title: The Use of a Closed-Suction Drain in Revision Knee Arthroplasty May Not Be Necessary: A Prospective Randomized Study.
abstract: The benefit of suction drains (SD) for the first 24-48 hours following joint replacement surgery is controversial. We aimed to determine if there is any difference in the early outcome of revision TKA when performed with, or without SD.
  
  
  
  83 cases indicated for revision knee arthroplasty were randomized to receive (42) or not receive (41) a deep intra-articlular drain. First-stage revisions for treating periprosthetic infection were excluded. Patients were statistically compared for demographic parameters, early complications and early knee functional outcome. The assessed outcomes included total blood loss, number of transfusions, fever and wound complication rate at 24 months follow-up. In addition, the change in knee society score at 12 weeks postoperatively was compared between the groups.
  
  
  
  There were no significant difference in demographic factors, wound complications, knee scores at 12 weeks and infection rate 24 months after surgery in either group. Average blood loss was 1856ml and 1533ml for the drain and no drain groups, respectively (P value=0.0470). The need for transfusion was significantly less in the no-drain group with an average of 0.15 unit/patient as compared to an average 0.37 unit/patient for the drain group (P value=0.0432).
  
  
  
  We were unable to find a point of superiority for using a drain for revision knee arthroplasty. Future studies with longer follow-up and larger population of patients are needed to make a valid conclusion.
authors.affiliation: Division of Orthopedic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada; Department of Orthopedic Surgery, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mansour
authors.initials: M
authors.lastname: Abolghasemian
authors.affiliation: Division of Orthopedic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
authors.forename: Todd W
authors.initials: TW
authors.lastname: Huether
authors.affiliation: Division of Orthopedic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
authors.forename: Leslie J
authors.initials: LJ
authors.lastname: Soever
authors.affiliation: Division of Orthopedic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Drexler
authors.affiliation: Division of Orthopedic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: MacDonald
authors.affiliation: Division of Orthopedic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
authors.forename: David J
authors.initials: DJ
authors.lastname: Backstein
mesh_terms: D000368:Aged; D001178:Arthroplasty; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001803:Blood Transfusion; D015992:Body Mass Index; D004322:Drainage / Q000295:instrumentation*; D004912:Erythrocytes / Q000166:cytology; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D011475:Prosthesis Failure; D012086:Reoperation; D013396:Suction; D013997:Time Factors; D014148:Tranexamic Acid / Q000627:therapeutic use; D016896:Treatment Outcome; D014945:Wound Healing; D014946:Wound Infection / Q000628:therapy
chemical_list: D014148:Tranexamic Acid
keywords: infection; knee; revision arthroplasty; suction drain; wound healing