Drainage relieves pain without increasing post-operative blood loss in high tibial osteotomy: a prospective randomized c
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ORIGINAL PAPER
Drainage relieves pain without increasing post-operative blood loss in high tibial osteotomy: a prospective randomized controlled study Songlin Li 1 & Jianling Yang 2 & Christiaan Watson 3 & Qunshan Lu 1 & Meng Zhang 1 & Zhuang Miao 1 & Desu Luo 1 & Peilai Liu 1 Received: 21 December 2019 / Accepted: 4 March 2020 # SICOT aisbl 2020
Abstract Purpose Drainage is a common procedure in high tibial osteotomy (HTO), but the benefits of drainage during HTO remain poorly investigated. This study was designed to investigate the effect of drainage on blood loss and early functional recovery in HTO. Methods Altogether, 80 patients undergoing HTO were analyzed from August 2018 to September 2019. Patients were randomized into two groups: group A (drainage, n = 40) and group B (no drainage, n = 40). There were no intergroup differences in baseline parameters between the two groups, and the same surgical techniques and haemostatic methods were used. The mean follow-up time was 3.2 months. Blood loss and early functional recovery of the knee were examined post-operatively in both groups. Results The total post-operative blood loss was 253.34 ± 104.18 ml in group A and 222.51 ± 106.89 ml in group B. This difference was non-significant (p > 0.05). The post-operative haemoglobin and haematocrit differences between groups were also non-significant (p > 0.05). Post-operative visual analogue scale (VAS) pain scores and lower leg swelling were lower in group A than those in group B (p < 0.05), and the early range of motion of the knee joint was higher in group A than that in group B (p < 0.05). Group A had lower incidence rates of dressing seepage and incision complications than group B (p < 0.05). The differences in three month post-operative VAS and knee function scores were non-significant (p > 0.05). Conclusion Drainage in HTO does not increase patients’ total blood loss, but it can promote early knee function recovery by reducing post-operative pain, lower leg swelling, and the incidence of incision complications. Trial registration NCT-03954860 Keywords High tibial osteotomy . Drainage . Blood loss . Tranexamic acid
Introduction High tibial osteotomy (HTO) has become an effective method for the treatment of unicompartmental osteoarthritis of the knee with varus deformity [1]. In 1958, Jackson and Waugh first reported the use of HTO to treat knee arthritis with varus deformity [2]. After the improvement of surgical technique and internal fixation device, the incidence of complications * Peilai Liu [email protected] 1
Department of Orthopedics, Qilu Hospital of Shandong University, Jinan, Shandong, China
2
Department of Orthopedics, Laoling Hospital of traditional Chinese Medicine, Dezhou, Shandong, China
3
Shandong University Cheeloo College of Medicine, Jinan, Shandong, China
gradually decreased, and the surgical effect also improved and more affirmation [3, 4]. The main function of drainage is to drain the fluid accumulated in the surgical cavity, which reduces haematoma formation and thus reduces incisio
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