Comparison of complications in one-stage bilateral total knee arthroplasty with and without drainage
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RESEARCH ARTICLE
Open Access
Comparison of complications in one-stage bilateral total knee arthroplasty with and without drainage Ning Li†, Ming Liu†, Dan Wang, Mang He and Lei Xia*
Abstract Purpose: The aim of this meta-analysis was to compare the complication rates of one-stage bilateral total knee arthroplasty (TKA) with and without drainage in order to identify whether there was no clinical significance and the value of drainage. Methods: Randomized controlled trials (RCTs) based on bilateral TKA with and without drainage were identified via a search of PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Wanfang databases, and Google Scholar, which were published up to May 2014. Methodological quality was assessed by the Physiotherapy Evidence Database scale. After data extraction, we compared the outcomes using fixed-effects or random-effects models depending on the heterogeneity. Results: Three RCTs involving 125 one-stage bilateral TKA patients with an average follow-up of 14 months met the predetermined inclusion criteria. There were 56 total complications in TKA without drainage and 17 with drainage. Except for less erythema and ecchymosis around the wound in the drainage group, there were no statistical differences in wound healing, wound infection, swelling, and deep vein thrombosis in one-stage bilateral TKA with and without drainage. Conclusion: The current evidences confirm that both drainage and non-drainage have similar clinical value in one-stage bilateral TKA. However, the conclusion should be used with caution due to the limitations of the current study. Keywords: Drainage, One-stage, Bilateral, Total knee arthroplasty, Randomized controlled trials
Introduction Total knee arthroplasty (TKA) is a standardized highly successful procedure in treating late osteoarthritis (OA) and rheumatoid arthritis (RA) of knee joints. Drainage is frequently used with the purpose of preventing hematoma accumulation, decreasing the risk of infection, and delaying wound healing in TKA [1]. However, some studies claimed that there was no difference in healing of wounds, postoperative blood transfusions, complications, or range of motion in primary TKA [2-4]. What needs to be noted is that the above findings were based on unilateral TKA, and there may be possible influences
of age, sex, systemic disease, reaction to anticoagulants or other medications, and effort and differences in rehabilitation. Until now, no meta-analyses based on bilateral TKA were conducted to evaluate the clinical efficacy and safety of drainage. Therefore, it is necessary to have a latest, up-to-date meta-analysis to investigate this issue. In the current study, we performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to compare complication rates of one-stage bilateral TKA with and without drainage in order to identify the clinical significance and value of drainage.
* Correspondence: [email protected] † Equal contributors Department of Orthopedics, The First Affiliated Hospital of Zhengzhou Univer
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