Introduction The use of a drain after various types of arthroscopic surgeries has long been debated. Whether a drain offers an advantage in terms of pain, swelling, and functional outcome after arthroscopy-assisted reconstruction of the anterior cruciate ligament (ACL) needs to be investigated. This study was designed to assess the validity of the use of an intra-articular drain after routine arthroscopic ACL reconstruction and to assess the various complications associated with its use. Material and methods Forty-four patients (group I included patients for whom an intra-articular drain was used and group II included patients for whom an intra-articular drain was not used) diagnosed with ACL injury were included in the study. The patients in group I had a drain placed inside the joint, while those in group II had a drain placed outside the joint cavity but the drain placement was such that there remained no patient or observer bias. Results Outcome assessment was performed on days one, two, and three followed by weeks one, four, and eight, and six months after surgery by determining a visual analog pain (VAS) score. The assessment was also done for the range of motion (ROM) in terms of loss of flexion and extension with a hand-held goniometer, knee hemarthrosis, and thigh circumference. Although there was a difference in both the groups in terms of the above-mentioned parameters in the early post-operative period, the difference becomes insignificant at the final follow-up at six months. Conclusion From this study, we conclude that putting an intra-articular drain after ACL reconstruction offers no advantage in terms of functional outcome in the long term.
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http://dx.doi.org/10.7759/cureus.16928 | DOI Listing |
J Orthop Surg Res
December 2024
Department of Joint Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266000, China.
Background: This study aimed to elucidate the safety and intra-articular elution profiles of vancomycin and gentamicin bone cement in patients undergoing primary total knee arthroplasty (TKA), with a focus on serum safety thresholds and therapeutic efficacy.
Methods: Consecutive patients who underwent unilateral primary TKA were prospectively enrolled. The implants were fixed using gentamicin-impregnated bone cement, and after arthrotomy closure, 1000 mg of vancomycin suspended in 25 mL of normal saline was directly injected into the joint.
Cir Cir
July 2024
Department of Orthopedic Surgery and Traumatology, Clinical Center of Vojvodina, Novi Sad.
Objective: The number of participants in sports or some form of recreation globally has led to an increase in the incidence of anterior cruciate ligament (ACL) injuries and the number of surgeries performed. Although it does not belong to risky surgical interventions, this operation is accompanied by complications that slow down post-operative rehabilitation. The objective is to analyze the effects of intra-articular (IA) injection of tranexamic acid (TXA) on the reduction of post-operative drained blood volume, pain intensity, and incidence of hemarthrosis after ACL reconstruction.
View Article and Find Full Text PDFJ Bone Joint Surg Am
September 2024
Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Background: The use of antibiotic-loaded bone cement (ALBC) to help reduce the risk of infection after primary total knee arthroplasty (TKA) is controversial. There is a paucity of in vivo data on the elution characteristics of ALBC. We aimed to determine whether the antibiotic concentrations of 2 commercially available ALBCs met the minimum inhibitory concentration (MIC) and minimum biofilm eradication concentration (MBEC) for common infecting organisms.
View Article and Find Full Text PDFActa Chir Orthop Traumatol Cech
July 2024
Arel University, Memorial Ataşehir Hospital, Department of Orthopedics and Traumatology, İstanbul, Turkey.
Purpose Of The Study: Our aim was to compare the effects of intraarticular and intravenous (IV) tranexemic acid (TXA) application on bleeding and complication rates in patients who underwent total knee arthroplasty (TKA).
Material And Methods: Between 2017 and 2021, 406 patients who underwent TKA with 2 g of IV TXA and retrograde 1.5 g of TXA applied through the drain were included in the study.
BMC Musculoskelet Disord
June 2024
Department of Orthopedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-Ku, Sagamihara City, Kanagawa, 252-0374, Japan.
Background: Suction drainages are commonly used after total knee arthroplasty (TKA) procedures; however, their use is somewhat controversial. Recently, some reports have claimed that the administration of tranexamic acid (TXA) may prevent postoperative bleeding following TKAs. Although numerous studies have reported regarding different dosages, timings of administration, or drain clamping times for intravenous and intra-articular TXA injections (IA-TXAs), few have examined whether suction drainage is necessary when TXA is administered.
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