A Multivariate Analysis on the Effect of No Closed Suction Drain on the Length of Hospital Stay in Total Knee Arthroplasty

Kohei Nishitani, Shinichi Kuriyama, Shinichiro Nakamura, Hiromu Ito, Shuicih Matsuda, Kohei Nishitani, Shinichi Kuriyama, Shinichiro Nakamura, Hiromu Ito, Shuicih Matsuda

Abstract

Purpose: Despite the long history of drain use in total knee arthroplasty (TKA), no drain has been gaining popularity. The purpose of this study was to investigate whether drainage is related to the length of hospital stay.

Materials and methods: A total of 166 consecutive unilateral TKAs performed on 135 patients with osteoarthritis were retrospectively reviewed. Closed suction drainage was used in 111 cases (67%). Length of hospital stay after surgery was recorded, and a multivariate linear regression analysis was performed to evaluate various variables (patient factors, surgical factors, and post-surgical factors) and to investigate whether drainage was an independent variable.

Results: Hospital stay was shorter in no drain cases (21.7±4.8 days) than in drain cases (24.2±3.7 days, p<0.001). The multivariate analysis showed that older age (β=0.12, p=0.02), drain use (β=2.81, p=0.03), and occurrence of comorbidity (β=1.46, p=0.04) were the independent variables associated with the extended hospital stay. There was no difference in comorbidity between drain cases (39.6%) and no drain cases (27.2%, p=0.13).

Conclusions: The drain use, age, and occurrence of comorbidity were related to the length of hospital stay. TKA without drain is an effective procedure both medically and economically.

Keywords: Arthroplasty; Drain; Hospitalization; Knee; Recovery.

Conflict of interest statement

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Bar charts showing frequency of each procedure in each year. (A) Use of tranexamic acid. (B) Use of drain. (C) Use of an analgesic cocktail. CSD: closed suction drainage.
Fig. 2
Fig. 2
Hospital stay of no drain cases and closed suction drainage (CSD) cases. Data are shown as mean±standard deviation.
Fig. 3
Fig. 3
Functional recovery at discharge. (A) Knee extension strength. (B) Timed Up and Go test. CSD: closed suction drainage.

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