Utility of postoperative drainage in total hip arthroplasty. A systematic review.

Abstract

Aim and hypothesis: To investigate the advantages associated with the use of drainage in primary total hip arthroplasty (THA) versus not using drainage and to determine if drainage can be systematically discontinued. The starting hypothesis was that eliminating the use of drainage systematically in THA does not significantly increase the risk of postoperative complications.

Materials and methods: A systematic review was carried out following the PRISMA guidelines in the PubMed and Cochrane Library databases. The search was conducted on February 15, 2024, by entering the terms ("suction drainage") AND ("total hip arthroplasty"). The Joanna Briggs Institute quality assessment tool was used to assess the quality of the included studies.

Results: Sixteen clinical trials comparing the use of drainage with no drainage in THA were included. No differences were observed in terms of infection rate or haematoma. Some authors find that the use of drainage increases the percentage of patients requiring transfusion and the length of hospitalisation. Of 16 studies, 13 recommend not to use drainage routinely in THA.

Conclusions: The use of drainage in THA has no advantage over no drainage. The results of the clinical trials reviewed suggest that drainage should not be used routinely in THA.