Abstract
Suction drainage after primary total hip arthroplasties (THA) offers no benefits. Revision hip arthroplasties (RHA) are more demanding procedures and associated with greater blood loss compared to primary cases. There is still a lack of literature regarding the application of drainage in RHA. A total of 40 patients who underwent RHA were included in this prospective study. Simple randomization with an allocation ratio 1:1 was performed. Primary outcomes: total blood loss, hemoglobin drop, joint hematoma size in USG, infection. Secondary outcomes: blood transfusion rate, soft tissue hematomas, C-reactive protein levels, Visual Analogue Scale before and on 3rd day after surgery, Harris Hip Score before and 6 weeks after surgery. An intention to treat analysis was performed, with a 2-year follow up. Statistically significant differences between groups was in blood loss: drainage 1559.78 ml, non-drainage 1058.27 ml, (p = 0.029) and hemoglobin level on 1st day after surgery: drainage 10.58 g/dl, non-drainage 11.61 g/dl (p = 0.0496). In terms of the other analyzed parameters, statistical differences were not found. Our study revealed that the use of suction drainage may lead to higher blood loss in the early postoperative period. Further studies are needed to evaluate our results.
Highlights
Suction drainage after primary total hip arthroplasties (THA) offers no benefits
There are many scientific reports emphasizing that non-draining protocols are safe and effective in THA, there is still not sufficient evidence to support or discourage the routine use of suction drainage in Revision hip arthroplasties (RHA)
We found statistically significant lower volume of blood loss after surgery and haemoglobin drop at day 1 after surgery in no-drainage group
Summary
Suction drainage after primary total hip arthroplasties (THA) offers no benefits. Revision hip arthroplasties (RHA) are more demanding procedures and associated with greater blood loss compared to primary cases. Primary outcomes: total blood loss, hemoglobin drop, joint hematoma size in USG, infection. Revision hip arthroplasties (RHA) compared to primary procedures are more aggravating for both patients and surgeons Different procedures such as mobile components exchange, partial reimplantation of a cup or stem, and the most difficult cases of total prosthesis reimplantation are performed during the RHA. Blood loss after surgery is one of the major problems of RHA In these cases, drainage application prevents hematoma organization in the joint space and leads to its evacuation, which may subsequently cause a significant hemoglobin and hematocrit drop. The aim of this study was to evaluate the impact of suction drainage in terms of blood loss, hemoglobin drop, intra-articular size of the hematoma, and infection incidence after RHA
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