Abstract
PurposeThe 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.MethodsRandomized 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.ResultsThree 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.ConclusionThe 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.
Highlights
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]
One study was a prospective clinical controlled trial, but not a randomized controlled trials (RCTs), and the general characteristics of patients were unclear [1]; one study was overlapping with another RCT [8]
Summary
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]. Some studies claimed that there was no difference in healing of wounds, postoperative blood transfusions, complications, or range of motion in primary TKA [2,3,4]. No meta-analyses based on bilateral TKA were conducted to evaluate the clinical efficacy and safety of drainage. 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
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