Abstract

USE OF CLOSED SUCTION DRAIN AFTER PRIMARY TOTAL KNEE ARTHROPLASTY: AN OVERRATED PRACTICE

Wali Muhammad*, Maj. Gen. Suhail Amin, Muhammad Arsalan Azmat Swati, Zainullah Kakkar, Adeel Habib and Zeeshan Aslam

Abstract

Background: Knee osteoarthritis is a common presentation in an orthopedic setting. The most common procedure of knee is total knee replacement for severe conditions. After surgery, significant bleeding can occur subcutaneously and in intraarticular spaces, necessitating blood transfusions and their associated risks. Sodrain is normally placed after surgery. The use of suction drains in arthroplasties is still controversial. Objective: To compare the outcome of total knee arthroplasty with or without closed suction drain placed after surgery. Material and Methods: This randomized controlled trial was done at the department of Orthopedic Surgery, Combined Military Hospital, Rawalpindi for about 3 months. Eighty cases; 40 in both groups diagnosed with grade 3 & 4 knee osteoarthritis were enrolled and were randomly divided in two groups. In group A, suction tube was placed. In group B, no suction drain was placed. After surgery, patients were evaluated for drop in hemoglobin level, infection at drain site, pain and range of motion after a week. Patients will be discharged and total hospital stay was noted. Patients were evaluated for WOMAC and Oxford knee score of knee after 3 and 6 months. All the data was recorded in proforma. SPSS v. 22 was used to enter and analyses the data. Results: In drain group, the mean age of patients was 65.55 ± 8.63 years. In no drain group, the mean age of patients was 63.30 ± 9.03 years. In drain group, there were 18 (45.0%) male patients and 22 (55.0%) female patients. In no drain group, there were 21 (52.5%) male patients and 19 (47.5%) female patients. After one week of surgery, pain score was 3.70 ± 1.76 with drain and 1.90 ± 1.13 without drain (p-value < 0.05). The range of motion was 64.68 ± 9.39 vs. 69.90 ± 6.69, mean hospital stay of patients was 6.15 ± 1.98 vs. 4.98 ± 1.46 days, WOMAC score was 39.75 ± 5.99 vs. 45.30 ± 6.21 after 3 months, 51.18 ± 5.86 vs. 57.53 ± 7.31 after 6 months, mean Oxford Knee Score was 33.05 ± 5.48 vs. 35.55 ± 5.43 and 40.35 ± 6.29 vs. 43.88 ± 5.29 after 6 months of surgery (p-value < 0.05). Conclusion: Thus, there is no use of placing closed suction drains after surgery, however, the outcome was better and improved without drain.

Keywords: Closed Suction Drain, Primary Total Knee Arthroplasty, Pain, Hemoglobin, Blood Loss, Infection, Hospital Stay.