title: Closed Suction Drainage Is Not Necessary for Total Knee Arthroplasty: A Prospective Study on Simultaneous Bilateral Surgeries of a Mean Follow-Up of 5.5 Years.
abstract: BACKGROUND
  Closed suction drainage has been widely used for orthopedic surgeries including total knee arthroplasty (TKA) to prevent fluid collections at the operative site such as blood around the wound. However, it is still controversial whether suction drainage is necessary for TKA. The present study aimed to clarify the need for suction drainage by assessing short-term and long-term clinical outcomes of simultaneous bilateral TKA.
  
  
  METHODS
  Our subjects were 63 patients (126 knees) who underwent simultaneous bilateral TKA using a cemented posterior stabilized prosthesis, classified into 3 groups: 20 patients with a closed suction drain on both sides (bilateral group), 22 patients with a closed suction drain on one side and no drain on the other side (unilateral group), and 21 patients with no drain (no-drainage group). Short- and long-term clinical outcomes were evaluated.
  
  
  RESULTS
  Mean hemoglobin drop on the day after surgery was significantly greater in the bilateral group (2.2 g/dL, P = .038) and unilateral group (2.2 g/dL, P = .045) compared with the no-drainage group (1.5 g/dL). The incidence of short-term and long-term complications was not significantly different between knees with drainage and those without drainage. In side-to-side comparisons, no significant differences were found in knee extension, flexion, or circumference in the unilateral group. In group comparisons, we found no significant differences in clinical outcomes between the bilateral group and no-drainage group, either.
  
  
  CONCLUSIONS
  These findings suggest closed suction drainage is not necessary after TKA with cemented posterior-stabilized prostheses.
authors.affiliation: Department of Orthopaedic Surgery, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan. Electronic address: watanabe.orj@tmd.ac.jp.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Orthopaedic Surgery, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Muneta
authors.affiliation: Department of Orthopaedic Surgery, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Yagishita
authors.affiliation: Department of Orthopaedic Surgery, Kameda Medical Center, Kamogawa, Chiba, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Hara
authors.affiliation: Department of Orthopaedic Surgery, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Koga
authors.affiliation: Department of Orthopaedic Surgery, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Sekiya
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016059:Range of Motion, Articular; D013396:Suction; D016896:Treatment Outcome
keywords: blood loss; management; results; suction drainage; total knee arthroplasty