A Comparative Study of Subcutaneous versus Intra-Articular Indwelling Closed Suction Drainage after Total Knee Arthroplasty

Young-Joon Choi; Ki-Won Lee; Hyun-Il Lee; Wan-Jong Cho; Do-Yon Hwang; Sang-Jun Shim; Hyung-Kwon Cho

doi:10.4055/jkoa.2015.50.4.313

Journal List > J Korean Orthop Assoc > v.50(4) > 1013386

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Choi, Lee, Lee, Cho, Hwang, Shim, and Cho: A Comparative Study of Subcutaneous versus Intra-Articular Indwelling Closed Suction Drainage after Total Knee Arthroplasty

Original Article

Journal of the Korean Orthopaedic Association 2015; 50(4): 313-319.

Published online: 24 August 2015

DOI: https://doi.org/10.4055/jkoa.2015.50.4.313

A Comparative Study of Subcutaneous versus Intra-Articular Indwelling Closed Suction Drainage after Total Knee Arthroplasty

Young-Joon Choi, M.D., Ki-Won Lee, M.D., Hyun-Il Lee, M.D., Wan-Jong Cho, M.D., Do-Yon Hwang, M.D., Sang-Jun Shim, M.D., Hyung-Kwon Cho, M.D.

Department of Orthopaedic Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.

Correspondence to: Hyun-Il Lee, M.D. Department of Orthopaedic Surgery, Gangneung Asan Hospital, 38 Bangdong-gil, Sacheon-myeon, Gangneung 25440, Korea. TEL: +82-33-610-3243, FAX: +82-33-641-8050, hyunil@gnah.co.kr

Received 15 March 2015 Revised 21 April 2015 Accepted 23 April 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The aim of this study was to compare the drainage amount, total blood loss, and clinical results between two different positions of suction drainage after total knee arthroplasty.

Materials and Methods

A total of 100 patients who underwent one stage bilateral total knee arthroplasty were enrolled. In experiment 1 with 50 patients, we compared the drainage amount, pain, range of motion, and complications of the leg whose suction drain was inserted into the joint cavity with those of the contralateral leg whose suction drain was inserted in subcutaneous tissue. Another 50 patients of experiment 2 had suction drainage in the joint cavity of both legs and the total blood loss (sum of drainage output, exudates, and hematoma of subcutaneous tissue and joint) was calculated and compared with that of experiment 1.

Results

In experiment 1, the drainage amount was less in the leg with suction drainage in subcutaneous tissue compared with the contralateral leg with suction drainage in the joint cavity (p<0.001). However, the postoperative joint pain was significantly different only on post-operative day 2 between two legs. In experiment 2, there was no significant difference in the total blood loss between the two groups.

Conclusion

Although the drainage amount was less in the leg whose suction drain was kept in subcutaneous tissue compared with the contralateral leg whose suction drain was in the joint cavity, the total blood loss and the clinical results were not significantly different according to the position of the suction drain. Therefore, we can conclude that the subcutaneous position of the suction drain did not yield superior results.

Keywords: knee, total knee arthroplasy, suction drainage, subcutaneous tissue

Figures and Tables

Figure 1

Placement of either the intra-articular indwelling (A) or the subcutaneous indwelling drain (B) is shown on the lateral X-ray.

Figure 2

Placement of either the intraarticular (A) or subcutaneous closed suction drainage system (B) is shown in a medical photo.

Table 1

Demographic Data of Patients in Experiment 1 and 2 Groups

Values are presented as percent only or mean±standard deviation.

^*Patients in the experiment 1 group had subcutaneous drainage in one knee and intra-articular drainage in the contralateral knee. ^†Patients in the experiment 2 group had intra-articular drainage in both knees.

Table 2

Comparisons of Postoperative Outcomes for Intra-Articular and Subcutaneous Groups

Values are presented as mean±standard deviation or number only. ^*Bold case indicates p-value less than 0.05. ^†The value indicates average day when patients could actively raise their leg with full extension of knee (straight leg raising test) over 45°. POD, postoperative day.

Table 3

Comparison of Variables between Different Implants

Values are presented as mean±standard deviation. POD, postoperative days.

Notes

^{CONFLICTS OF INTEREST} The authors have nothing to disclose.

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