12):1121–1124, discussion 1124–5PubMed
15.
Zurück zum Zitat Parker MJ, Roberts CP, Hay D (2004) Closed suction drainage for hip and knee arthroplasty. A meta-analysis. J Bone Joint Surg Am 86-A(6):1146–1152PubMed Parker MJ, Roberts CP, Hay D (2004) Closed suction drainage for hip and knee arthroplasty. A meta-analysis. J Bone Joint Surg Am 86-A(6):1146–1152PubMed
16.
Zurück zum Zitat Clifton R, Haleem S, McKee A, Parker MJ (2008) Closed suction surgical wound drainage after hip fracture surgery: a systematic review and meta-analysis of randomised controlled trials. Int Orthop 32(6):723–727CrossRefPubMedCentralPubMed Clifton R, Haleem S, McKee A, Parker MJ (2008) Closed suction surgical wound drainage after hip fracture surgery: a systematic review and meta-analysis of randomised controlled trials. Int Orthop 32(6):723–727CrossRefPubMedCentralPubMed
18.
Zurück zum Zitat Mengal B, Aebi J, Rodriguez A, Lemaire R (2001) A prospective randomized study of wound drainage versus non-drainage in primary total hip or knee arthroplasty. Rev Chir Orthop Reparatrice Appar Mot 87(1):29–39PubMed Mengal B, Aebi J, Rodriguez A, Lemaire R (2001) A prospective randomized study of wound drainage versus non-drainage in primary total hip or knee arthroplasty. Rev Chir Orthop Reparatrice Appar Mot 87(1):29–39PubMed
19.
Zurück zum Zitat Cobb JP (1990) Why use drains? J Bone Joint Surg (Br) 72:993–995 Cobb JP (1990) Why use drains? J Bone Joint Surg (Br) 72:993–995
20.
Zurück zum Zitat Canty SJ, Shepard GJ, Ryan WG, Banks AJ (2003) Do we practice evidence based medicine with regard to drain usage in knee arthroplasty? Results of a questionnaire of BASK members. Knee 10(4):385–387CrossRefPubMed Canty SJ, Shepard GJ, Ryan WG, Banks AJ (2003) Do we practice evidence based medicine with regard to drain usage in knee arthroplasty? Results of a questionnaire of BASK members. Knee 10(4):385–387CrossRefPubMed
21.
22.
Zurück zum Zitat Saleh K, Olson M, Resig S, Bershadsky B, Kuskowski M, Gioe T, Robinson H, Schmidt R, McElfresh E (2002) Predictors of wound infection in hip and knee joint replacement: results from a 20 year surveillance program. J Orthop Res 20(3):506–515CrossRefPubMed Saleh K, Olson M, Resig S, Bershadsky B, Kuskowski M, Gioe T, Robinson H, Schmidt R, McElfresh E (2002) Predictors of wound infection in hip and knee joint replacement: results from a 20 year surveillance program. J Orthop Res 20(3):506–515CrossRefPubMed
23.
Zurück zum Zitat Zamora-Navas P, Collado-Torres F, de la Torre-Solís F (1999) Closed suction drainage after knee arthroplasty. A prospective study of the effectiveness of the operation and of bacterial contamination. Acta Orthop Belg 65(1):44–47PubMed Zamora-Navas P, Collado-Torres F, de la Torre-Solís F (1999) Closed suction drainage after knee arthroplasty. A prospective study of the effectiveness of the operation and of bacterial contamination. Acta Orthop Belg 65(1):44–47PubMed
24.
Zurück zum Zitat Greidanus NV, Peterson RC, Masri BA, Garbuz DS (2011) Quality of life outcomes in revision versus primary total knee arthroplasty. J Arthroplasty 26(4):615–620 Greidanus NV, Peterson RC, Masri BA, Garbuz DS (2011) Quality of life outcomes in revision versus primary total knee arthroplasty. J Arthroplasty 26(4):615–620
25.
Zurück zum Zitat Cao L, Ablimit N, Mamtimin A, Zhang KY, Li GQ, Li G, Peng LB (2009) Comparison of no drain or with a drain after unilateral total knee arthroplasty: a prospective randomized controlled trial. Zhonghua Wai Ke Za Zhi 47(18):1390–1393PubMed Cao L, Ablimit N, Mamtimin A, Zhang KY, Li GQ, Li G, Peng LB (2009) Comparison of no drain or with a drain after unilateral total knee arthroplasty: a prospective randomized controlled trial. Zhonghua Wai Ke Za Zhi 47(18):1390–1393PubMed
26.
Zurück zum Zitat Lin J, Fan Y, Chang X, Wang W, Weng XS, Qiu GX (2009) Comparative study of one stage bilateral total knee arthroplasty with or without drainage. Zhonghua Yi Xue Za Zhi 89(21):1480–1483PubMed Lin J, Fan Y, Chang X, Wang W, Weng XS, Qiu GX (2009) Comparative study of one stage bilateral total knee arthroplasty with or without drainage. Zhonghua Yi Xue Za Zhi 89(21):1480–1483PubMed
27.
Zurück zum Zitat Tao K, Wu HS, Li XH, Qian QR, Wu YL, Zhu YL, Chu XB, Xu CM (2006) The use of a closed-suction drain in total knee arthroplasty: a prospective, randomized study. Zhonghua Wai Ke Za Zhi 44(16):1111–1114PubMed Tao K, Wu HS, Li XH, Qian QR, Wu YL, Zhu YL, Chu XB, Xu CM (2006) The use of a closed-suction drain in total knee arthroplasty: a prospective, randomized study. Zhonghua Wai Ke Za Zhi 44(16):1111–1114PubMed
28.
Zurück zum Zitat Martin A, Prenn M, Spiegel T, Sukopp C, von Strempel A (2004) Relevance of wound drainage in total knee arthroplasty—a prospective comparative study. Z Orthop Ihre Grenzgeb 142(1):46–50CrossRefPubMed Martin A, Prenn M, Spiegel T, Sukopp C, von Strempel A (2004) Relevance of wound drainage in total knee arthroplasty—a prospective comparative study. Z Orthop Ihre Grenzgeb 142(1):46–50CrossRefPubMed
29.
Zurück zum Zitat Seyfert C, Schulz K, Pap G (2002) The influence of the drain suction in knee arthroplasty. [Article in German] Zentralbl Chir 127(10):886–889 Seyfert C, Schulz K, Pap G (2002) The influence of the drain suction in knee arthroplasty. [Article in German] Zentralbl Chir 127(10):886–889
Metadaten
Titel
The use of postoperative suction drainage in total knee arthroplasty: a systematic review
verfasst von
Mark Quinn
Andrea Bowe
Rose Galvin
Peter Dawson
John O’Byrne
Publikationsdatum
01.04.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 4/2015
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-014-2455-2

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