Acta Scientific Orthopaedics (ISSN: 2581-8635)

Research Article Volume 5 Issue 10

Interest of Drainage in Shoulder Arthroplasty: A Prospective Multicenter Study

Kevin Bargoin*1, Jean-Marc Glasson2, Jacques-Emmanuel AYEL3, Emmanuel BEAUDOUIN,4 Régis GUINAND5 and Anne Vidil6

1Private Confluent Hospital, Nantes, France
2Imperial Park Clinic, Nice, France
3Cedars Clinic, CORNEBARRIEU, France
4Hospital Center Savoie Metropolis, Chambéry, France
5New Clinic of the Union, Saint-Jean, France
6Clinique Bizet, Paris, France

*Corresponding Author: Kevin Bargoin, Private Confluent Hospital, Nantes, France.

Received: May 13, 2022; Published: September 09, 2022

Abstract

Objectives of the study: It is common to drain the operative wound to limit the occurrence of postoperative hematoma after shoulder prosthesis (TSA). The interest of drainage has been questioned in hip and knee replacement surgeries for the sake of blood saving. Rapid recovery protocols after surgeries are suitable for shoulder surgery and the usefulness of drainage is a determining factor. A prospective, multicenter controlled study was performed on shoulder prostheses with or without drainage to analyze blood loss, mean length of stay (SMD) and complications.

Hypothesis: the drain increases the length of hospitalization and does not decrease the risk of complications.

Material and Method: A continuous prospective study was carried out on 6 centres in France for a total of 139 TSA over a year divided into 2 groups, the first 6 months with drainage (AD: 80 TSA) and the following 6 months without drainage (SD: 59 TSA). The study compared the 2 groups with clinical scores in preoperative and at 6 months postoperatively (M6): Constant, SST, SSV and ASES. Blood loss was assessed on the evolution of hemoglobin (Hb) levels, the volume of the redon on the 1st and2nd day and any transfusions. SMD and postoperative complications were identified. The groups with and without drain are comparable in age, ASA score and types of prosthesis.

Results: No significant difference on the constant (M6) AD scores: 62 points (pts), SD: 60 pts p = 0.37, ASES, SST, SSV nor on the rate of change in preoperative hemoglobin and J2 AD (-1.87g/dL) SD (-1.83g/dL). No significant difference on the SMD (3.9d – 4.1d) with extremes of 2 to 15 days. A difference in SMD is found depending on the etiology: fractures vs other causes (6.06days - 3.7 days) p = 0.015. Analysis of complications was less hematoma collected in the drain group AD 2.5%, SD 8.5%, not significant p = 0.13, 4 times in the group with drain vs 2 times in the group without drain.

Discussion: Drainage did not increase blood loss, lack of drainage did not decrease SMD in our study. The main factor in increasing SMD is traumatic etiology with a SMD that is often greater than a week. Drainage does not influence the recovery rate. Systematic drainage is above all a matter of practice.

Conclusion: Drainage does not appear to be essential for shoulder prostheses in patients who do not have a coagulation abnormality.

Level of Evidence: III

Keywords: Drainage; Shoulder Arthroplasty; Multicenter

References

  1. Bjerke-Kroll ASA, et al. “The increased total cost associated with post-operative drains in total hip and knee arthroplasty”. The Journal of Arthroplasty 29.5 (2014): 895-899.
  2. Ovadia D., et al. “Efficacy of closed wound drainage after total joint arthroplasty. A prospective randomized study”. The Journal of Arthroplasty 3 (1997): 317-321.
  3. Omonbude D., et al. “Measurement of joint effusion and haematoma formation by ultrasound in assessing the effectiveness of drains after total knee replacement: A prospective randomised study”. The Journal of Bone and Joint Surgery British 1 (2010): 51-55.
  4. Suarez JC., et al. “Closed Suction Drainage Has No Benefits in Anterior Hip Arthroplasty: A Prospective, Randomized Trial”. The Journal of Arthroplasty 9 (2016): 1954-1958.
  5. Watanabe T., et al. “Closed Suction Drainage Is Not Necessary for Total Knee Arthroplasty: A Prospective Study on Simultaneous Bilateral Surgeries of a Mean Follow-Up of 5.5 Years”. The Journal of Arthroplasty 3 (2016): 641-645.
  6. Li C., et al. “No clear advantage to use of wound drains after unilateral total knee arthroplasty: a prospective randomized, controlled trial”. The Journal of Arthroplasty 4 (2011): 519-522.
  7. Trofa DP., et al. “Short-term outcomes associated with drain use in shoulder arthroplasties: a prospective, randomized controlled trial”. Journal of Shoulder and Elbow Surgery 2 (2019): 205-211.
  8. Hulet C., et al. “Developments in ambulatory surgery in orthopedics in France in 2016”. Orthopaedics and Traumatology: Surgery and Research 1S (2017): S83-S90.
  9. Gartsman GM., et al. “Closed wound drainage in shoulder surgery”. Journal of Shoulder and Elbow Surgery 3 (1997): 288-290.
  10. Makhni EC., et al. “Risk factors associated with blood transfusion after shoulder arthroplasty”. JSES Open Access1 (2017): 10-14.
  11. Ryan DJ., et al. “Blood transfusion in primary total shoulder arthroplasty: incidence, trends, and risk factors in the United States from 2000 to 2009”. Journal of Shoulder and Elbow Surgery 5 (2015): 760-765.
  12. Hardy JC., et al. “Blood transfusion associated with shoulder arthroplasty”. Journal of Shoulder and Elbow Surgery 2 (2013): 233-239.
  13. Dacombe PJ., et al. “Blood transfusion rates following shoulder arthroplasty in a high volume UK centre and analysis of risk factors associated with transfusion”. Shoulder Elbow2 (2019): 67-72.
  14. Cunningham G., et al. “A Single Dose of Tranexamic Acid Reduces Blood Loss After Reverse and Anatomic Shoulder Arthroplasty: A Randomized Control Trial”. Journal of Shoulder and Elbow Surgery (2021).
  15. Vara AD., et al. “Intravenous tranexamic acid reduces total blood loss in reverse total shoulder arthroplasty: a prospective, double-blinded, randomized, controlled trial”. Journal of Shoulder and Elbow Surgery 8 (2017): 1383-1389.
  16. Gillespie R., et al. “Neer Award 2015: A randomized, prospective evaluation on the effectiveness of tranexamic acid in reducing blood loss after total shoulder arthroplasty”. Journal of Shoulder and Elbow Surgery 11 (2015): 1679-1684.
  17. Gruson KI., et al. “Transfusion after shoulder arthroplasty: an analysis of rates and risk factors”. Journal of Shoulder and Elbow Surgery 2 (2009): 225-230.
  18. Frye BD., et al. “Drains Are Not Beneficial in Primary Shoulder Arthroplasty”. Orthopedics 1 (2019): e29-e31.
  19. Aim F., et al. “One- or two-stage exchange for periprosthetic shoulder infection: Systematic review and meta-analysis”. Orthopaedics and Traumatology: Surgery and Research 1 (2020): 5-15.
  20. Boileau P. “Complications and revision of reverse total shoulder arthroplasty”. Orthopaedics and Traumatology: Surgery and Research1 (2016): S33-43.

Citation

Citation: Kevin Bargoin., et al. “Interest of Drainage in Shoulder Arthroplasty: A Prospective Multicenter Study".Acta Scientific Orthopaedics 5.10 (2022): 21-27.

Copyright

Copyright: © 2022 Kevin Bargoin., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate33%
Acceptance to publication20-30 days

Indexed In



News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is December 25, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"

Contact US