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Transfusion drains versus suction drains in total knee replacement: meta-analysis

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The use of autologous blood transfusion drains in orthopaedic surgery has been the subject of debate for several years. The aim of this meta-analysis was to review the use of autologous blood transfusion drains in total knee replacement.

Methods

The primary outcomes were as follows: the number of patients requiring homologous blood transfusion, pre-operative haemoglobin and post-operative haemoglobin days 5–7. The secondary outcome measures for the meta-analysis were drainage volume, length of hospital stay, average number of units transfused per patient, post-operative wound infection, and deep vein thrombosis.

Results

Eight randomised controlled trials met the inclusion criteria and were included in this analysis. Autologous transfusion drains were associated with a decrease in the number of patients requiring post-operative blood transfusion (pooled odds ratio = 0.36, 95% CI = 0.15–0.85, P = 0.02), the number of units transfused per patient (weighted mean difference = −0.84 (95% CI = −1.13 to −0.56), P < 0.0001), and length of hospital stay (weighted mean difference = −0.25 (95% CI = −0.48 to −0.01), P = 0.04).

Conclusion

The results of our study highlight both likely clinical and economic benefits within total knee replacement surgery. The clinical benefits of autologous transfusion drains in the total knee replacement surgery suggested by this meta-analysis include a reduced requirement for post-operative blood transfusion and a shorter length of hospital stay. However, further large-scale high-powered randomized controlled trials are recommended to further elucidate subtle effects of autologous drains on post-operative outcome following total knee replacement.

Level of evidence

II.

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Authors and Affiliations

  1. Department of Trauma and Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, 235 Euston Road, London, NW1 2BU, UK

    Sheraz R. Markar, Gareth G. Jones, Nicholas Segaren & Rahul V. Patel

  2. Department of General Surgery, Chelsea and Westminster NHS Foundation Trust, London, UK

    Alan Karthikesalingam

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  1. Sheraz R. Markar
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  2. Gareth G. Jones
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  3. Alan Karthikesalingam
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  4. Nicholas Segaren
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  5. Rahul V. Patel
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Correspondence to Sheraz R. Markar.

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Markar, S.R., Jones, G.G., Karthikesalingam, A. et al. Transfusion drains versus suction drains in total knee replacement: meta-analysis. Knee Surg Sports Traumatol Arthrosc 20, 1766–1772 (2012). https://doi.org/10.1007/s00167-011-1761-0

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  • DOI: https://doi.org/10.1007/s00167-011-1761-0

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