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. 2021 Mar 3;16(3):e0247845.
doi: 10.1371/journal.pone.0247845. eCollection 2021.

Effects of disusing closed suction drainage in simultaneous bilateral total hip arthroplasty: A retrospective cohort study

Chan-Woo Park  1 , Seung-Jae Lim  1 , Insun Yoo  1 , Youngsik Lee  1 , Jae-Yeon Won  1 , Youn-Soo Park  1
Affiliations

Effects of disusing closed suction drainage in simultaneous bilateral total hip arthroplasty: A retrospective cohort study

Chan-Woo Park et al. PLoS One. .

Abstract

Purpose: Increased blood loss remains a major drawback of simultaneous bilateral total hip arthroplasty (SBTHA). We examined the effects of disusing closed suction drainage (CSD) on postoperative blood loss and transfusion requirement in cementless SBTHA.

Methods: A retrospective cohort study was conducted with a consecutive series of cementless SBTHAs performed by a single surgeon between January 2014 and March 2017. The surgeon routinely used CSD until May 2015 and refrained from CSD in all primary THAs thereafter. This study included SBTHAs with intravenous administration of tranexamic acid (TXA). Postoperative hemoglobin drop, blood loss, transfusion rate, pain scores, complication rates, and implant survivorships were compared between the groups of SBTHA with and without CSD. The minimum follow-up duration was 1 year.

Results: Among the 110 patients (220 hips), 46 (92 hips) and 64 (128 hips) underwent SBTHA with and without CSD, respectively. Maximum hemoglobin drop (mean, 4.8 vs. 3.9 g/dL; P = 0.001), calculated blood loss (mean, 1530 vs. 1190 mL; P<0.001), transfusion rate (45.7% vs. 21.9%; P = 0.008), and length of hospital stay (mean, 6.6 vs. 5.8 days; P = 0.004) were significantly lower in patients without CSD. There were no significant differences in postoperative pain scales and wound complication rates. The mean Harris Hip scores at final follow-up (92.5 vs. 92.1; P = 0.775) and implant survivorships with an end-point of any revision at 4 years (98.9% vs. 98.4%; log-rank, P = 0.766) were similar between groups.

Conclusions: Disusing CSD significantly reduced postoperative blood loss and transfusion requirement without increasing postoperative pain and surgical wound complications in cementless SBTHA with concurrent administration of intravenous TXA.

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Conflict of interest statement

I have read the journal’s policy and the authors of this manuscript have the following competing interests: Youn-Soo Park is a paid consultant for DePuy Synthes and Corentec and has received royalties for Corentec products. This does not alter our adherence to PLOS ONE policies on sharing data and materials. Other authors confirm that they have no competing interests.

Figures

Fig 1
Fig 1
(A) Preoperative hip radiograph of a 43-old man with osteonecrosis of the femoral head involving both hips. (B) Simultaneous bilateral total hip arthroplasty was performed with cementless acetabular components and tapered wedge femoral stems. Closed suction drainage was not used for this case. Calculated blood loss was 1254 mL, and allogenic blood transfusion was not performed. (C) A 4-year postoperative radiograph showed stable implant fixations. The patient was able to participate in daily activities without pain and was satisfied with the surgical outcome.
Fig 2
Fig 2. Kaplan-Meier survival curves with ends points of revision for any reason.
CSD, closed suction drainage.
See this image and copyright information in PMC

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