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Subcutaneous versus Intraarticular Indwelling Closed Suction Drainage after TKA: A Randomized Controlled Trial

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

TKA can involve substantial bleeding, and the issue regarding whether vacuum drainage should be used during TKA continues to be debated as both methods have disadvantages.

Questions/purposes

We therefore asked whether subcutaneous indwelling vacuum drainage is advantageous over intraarticular indwelling vacuum drainage in terms of blood drainage, bleeding-related complications, and functional outcomes in primary TKA.

Patients and methods

We randomized 111 patients undergoing TKAs to have either a subcutaneous indwelling or an intraarticular indwelling catheter and compared the two groups for blood loss (hemoglobin decrease, transfusion requirements, hypotension episode), incidence of wound problems (requirements for dressing reinforcement, oozing, hematoma, hemarthrosis, ecchymosis, infection), and functional outcomes (recovery of motion arc, American Knee Society, WOMAC, and SF-36 scores) at 12 months after surgery.

Results

The mean vacuum drainage volume was less in the subcutaneous indwelling group than in the intraarticular indwelling group (140 mL versus 352 mL). The groups were similar in terms of decreases in hemoglobin after 2 and 5 days (3.0 versus 3.3 g/dL and 3.3 versus 3.7 g/dL, respectively), allogenic transfusion requirements (4% versus 11%), incidence of wound problems, and functional scores.

Conclusions

The data suggest subcutaneous indwelling closed-suction drainage is a reasonable alternative to intraarticular indwelling closed-suction drainage and to no suction drainage.

Level of Evidence

Level I, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Yeon Gwi Kang for help with motion arc measurements and maintenance of the database.

Author information

Authors and Affiliations

  1. Joint Reconstruction Center, Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea

    Eun Seok Seo MD, Su Won Yoon RN, In Jun Koh MD, Chong Bum Chang MD, PhD & Tae Kyun Kim MD, PhD

  2. Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea

    Chong Bum Chang MD, PhD & Tae Kyun Kim MD, PhD

Authors
  1. Eun Seok Seo MD
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  2. Su Won Yoon RN
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  3. In Jun Koh MD
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  4. Chong Bum Chang MD, PhD
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  5. Tae Kyun Kim MD, PhD
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Corresponding author

Correspondence to Tae Kyun Kim MD, PhD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution approved the human protocol used for this investigation, that all investigations were conducted in conformity with the ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at Seoul National University Bundang Hospital.

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Seo, E.S., Yoon, S.W., Koh, I.J. et al. Subcutaneous versus Intraarticular Indwelling Closed Suction Drainage after TKA: A Randomized Controlled Trial. Clin Orthop Relat Res 468, 2168–2176 (2010). https://doi.org/10.1007/s11999-010-1243-6

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  • DOI: https://doi.org/10.1007/s11999-010-1243-6

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