THE USE OF AUTOLOGOUS RE-TRANSFUSION DRAINS IN PRIMARY LOWER LIMB ARTHROPLASTY- DO THEY CONFER A BENEFIT?

Abstract

Aim: To compare the outcomes of autologous versus no drainage in patients undergoing primary hip and knee arthroplasty.

Methods: Retrospective review of patients undergoing primary total hip or knee arthroplasty within our unit was carried out. There were 4 groups, each consisting of 20 patients. These were; total hip arthroplasty with and without the use of autologous drains, and total knee arthroplasty with and without the use of autologous drains. Outcome measures were- requirement for homologous (banked) blood, post-operative drop in haemoglobin and length of stay in hospital.

Results: For the knee arthroplasty groups, the homologous transfusion rate was 25% in non-drain patients compared with 5% in patients with drains. The average drop in Hb was 3.3 g/dl in the no-drain group compared with 2.7 in the drain group. The average length of stay was 6.35 days in the no-drain group compared with 6.75 days in the drain group. For the hip arthroplasty groups, the homologous transfusion rate was 10% in the non-drain group compared with 15% in the drain group. The average drop in Hb was 3.9 in the no drain group compared with 3.3 in the drain group. The average length of stay was 6.8 days in the no-drain group compared with 6.9 days in the drain group.

Conclusion: These results demonstrate improvements in the transfusion requirements as well as post-operative Hb drop in knee arthroplasty, but not hip arthroplasty when autologous re-transfusion drains were used. The length of stay was not significantly altered by the usage of drains. Based on these results, we would therefore recommend the use of autologous drains in primary total knee arthroplasty but not in primary total hip arthroplasty.