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Evidence-Based Orthopaedics   |    
A Closed-Suction Drain Was Not Beneficial in Knee Arthroplasty with Cement

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For correspondence: Mr. C.N.A. Esler, Department of Trauma and Orthopaedic Surgery, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK
Source of funding: Not stated.
Esler CNA, Blakeway C, Fiddian NJ. The Use of a Closed-Suction Drain in Total Knee Arthroplasty: A Prospective, Randomised Study.
J Bone Joint Surg Br
. 2003 Mar;85: 215-7.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2003 Nov 01;85(11):2257-2257
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Extract

Question: In patients having primary total knee arthroplasty, how effective is a deep closed-suction drain compared with no drain?Design: Randomized (unclear allocation concealment), unblinded, controlled trial with 10-day follow-up.Setting: A university hospital in Leicester, United Kingdom.Patients: 100 patients (mean age, 73 years; 55% women) who were having primary total knee replacement. Follow-up was complete.Intervention: Patients were allocated to insertion of 1 deep drain (Medinorm 600 System, 1/8, Quierschied, Germany) (n = 50) or no drain (n = 50) immediately before closure of the wound. All other operative procedures were the same in the 2 groups: a cemented posterior-cruciate-retaining prosthesis (PFC; Johnson and Johnson, Bracknell, UK) was implanted, and a tourniquet was used until the dressings were in place. Above-the-knee graduated compression stockings and aspirin (300 mg, once daily) were used for antithrombotic prophylaxis. The dressings were left for 48 hours unless they became saturated with blood or caused discomfort or constriction. Patients were mobilized after 24 hours, and the drain was removed after 48 hours.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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