title: The effect of drainage tube on bleeding and prognosis after total knee arthroplasty: a prospective cohort study.
abstract: BACKGROUND
  To evaluate the effect of drainage tube on prognosis after total knee arthroplasty (TKA) and explore an effective treatment with favorable prognosis.
  
  
  METHODS
  In a prospective study, 18 patients with TKA for the first time were included and randomly divided into three groups, group A (no placement of drainage tube), group B (negative pressure drainage), and group C (4 h clamping drainage). Intraoperative and postoperative blood loss, operation time, and the drainage volume were recorded and analyzed. Arthrocele, ecchymosis, and range of motion (ROM) were examined postoperatively. The degree of pain was scored by Visual Analog Scale (VAS) after 6, 12, and 24 h of operation. The complications were examined and HSS (hospital for special surgery) knee score was taken during the follow-up period.
  
  
  RESULTS
  There was no significant difference in operation time, total blood loss, intraoperative blood loss, and VAS score among three groups. Meanwhile, the hidden blood loss in group B was significantly decreased compared with group A (P = 0.0015). The postoperative drainage volume of group B was significantly increased compared with group C (P = 0.0002). No drainage increased the rate of arthrocele and ecchymosis. Compared with group A, ROM after 3 days of operation in groups B and C was significantly increased (P = 0.0357, P = 0.0372, respectively). During follow-up study, no deep infection or deep venous thrombosis was found.
  
  
  CONCLUSIONS
  After TKA, early clamping of the drainage tube reduced the bleeding loss without adverse effect on prognosis, which might be useful for clinical application in future.
authors.forename: Xiao-Han
authors.initials: XH
authors.lastname: Liu
authors.forename: Pei-Liang
authors.initials: PL
authors.lastname: Fu
authors.forename: Shi-Ying
authors.initials: SY
authors.lastname: Wang
authors.forename: Ya-Juan
authors.initials: YJ
authors.lastname: Yang
authors.affiliation: Department of Nursing, Changzheng Hospital, Second Military Medical University, No, 415 Fengyang Road, Shanghai 200003, China. lugd2006@sina.com.
authors.forename: Gen-Di
authors.initials: GD
authors.lastname: Lu
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D015331:Cohort Studies; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control*; D011446:Prospective Studies; D016896:Treatment Outcome
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