Does Temporary Clamping of Drain Following Knee Arthroplasty Reduce Blood Loss? : A Prospective Randomized Controlled Pilot Study

Abstract

Total knee arthroplasty is sometimes associated with major post-operative bleeding. We prospectively randomized 40 patients diagnosed as severe osteoarthritis and scheduled for cemented total knee replacement into two groups : Group1-immediate release of drain following the release of tourniquet (20 cases), and Group 2-delayed release of the drain clamp by two hours. (20 cases) Both groups were matched for sex, age, side, pre-operative hemoglobin and operating times. The finding was revealed that post-operative blood loss was significantly greater in the group with immediate release of drain (785.15 ml) than the one with temporary clamping of drain (513.25 ml) (p = 0.001). There was no statistically significant difference in the reduction of hemoglobin level at 72 hours after the operation, pain scores, range of motion, wound complications and prosthetic infection rate at a minimum of 6 months of the follow up period. In conclusion, we found that temporary clamping of drain by 2 hours reduced post-operative blood loss following total knee arthroplasty. However, further studies with a greater number of cases and the longer follow-up period need to be conducted to confirm this finding.