Top

Published in:

01-10-2009 | Original Paper

Conventional drainage versus four hour clamping drainage after total knee arthroplasty in severe osteoarthritis: a prospective, randomised trial

Authors: Justinas Stucinskas, Sarunas Tarasevicius, Algimantas Cebatorius, Otto Robertsson, Alfredas Smailys, Hans Wingstrand

Published in: International Orthopaedics | Issue 5/2009

Abstract

Total knee replacement in severe osteoarthritis usually requires extensive soft tissue releases often associated with considerable bleeding. In a prospective, randomised trial we compared postoperative conventional suction drainage versus four hour clamping drainage in 60 patients undergoing total knee arthroplasty for severe osteoarthritis. We compared blood loss, number of transfusions, postoperative complications and knee function and found significantly less postoperative blood loss through the drains (p < 0.001), and fewer blood transfusions (p = 0.09) were needed in the clamped group. We conclude that clamping drainage after total knee arthroplasty in severe osteoarthritis reduces blood loss through the drains and the need for blood transfusions.

Bernard L, Pron B, Vuagnat A, Gleizes V, Signoret F, Denormandie P, Si-Ali A, Perrone C, Feron JM, Gaillard JL, Groupe d’Etude sur l’Ostéite (2002) The value of suction drainage fluid culture during aseptic and septic orthopedic surgery: a prospective study of 901 patients. Clin Infect Dis 34:46–49PubMedCrossRef

Brecher ME, Monk T, Goodnough LT (1997) A standardized method for calculating blood loss. Transfusion 37:1070–1074PubMedCrossRef

Burnett S, Hart DJ, Cooper C et al (1994) A radiographic atlas of osteoarthritis. Springer, London

Clark CR, Spratt KF, Blondin M, Craig S, Fink L (2006) Perioperative autotransfusion in total hip and knee arthroplasty. J Arthroplasty 21:23–35PubMedCrossRef

Esler CNA, 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 85:215–217PubMedCrossRef

Fiebig E (1998) Safety of the blood supply. Clin Orthop Relat Res 357:6–18PubMedCrossRef

Han SH, Bahk JH, Kim JH, Lim YJ, Park CD, Do SH, Park YS (2006) The effect of esmolol-induced controlled hypotension in combination with acute normovolemic hemodilution on cerebral oxygenation. Acta Anaesthesiol Scand 50:863–868PubMedCrossRef

Holt BT, Parks NL, Engh GA et al (1997) Comparison of closed-suction drainage and no drainage after primary total knee arthroplasty. Orthopedics 20(12):1121–1124PubMed

Kiely N, Hockings M, Gambhir A (2001) Does temporary clamping of drains following knee arthroplasty reduce blood loss? A randomised controlled trial. Knee 8:325–327PubMedCrossRef

10.

Kim YH, Cho SH, Kim RS (1998) Drainage versus nondrainage in simultaneous bilateral total knee arthroplasties. Clin Orthop 347:188–193PubMed

11.

Müller U, Exadaktylos A, Roeder C, Pisan M, Eggli S, Jüni P (2004) Effect of a flow chart on use of blood transfusions in primary total hip and knee replacement: prospective before and after study. BMJ 328:934–938PubMedCrossRef

12.

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:1146–1152PubMed

13.

Prasad N, Padmanabhan V, Mullaji A (2005) Comparison between two methods of drain clamping after total knee arthroplasty. Arch Orthop Trauma Surg 125:381–384PubMedCrossRef

14.

Shen PC, Jou IM, Lin YT, Lai KA, Yang CY, Chern TC (2005) Comparison between 4-hour clamping drainage and nonclamping drainage after total knee arthroplasty. J Arthroplasty 20:909–913PubMedCrossRef

15.

Tsumara N, Yoshiya S, Chin T, Shiba R, Kohso K, Doita M (2006) A prospective comparison of clamping the drain or post-operative salvage of blood in reducing blood loss after total knee arthroplasty. J Bone Joint Surg Br 88:49–53PubMedCrossRef

16.

Walmsley PJ, Kelly MB, Hill RMF, Brenkel I (2005) A prospective, randomised, controlled trial of the use of drains in total hip arthroplasty. J Bone Joint Surg Br 87:1397–1401PubMedCrossRef

17.

Wittmann FW, Ring PA (1984) Blood loss associated with Ring uncemented total knee replacement: comparison between continuous and intermittent suction drainage. J R Soc Med 77:556–558PubMed

18.

Yamada K, Imaizumi T, Uemura M, Takada N, Kim Y (2001) Comparison between 1-hour and 24-hour drain clamping using diluted epinephrine solution after total knee arthroplasty. J Arthroplasty 16:458–462PubMedCrossRef

19.

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

Title: Conventional drainage versus four hour clamping drainage after total knee arthroplasty in severe osteoarthritis: a prospective, randomised trial
Authors: Justinas Stucinskas
Sarunas Tarasevicius
Algimantas Cebatorius
Otto Robertsson
Alfredas Smailys
Hans Wingstrand
Publication date: 01-10-2009
Publisher: Springer-Verlag
Published in: International Orthopaedics / Issue 5/2009
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-008-0662-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Conventional drainage versus four hour clamping drainage after total knee arthroplasty in severe osteoarthritis: a prospective, randomised trial

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 5/2009

Prevalence of femoroacetabular impingement in Asian patients with osteoarthritis of the hip

Arthroplasty or internal fixation for displaced femoral neck fractures: which is the optimal alternative for elderly patients? A meta-analysis

Hemilaminoplasty for the treatment of lumbar disc herniation

Treatment of supracondylar fractures of the humerus in children through an anterior approach is a safe and effective method

Pattern of limb amputation in a Kenyan rural hospital

Long-term results of scaphoid nonunion treated by intercalated bone grafting and Herbert’s screw fixation—a study of 49 patients for at least five years