Publications

Total knee arthroplasty (TKA) is a common surgery that reduces pain and significantly improves function and quality of life in
patients with knee disorders. Drains in TKR have been used historically for the theoretical benefit of preventing wound
hematoma, improving wound healing, and preventing infection. However, literature available to support these beliefs is sparse.
The purpose of our study was to assess if a patient undergoing a TKA would benefit from a wound drainage system.
Materials and Methods: Forty-two patients who underwent primary total knee replacement were included in the study; 23
knees in the drained group and 23 knees in the non-drained group. Both the groups had their coagulation workup done and
were given deep venous thrombosis prophylaxis as per protocol. A single wound drain system was placed in those patients
enrolled in the group with the drains. The outcome was compared between the two groups in terms of blood loss, transfusion
requirements, and progression of rehabilitation.
Results: The median drop in Hb was higher in the drained group (2.4 g/dL) compared to the non-drained group (1 g/dL),
which statistical analysis was found to be significant (P < 0.001). In the drained group, 65.2% of cases required transfusion,
whereas only 21.7% of cases in the non-drained group required transfusions. This was found to be statistically significant (P =
0.01). There was no significant difference in the visual analog score pain scores between the two groups in the post-operative
period (P = 0.109). The number of days required to achieve active straight leg raise and knee flexion of 90 degrees was also
more in the drained group, which was statistically significant (P < 0.05). The number of days taken for suture removal was
found to be higher in the drained group (mean = 12.71) versus the non-drained group (mean = 12.04), and this was found to
have statistical significance (P < 0.001).
Conclusions: In our study, the use of a closed drainage system in total knee replacement was associated with higher blood loss
postoperatively which essentially translated to an increased requirement of blood transfusions. The progression of wound
healing and achievement of post-operative rehabilitation goals were found to be better in the group without the wound drainage
system. Although post-operative pain remained to be the same when compared between both the groups.( Kindly review the
sentence as it seems to be incomplete.)
Keywords: Drainage, arthroplasty, total knee arthroplasty, blood transfusion, blood loss, wound healing.