Outcomes of Drain Versus No Drain Following a Total Knee Joint Replacement

Background: The use of drains following total knee replacement (TKR) continues to remain debatable. We evaluated Haemoglobin (Hb) levels, drop in hematocrit levels, and wound complications to compare closed suction drains and no drains following TKR. Objective: To compare the outcome in TKR with and without placing a drain. Methods: This prospective interventional study conducted at the Department of Orthopaedic Surgery King Edward Medical University / Mayo Hospital Lahore between September 2019 and October 2022. A total of 79 cases were included in the study divided into 2 groups. At day 3 after TKR, Hemogram was performed and were compared to preoperative values. Secondary parameters e.g. length of hospital stay, 30-day reoperation rate, and superficial / deep infection were also measured. Results: A total of 79 patients were enrolled divided in group A (drain group) 43 patients and group B (No-drain group) 36 patients. The mean variation of Haematocrit in the drain group was 4.37% and 2.51% in No-drain group (p = 0.001). The mean Hemoglobin drop in the drain group was 1.8 grams/deciliters. On the other hand, 1.5 grams/deciliters of Hemoglobin were reduced in Group B (p <.001). The mean length of stay in patients with a drain was 3.6 ± 1.4 days while 2.8 ± 0.5 days were observed in patients without a drain (p=0.0017). Conclusion: When TKR is performed with drains, more blood loss and longer hospital stays were observed. The difference between the two procedures in terms of 30-day re-operation rate and wound complications was not significant.