Observational studyKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2026
Time-dependent wound management protocol prevents periprosthetic joint infection in total knee arthroplasty with persistent drainage.
Observational study in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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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.
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Who cites it
2 citing papers in PubMed.
- Review
- Rethinking thromboprophylaxis duration after total joint arthroplasty: when historical evidence meets modern surgical practice.Journal of thrombosis and thrombolysis · 2026Article
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Authors and funding
9 authors.
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No grant is acknowledged in the PubMed record.
Abstract
purposeThis study aimed to evaluate the success rate of a standardised protocol for managing persistent wound drainage following total knee arthroplasty (TKA).
methodsA prospective observational study was conducted at four institutions between January and June 2022 across primary and revision TKAs. Sixty-two patients (mean age 71.5 ± 9.3 years; 45.2% male) who experienced postoperative wound drainage after primary (58.1%) or revision (41.9%) TKA were enrolled. The protocol included staged interventions: anticoagulation adjustments and dressing changes during Days 1-3, incisional negative pressure wound therapy during Days 3-5, and wound debridement above the joint capsule if drainage persisted beyond Day 7. Outcomes were evaluated using the ASEPSIS score. The primary outcome was defined as complete wound healing without progression to debridement, antibiotics and implant retention (DAIR) procedure or periprosthetic joint infection (PJI).
resultsThe mean follow-up was 13.2 months (range, 11.7-15.1 months). The protocol achieved a 91.9% success rate in preventing progression to DAIR. The median number of visits required to achieve wound healing was 3.5 for the cohort. DAIR rate was 8.1% (n = 5), while PJI rate was 1.6% (n = 1). Primary TKA procedures demonstrated more efficient healing trajectories compared to revision cases, requiring fewer clinical visits (median 3 vs. 5, p < 0.001) and shorter hospital stays (mean 4.5 vs. 7.5 days, p = 0.017). Cox proportional hazards model identified intervention type (revision vs. primary, hazard ratio [HR] 0.24, p < 0.001), advanced age (HR: 0.95 per year, p = 0.006), and male gender (HR: 0.45, p = 0.020) as significant independent predictors of increased time required to achieve wound healing.
conclusionOur standardised wound management protocol achieved a high success rate in preventing progression to PJI following TKA. The time-dependent approach to intervention escalation provides clear clinical decision-making criteria and suggests that early identification and systematic management of wound complications are critical determinants of successful outcomes, particularly for primary TKA procedures. LEVEL OF EVIDENCE: Level II.
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