Non-drainage versus drainage in tourniquet-free knee arthroplasty: a prospective trial.

BACKGROUND: It is still unknown whether drainage is necessary and non-drainage is safe and acceptable after tourniquet-free total knee arthroplasty (TKA). We aim to investigate whether non-drainage use is accepted in TKA that is performed without a tourniquet.

METHODS: Clinical data of 80 adult patients who did or did not receive drainage in our centres from August 2015 to December 2015 were prospective investigated.

RESULTS: The drainage group exhibited reduced hidden blood loss (47.6 ± 43.6 mL versus 151.1 ± 97.1 mL, P < 0.001), less calf swelling (d1: 3.2% versus 5.2%, P = 0.02) and milder knee active pain (d3: 4.9 ± 1.9 versus 5.9 ± 1.2, P = 0.01; d5: 3.2 ± 1.6 versus 4.2 ± 1.5, P = 0.003) than the non-drainage group. However, the non-drainage group had higher haemoglobin level (d1: 112.1 ± 10.6 g/dL versus 106.1 ± 12.4 g/dL, P = 0.026; d3: 99.5 ± 9.6 g/dL versus 92.7 ± 13.1 g/dL, P = 0.011) and less haematopoietic medication usage (42.1% versus 66.6%, P = 0.03) in the initial postoperative period following TKA. Earlier postoperative time to ambulation (22.4 ± 12.3 h versus 30.1 ± 14.6 h, P = 0.01) and shorter length of stay (5.5 ± 1.2 days versus 6.3 ± 1.7 days, P = 0.02) were found in the non-drainage group.

CONCLUSION: It is practicable to abandon wound drainage in uncomplicated, primary, tourniquet-free TKA.