Non‐drainage versus drainage in tourniquet‐free knee arthroplasty: a prospective trial

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Wound drainage is an established routine procedure for orthopaedic surgeries, including total knee arthroplasty (TKA), to decrease haematoma formation in the joint cavity, and it is believed to reduce ecchymosis, erythema and wound infection.1 However, in recent years, the role of wound drainage following TKA is controversial. Many side effects of wound drainage are reported, such as increasing blood loss, developing retrograde infection, incurring additional nursing care and impeding early mobilization.2 Today, an increasing number of researchers support non‐drainage in an uncomplicated TKA.3
Furthermore, although tourniquet use is widely accepted, tourniquet‐related complications have been reported in the literature, including wound complications, thigh pain, limb swelling, nerve palsy, muscle myofibrils injury and venous thrombotic embolism.5 Considering these complications, increasing numbers of surgeons would prefer to operate without a tourniquet.6
However, for tourniquet‐free TKAs, there is little available data on whether drainage is necessary and non‐drainage is acceptable.9 Therefore, we conducted a randomized, controlled, perspective trial in which all the patients received primary tourniquet‐free TKA, with or without drainage. We hypothesized that not placing drainage is associated with less Hb decrease and a shorter length of stay, but there are no differences in knee range of motion (ROM) and complications.
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