RESUMEN
BACKGROUND: The benefit of suction drains (SD) for the first 24-48 hours following joint replacement surgery is controversial. We aimed to determine if there is any difference in the early outcome of revision TKA when performed with, or without SD. METHODS: 83 cases indicated for revision knee arthroplasty were randomized to receive (42) or not receive (41) a deep intra-articlular drain. First-stage revisions for treating periprosthetic infection were excluded. Patients were statistically compared for demographic parameters, early complications and early knee functional outcome. The assessed outcomes included total blood loss, number of transfusions, fever and wound complication rate at 24 months follow-up. In addition, the change in knee society score at 12 weeks postoperatively was compared between the groups. RESULTS: There were no significant difference in demographic factors, wound complications, knee scores at 12 weeks and infection rate 24 months after surgery in either group. Average blood loss was 1856ml and 1533ml for the drain and no drain groups, respectively (P value=0.0470). The need for transfusion was significantly less in the no-drain group with an average of 0.15 unit/patient as compared to an average 0.37 unit/patient for the drain group (P value=0.0432). CONCLUSION: We were unable to find a point of superiority for using a drain for revision knee arthroplasty. Future studies with longer follow-up and larger population of patients are needed to make a valid conclusion.
Asunto(s)
Artroplastia de Reemplazo de Rodilla/métodos , Drenaje/instrumentación , Articulación de la Rodilla/cirugía , Anciano , Artroplastia , Transfusión Sanguínea , Índice de Masa Corporal , Eritrocitos/citología , Femenino , Humanos , Articulación de la Rodilla/fisiopatología , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias , Estudios Prospectivos , Falla de Prótesis , Reoperación , Succión , Factores de Tiempo , Ácido Tranexámico/uso terapéutico , Resultado del Tratamiento , Cicatrización de Heridas , Infección de Heridas/terapiaRESUMEN
Down Syndrome can result in musculoskeletal abnormalities of the hip at an early age. Avascular necrosis of the femoral head can occur as a result of slipped capital femoral epiphysis causing the patient a great deal of pain, limiting the ability to ambulate. Despite the benefits that this patient group can receive from the surgery, surgeons may be apprehensive to operate. It is our experience that these patients benefit greatly from arthroplasty without complication. In this report, we present a total hip replacement to treat avascular necrosis in an adolescent and address the concerns that surgeons may have in treating this patient population.