当前位置： SCI文献检索 > Orthopaedics & Traumatology-Surgery & Research期刊下所有文献 > Tourniquet and closed-suction drains in total knee arthroplasty. No beneficial effects on bleeding management and knee function at a higher cost.

Tourniquet and closed-suction drains in total knee arthroplasty. No beneficial effects on bleeding management and knee function at a higher cost.

Abstract：

BACKGROUND:Blood loss is a major concern in total knee arthroplasty (TKA) along with postoperative knee function. The present study explores the impact of tourniquet (T) and closed-suction drains (D) on these parameters in TKA. MATERIALS AND METHODS:A prospective study was conducted on 111 patients admitted for TKA. Subjects were divided into three groups: 36 in group T+D+, 42 in T-D+ and 33 in T-D- (where T+: prolonged tourniquet use, T-: cementation-only tourniquet, D+: closed-suction drain use, and D-: no drain). RESULTS:No statistically significant differences were observed among the three groups(T+D+, T-D+ and T-D-) for total blood loss, hemoglobin levels over the first six postoperative weeks and blood transfusion rate. Intraoperative bleeding was significantly reduced in T+ subjects compared to T- subjects (100±88mL vs. 279±235mL respectively, P<0.001), yet length of surgery was unaffected. Hidden blood loss was lower in D+ subjects compared to D- subjects (1161±554mL vs. 1667±554mL respectively, P<0.001), but was offset by the blood loss in the drains. Early postoperative range of motion (ROM) was superior in group T-D- compared to group T+D+. Nevertheless, postoperative week 6 ROM was similar between the 3 groups as was patient-reported postoperative pain. A patient with a drain represents 35min of extra nursing time and a total cost of $31.87 CAD. CONCLUSIONS:Whole-course tourniquet and closed-suction drain use in TKA do not yield beneficial results while increasing costs. Their use is therefore deemed unnecessary. LEVEL OF EVIDENCE:III (case control prospective study).

journal_name

Orthop Traumatol Surg Res

journal_title

Orthopaedics & traumatology, surgery & research : OTSR

authors

Yin D,Delisle J,Banica A,Senay A,Ranger P,Laflamme GY,Jun J,Fernandes J

doi

10.1016/j.otsr.2017.03.002

subject

Has Abstract

pub_date

2017-06-01 00:00:00

pages

583-589

issue

4

issn

1877-0568

pii

S1877-0568(17)30081-6

journal_volume

103

pub_type

杂志文章,多中心研究

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