Can A Modified Robert Jones Bandage After Knee Arthroplasty Reduce Blood Loss? A Prospective Randomized Controlled Trial
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- Pinsornsak, P. & Chumchuen, S. Clin Orthop Relat Res (2013) 471: 1677. doi:10.1007/s11999-013-2786-0
A bulky compression dressing (Robert Jones bandage) is commonly used after TKA to reduce blood loss, pain, and swelling. However, it is unclear whether these dressings in fact reduce blood loss.
We compared postoperative blood loss, pain, knee swelling, and postoperative complications in two types of postoperative dressings after TKA: a modified Robert Jones dressing (MRJB) and a conventional wound dressing.
We conducted a prospective, randomized, controlled trial of 60 patients who underwent a unilateral primary TKA at our institution between November 2010 and July 2011. After wound closure, the patients were allocated into two groups. Thirty patients had the MRJB applied for 24 hours (Group 1) and 30 patients had a conventional wound dressing applied (Group 2). Postoperative hemorrhages in the vacuum drain, units of transfused blood, postoperative pain, knee swelling, and complications were assessed at 24 and 48 hours postoperatively.
We found no differences in the mean postoperative blood loss between the groups (Group 1, 418 mL versus Group 2, 467 mL). Blood transfusion amounts, postoperative pain, and knee swelling also were similar. Three patients in Group 1 experienced bruising and two patients in Group 2 also had bruising. One patient in Group 1 had a blister.
Although previous studies have shown reduced blood loss, pain, and knee swelling after application of a MRJB, we found no benefit of this bandage. Our data suggest a postoperative compression dressing is not necessary after primary TKAs.
Level of Evidence
Level I, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.