Comparison Between Bilateral Simultaneous Total Hip Arthroplasty With and Without Drainage; a Retrospective Cohort Study

Abstract

\n BackgroundThere are many reports staged bilateral THA without drainage is a better method than with drainage in many ways. However, there is little report regarding bilateral simultaneous THA (BSTHA) without drainage. This study aimed to evaluate the differences in the clinical outcomes and complication rate of BSTHA with drainage and without drainage.MethodsBetween October 2015 and April 2019, a retrospective cohort study was conducted with modified minimally invasive two-incision method and a consecutive series of 41 BSTHA performed with drainage were compared to 37 BSTHA performed without drainage. It was assessed clinically and radiographically for a mean of 2.1 ± 0.8 years (range, 1.0-4.8 years). Postoperative hematologic values (Hgb drop, Hct drop, total blood loss, transfusion rate), pain susceptibility, functional outcome, and complication were compared in the drained group and the non-drained group. All patients preoperatively received intravenous tranexamic acid (TXA) and intraoperatively received intra-articular TXA on each hip. Statistical analyses were performed using the independent t tests, Chi-squared or Fisher’s exact tests. A significance level of ≤ 0.05 was used for all statistical tests.Results Mean postoperative Hgb (g/dL, p < 0.001) & Hct drop (%, p < 0.001), mean total blood loss (ml, p < 0.001) and mean transfusion unit (IU, p < 0.001) were significantly lower in the BSTHA without drainage than in the BSTHA with drainage group. But the mean dose of morphine equivalent (mg, p < 0.001) was significantly larger in BSTHA without drainage.ConclusionBSTHA without drainage can reduce postoperative blood loss and the requirement for transfusion without increasing other complication. But BSTHA without drainage is more painful method than BSTHA with drainage. Therefore, BSTHA without drainage will be a good option to reduce the burden on the patient by reducing postoperative bleeding if it can control pain well after surgery.