Abstract
The use of postoperative drainage after total knee arthroplasty (TKA) in osteoarthritis patients was believed effective in decreasing hematoma, swelling, infection, and postoperative pain. However, the drainage can also cause infection due to retrograde migration of bacteria and impair early postoperative rehabilitation. The aim of the study was to compare pain intensity (VAS), hemoglobin level (Hb), range of motion (ROM), clinical results (KSS and WOMAC) in TKA patients with and without postoperative drainage.
This study was a prospective cohort study with samples of 98 patients at Dr. Hasan Sadikin Hospital from January 2017-January 2018. Simple random sampling with closed envelopes was used to determine TKA patients who undergone postoperative drainage and without drainage. The drainage group (K1) was 46 knees, the without drainage group (K2) was 52 knees. Both groups were compared based on VAS, Hb, ROM, KSS and WOMAC score on preoperative, 1st, 3rd, 5th day, 1st, 6th month, and 1 year postoperative.
VAS score on K1 group showed better results (3rd day VAS K2 1.77; K1 1.32; p-value 0.070; 5th day K2 1.46; K1 1.22; p-value 0.090; p-value < 0.1). Based on postoperative Hb, K2 group was better (K2: 11.74;K1: 10.835; p-value 0.06). ROM on K2 is better than K1 (1st day ROM K2 52.50; K1 42.85; p-value 0.64;3rd day K2 53.70; K1 47.24; p-value 0.832; 5th day K2 54, 60; K1 45.85; p-value 0.73). Based on the KSS and WOMAC score there were no significant differences between K2 and K1.
Our study concluded that there are several advantages for not using drainage after TKA in terms Hb, ROM on 1st, 3rd, and 5th day postoperative and early mobilization with weight bearing using walker at 3rd day postoperative. There is no rationale for the use of drain after primary TKA.