Drainage in primary cemented total knee arthroplasty required or not? A comparative study among northern Indian subjects

Background: Although there is no established evidence to support the use of drains in total knee arthroplasty (TKA), they are thought to reduce the formation of a haematoma and the incidence of deep infection. The aim of the study was planned to assess the need for drainage after total knee arthroplasty. Methods: For this comparative evaluation, a total of 100 patients were recruited into two groups. Group A consisted of 50 knees, in which drain was not used after TKA and a control group, group B with 50 knees, in which drain was inserted after TKA. Thus group A was study/ no drain group whereas group B was control/drain group. Pain intensity and analgesic intake were assessed as primary outcome factors. Visual analog scale (VAS) assessed pain intensity. Intake of analgesics was determined. Requirement for dressing reinforcement and the length of hospital stay were also evaluated. Results: Patients in the study group required approximately three times less opioids than patients in the control group (mean analgesia request amounted 0.16 and 0.45/patient, respectively). Overall mean pain score was higher in group B than in group A. In the study group every patient needed the dressing to be changed at an average 4.6±1.2 times during hospitalization compared with 5.3±1.2 times in the control group. Regarding differences in the pattern in the range of motion and length of hospital stay between the groups, there was no much difference. All the study subjects achieved full extension of the operated knee at discharge. Conclusions: On the basis of empirical evidences of this study it can be concluded that there is no rationale for the use of drain after primary cemented total knee arthroplasty. Use of drains in after primary cemented total knee arthroplasty has not much to offer.