Effect of Hemovac Drain Removal on Early Outcomes After Total Knee Arthroplasty

Effect of Timing of Hemovac Drain Removal on Early Outcomes After Total Knee Arthroplasty

This study aims to evaluate whether the timing of Hemovac drain removal affects early clinical outcomes after primary total knee arthroplasty (TKA). Hemovac drains are commonly used after TKA to reduce postoperative bleeding and swelling; however, the optimal timing for drain removal remains controversial.

In this prospective observational cohort study, patients undergoing primary TKA for knee osteoarthritis will be divided into two groups according to routine clinical practice: those whose drain is removed before the first postoperative rehabilitation session and those whose drain is removed after the first rehabilitation session.

The primary outcomes include the rate of postoperative hemarthrosis, early postoperative complications, and length of hospital stay. Secondary outcomes include postoperative pain levels and functional outcomes. The results of this study may help optimize postoperative management strategies following total knee arthroplasty.

Study Overview

• Status: Completed
• Conditions: Knee Osteoarthritis; Total Knee Arthroplasty

Detailed Description

Total knee arthroplasty (TKA) is a widely performed surgical procedure for the treatment of advanced knee osteoarthritis. Postoperative management often includes the use of closed suction drains, such as Hemovac systems, to reduce hematoma formation and wound complications. However, the necessity and optimal timing of drain removal remain subjects of debate.

This prospective observational cohort study is designed to compare early clinical outcomes associated with two different timings of Hemovac drain removal following primary TKA. Patients who undergo primary TKA at a single tertiary care center will be enrolled prospectively. According to routine postoperative practice, patients will be allocated into two groups: drain removal before the first postoperative rehabilitation session or drain removal after completion of the first rehabilitation session.

All patients will receive standardized surgical techniques, anesthesia protocols, postoperative care, and rehabilitation programs. Data will be collected prospectively. Primary outcomes include postoperative hemarthrosis, early postoperative complications, and length of hospital stay. Secondary outcomes include postoperative pain intensity and functional outcome measures.

This study aims to provide evidence to guide clinical decision-making regarding postoperative drain management in patients undergoing total knee arthroplasty.

• Study Type: Observational
• Enrollment (Actual): 207

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Ankara, Turkey (Türkiye)
    • Ankara Bilkent City Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The study population consists of adult patients diagnosed with knee osteoarthritis who underwent primary total knee arthroplasty at a single tertiary care center. All participants were treated according to standardized surgical and postoperative care protocols and were followed prospectively.

Description

Inclusion Criteria:

• Patients aged 18 years or older
• Diagnosis of knee osteoarthritis
• Undergoing primary total knee arthroplasty
• Provided written informed consent to participate in the study

Exclusion Criteria:

• Revision total knee arthroplasty
• History of inflammatory arthritis
• Known bleeding disorders or coagulopathy
• Active infection or periprosthetic joint infection
• Incomplete clinical data or loss to follow-up

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Early Drain Removal (Goup 1); Patients whose Hemovac drain is removed before the first postoperative rehabilitation session as part of routine clinical practice.
Late Drain Removal (Group 2); Patients whose Hemovac drain is removed after completion of the first postoperative rehabilitation session as part of routine clinical practice.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative Drain Output	Total postoperative Hemovac drain output measured in milliliters following primary total knee arthroplasty.	Postoperative days 0-3

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Length of Hospital Stay	Duration of postoperative hospital stay measured in days.	Postoperative days 0-discharge
Postoperative Hemoglobin Change	Change in hemoglobin level from preoperative baseline to postoperative measurement.	Postoperative first 24-48 hours
Knee Society Score (KSS)	Functional outcome assessed using the Knee Society Score.	Postoperative 1 month
Postoperative Pain Intensity	Pain intensity assessed using the Visual Analog Scale (VAS).	Postoperative 1 month

Collaborators and Investigators

• Sponsor: Ankara City Hospital Bilkent

Study record dates

Study Major Dates

• Study Start (Actual): May 1, 2025
• Primary Completion (Actual): November 30, 2025
• Study Completion (Actual): December 10, 2025

Study Registration Dates

• First Submitted: December 22, 2025
• First Submitted That Met QC Criteria: January 6, 2026
• First Posted (Actual): January 15, 2026

Study Record Updates

• Last Update Posted (Actual): January 15, 2026
• Last Update Submitted That Met QC Criteria: January 6, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: Total Knee Arthroplasty; Knee Osteoarthritis
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Arthritis; Joint Diseases; Rheumatic Diseases; Osteoarthritis; Osteoarthritis, Knee
• Other Study ID Numbers: TABED2-25-1015_TKA_DRAIN

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No