Evidence map›Paper›PMID 39105839›Full record

SynthesisArchives of orthopaedic and trauma surgery2024

Suction drain usage has no benefit following revision total hip and knee arthroplasty.

Andrew Lachance, Shaya Shahsavarani, Oliver Sogard, John McDonald, Mason Stilwell, Jeffrey Lutton

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Andrew LachanceDepartment of Orthopaedics, Guthrie Clinic, 1 Guthrie Square, Sayre, PA, 18840, USA. andrewdlachance@gmail.com.
Shaya ShahsavaraniDepartment of Orthopaedics, Guthrie Clinic, 1 Guthrie Square, Sayre, PA, 18840, USA.
Oliver SogardDepartment of Orthopaedics, Guthrie Clinic, 1 Guthrie Square, Sayre, PA, 18840, USA.
John McDonaldGeisinger Commonwealth School of Medicine, 525 Pine St., Scranton, PA, 18501, USA.
Mason StilwellDepartment of Orthopaedics, Guthrie Clinic, 1 Guthrie Square, Sayre, PA, 18840, USA.
Jeffrey LuttonDepartment of Orthopaedics, Guthrie Clinic, 1 Guthrie Square, Sayre, PA, 18840, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe use of drains after primary total joint arthroplasty (TJA) has shown little benefit. Few studies have investigated drain usage after revision TJA. The purpose of this study was to determine whether utilizing suction drains is beneficial for patients undergoing revision arthroplasty. MATERIALS AND

methodsWe performed a comprehensive literature review utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines from the PubMed, Embase, Web of Science, and Cochrane Library. Inclusion criteria of this review were all original articles written in English investigating the efficacy and safety of closed suction drainage in revision TKA or THA, reporting at least one of the following outcome measures: (1) estimated blood loss (EBL), (2) perioperative hemoglobin change, (3) needs for transfusion, (4) postoperative infection, and (5) wound complications. Articles were excluded if they are not available in English or they included case reports, systematic reviews, comments, editorials, surveys, or animal studies prior to July 22, 2023. A total of six studies met inclusion criteria. In total, 655 patients had a drain while 1765 patients did not have a drain after revision total hip or knee arthroplasty. Primary outcomes included for meta-analysis included estimated blood loss (EBL), postoperative hemoglobin, need for transfusion. Other data extracted includes postoperative infections, and wound complications.

resultsSix studies met the inclusion criteria. In total, 655 patients had drains, while 1765 patients did not after revision total hip or knee arthroplasty. The average age of the patients was 66.1+/- 3.4 years, and the average BMI was 30.3 +/-0.8. There was no difference in postoperative infections (p = 0.14), wound complications (p = 0.621) or need for transfusion (p = 0.521) between the two groups. There was also no difference in EBL (Hedges' g CI[-3.52, 2.77]) or postoperative Hb (Hedges' g CI[-1.65, 2.41]) between patients with and without drains.

conclusionsOur results do not show any benefit from drain placement after revision total hip or knee arthroplasty. With the increased cost, time and need for drain removal, this is likely an unnecessary intervention. LEVEL OF EVIDENCE: Level III, systematic review and meta-analysis.

Indexed as

Arthroplasty, Replacement, HipArthroplasty, Replacement, KneeReoperationBlood Loss, SurgicalHumansPostoperative ComplicationsSuctionSurgical Wound InfectionArthroplastyDrainRevisionTotal hipTotal knee

Identifiers

PMID39105839

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.