Are Post-Operative Drains Beneficial in Total and Reverse Total Shoulder Arthroplasty?
Journal Title: Orthopedics Research and Traumatology – Open Journal - Year 2016, Vol 1, Issue 1
Abstract
Background: Total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RTSA) are effective treatments for glenohumeral arthritis and rotator cuff arthropathy. Purpose: To determine if the use of a post operative closed-suction drain following TSA and RTSA affects hemoglobin levels, clinical outcomes, and complications. Hypothesis: Patients who did not receive a drain will have less hemoglobin loss, better clinical outcome scores, and lower complication rates following TSA/RTSA. Methods: All patients who underwent TSA or RTSA by one of two surgeons between January 1, 2011 and May 15, 2013 were recorded. Patient demographic information was recorded. Patients were grouped based on use of a post-operative deep drain. Pre and post-operative hemoglobin, length of hospital stay, clinical outcome scores, and complications were recorded and analyzed. Results: Sixty-four patients (average age 58.9±9.9 years, 55% male) underwent RTSA (13) or TSA (51) without the use of a post-operative closed-suction drain; 304 patients (average age 66.7±9.6 years, 55% female) underwent RTSA (179) or TSA (125) with the use of a post-operative closed-suction drain. Average follow up was similar in both groups: 14.95±7.22 months in the drain group and 14.55±6.74 months in the no drain group (p=.723). Using multivariate analysis to control for confounding variables and differences between the two groups, drain usage was correlated with significantly lower postoperative hemoglobin (p=0.0002), longer length of stay (p≤0.0001), and lower postoperative SST (p=0.003). Conclusion: Closed-suction drain usage following RTSA and TSA leads to greater loss of hemoglobin and longer length of stay. No clinically significant differences in transfusion rate and clinical outcome scores were seen with or without drain usage. LEVEL OF EVIDENCE: III: case-control study.
Authors and Affiliations
Brandon J. Erickson
Keywords
Related Articles
- EP ID EP552528
- DOI 10.17140/ORTOJ-1-105
- Views 130
- Downloads 0
The Use of Navigation In Minimal Invasive Spine Surgery (MIS)
Spine surgery is among the surgical specialities that is evolving tremendously and rapidly. The advancements in technology and diagnostic tools opened new era of spine surgery. The rapid growth in the implant industry de...
Balloon Kyphoplasty: Cement Augmentation in Acute Osteoporotic Thoraco-Lumbar Fractures
Background Several techniques have been developed for simpler and safer procedures during the last 2 decades. Techniques of vertebral body augmentation have been developed in an effort to treat these refractory cases. Th...
Complications in the Combined and Consecutive Use of External and Internal Fixation of the Femur with Reference to Use of the Extracortical Clamp Device
Aim The Extracortical Clamp Device (ECD) is a novel external fixation component which unlike conventional implants does not perforate long bone cortices. Therefore, it simplifies methods of combined and consecutive inter...
Halo-Vesting in Preschool Aged Children with Synchondrosis Fracture: A Case Series which Explores the Current Techniques Associated with this Procedure
Upper cervical spine injuries are the most common form of spinal cord trauma that occur in preschool children. Among such injuries, odontoid synchondrosis fractures are the most frequently observed, though relatively few...
Changing Ethics and the Hippocrates Oath
When I graduated in 1973 and registered with the Rajasthan state branch of the Medical Council of India, I was given a copy of the Hippocratic Oath. That it is no longer the practice speaks volumes for what it is worth....