Chinese Journal of Tissue Engineering Research ›› 2018, Vol. 22 ›› Issue (23): 3751-3758.doi: 10.3969/j.issn.2095-4344.0286

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Efficacy and safety of drainage placement after primary total knee arthroplasty: a meta-analysis  

Tang Jian, Wang Ren-chong, Tang Zhong-fei, Li Bai-chuan   

  1. Department of Shoulder and Elbow Surgery, West Branch of Liuzhou Worker’s Hospital, Liuzhou 545001, Guangxi Zhuang Autonomous Region, China
  • Online:2018-08-18 Published:2018-08-18
  • About author:Tang Jian, Master, Attending physician, Department of Sports Medicine and Shoulder and Elbow Surgery, West Branch of Liuzhou Worker’s Hospital, Liuzhou 545001, Guangxi Zhuang Autonomous Region, China


BACKGROUND: Total knee arthroplasty (TKA) has been extensively applied in treatment of advanced knee joint disease, because it can effectively alleviate pain and reconstruct knee function. However, whether drainage is needed after TKA remains controversial.

OBJECTIVE: To evaluate the clinical curative effect and complications whether drainage placement after primary TKA by meta-analysis .
METHODS: PubMed, Embase, Cochrane Library, WanFang and CNKI databases were retrieved for the randomized controlled trials (RCTs) and quasi-randomized controlled trial (qRCTs) concerning whether drainage placement is needed after primary TKA. Data from the relevant studies were collected and analyzed by Revman 5.3 software. The outcome indexes included postoperative hemoglobin, blood transfusion rate, blood loss, allogeneic blood transfusion, Visual Analogue Scale score, range of motion of the knee joint, knee function score, complications, and deep venous thrombosis.
RESULTS AND CONCLUSION:(1) Twelve articles were included, including 9 RCT trials and 3 qRCT trials, involving 836 patients (429 cases of receiving drainage, 407 cases receiving no drainage). (2) The results of meta-analysis showed that the postoperative hemoglobin (MD=-7.20, 95% CI (-11.02, -3.38), P=0.000 2), blood transfusion rate (RR=1.93, 95 %CI (1.50, 2.49), P < 0.000 01), blood loss (MD=293.73, 95%CI (217.47, 369.99), P=0.000 01), and allogeneic blood transfusion (MD=284.70, 95%CI (77.64, 491.76), P=0.007) showed significant differences between groups. However, the postoperative 1st day Visual Analogue Scale score (MD=-0.02, 95%CI (-0.38, 0.34), P=0.92), the 7th day Visual Analogue Scale score (MD=-0.06, 95%CI (-0.27, 0.15), P=0.86), Knee Society Score (MD=0.10, 95%CI (-2.03, 2.23), P=0.93), range of motion of the knee joint (MD= -2.77, 95%CI (-8.27, 2.72) , P=0.32), postoperative complications (RR=0.77, 95%CI (0.57, 1.05), P=0.10), and deep venous thrombosis (RR=1.60, 95%CI (0.64, 3.96), P=0.31) did not differ significantly between groups. (3) In summary, drainage placement in primary TKA will increase the postoperative blood loss, blood transfusion rate and blood transfusion, but it will not improve the function of the knee, alleviate postoperative pain and postoperative complications, so postoperative drainage is not recommended.


Key words: Arthroplasty, Replacement, Knee, Drainage, Randomized Controlled Trial, Meta-Analysis

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