Postoperative Mobilization Based Hemovac Drain Management After Total Knee Arthroplasty: A Prospective Comparative Study

Öz

Aim The optimal timing of hemovac drain removal after total knee arthroplasty (TKA) remains controversial. This study aimed to compare the effects of drain removal before versus after initial postoperative mobilization on early clinical outcomes, functional recovery, and length of hospital stay (LOS) following primary TKA. Materials and Methods This prospective comparative cohort study included 207 patients who underwent unilateral primary TKA for knee osteoarthritis. Patients were allocated into two groups: pre-mobilization drain removal (Group 1, n = 103) and post-mobilization drain removal (Group 2, n = 104). All patients followed standardized surgical, postoperative care, and rehabilitation protocols. Clinical outcomes included total drainage volume, hemoglobin change, transfusion requirement, acute infection, and LOS. Functional outcomes were assessed at 6 weeks postoperatively using the Knee Society Score (KSS), KSS-Function (KSS-F), and Visual Analog Scale (VAS). Results The post-mobilization group demonstrated a significantly higher total drainage volume (p < 0.001) but no significant difference in hemoglobin change or transfusion requirement compared with the pre-mobilization group. LOS was significantly shorter in the post-mobilization group (p < 0.001). No significant differences were observed between groups regarding acute infection rates or 6-week functional outcomes (KSS, KSS-F, VAS; all p > 0.05). Conclusion Hemovac drain removal after initial mobilization following TKA is associated with a shorter hospital stay without compromising early clinical safety or functional recovery. Optimizing drain removal timing after mobilization may facilitate earlier discharge and improve postoperative care efficiency. Keywords: Total knee arthroplasty, Hemovac drain, Drain removal timing, Early mobilization, Length of hospital stay

Anahtar Kelimeler

• Total knee arthroplasty
• Hemovac drain
• Drain removal timing
• Early mobilization
• Length of hospital stay

Destekleyen Kurum

none

Etik Beyan

Ethical approval was obtained from the local institutional ethics committee (2-25-1015, 30.04.2025), and the study was conducted in accordance with the principles of the Declaration of Helsinki.

Teşekkür

none

Diz Protezi Ameliyatı Sonrası Mobilizasyona Dayalı Hemovak Dren Yönetimi: Prospektif Karşılaştırmalı Bir Çalışma

Öz

Amaç: Total diz artroplastisi (TDA) sonrası hemovak dreninin ne zaman çıkarılmasının erken klinik ve fonksiyonel sonuçlar üzerine etkisi tartışmalıdır. Bu çalışmanın amacı, ilk postoperatif mobilizasyon öncesinde ve sonrasında yapılan hemovak dren çıkarımının erken dönem klinik sonuçlar, fonksiyonel iyileşme ve hastanede yatış süresi üzerindeki etkilerini karşılaştırmaktır. Yöntem: Bu prospektif karşılaştırmalı kohort çalışmaya, primer diz osteoartriti nedeniyle tek taraflı primer TDA uygulanan toplam 207 hasta dahil edildi. Hastalar iki gruba ayrıldı: mobilizasyon öncesi dren çıkarılan grup (Grup 1, n=103) ve mobilizasyon sonrası dren çıkarılan grup (Grup 2, n=104). Tüm hastalarda cerrahi teknik, postoperatif bakım ve rehabilitasyon protokolleri standart olarak uygulandı. Klinik değerlendirmede toplam drenaj miktarı, hemoglobin değişimi, kan transfüzyonu gereksinimi, akut enfeksiyon varlığı ve hastanede yatış süresi kaydedildi. Fonksiyonel değerlendirme, postoperatif 6. haftada Knee Society Skoru (KSS), KSS-Fonksiyon ve Vizüel Analog Skala (VAS) kullanılarak yapıldı. Bulgular: Mobilizasyon sonrası dren çıkarılan grupta toplam drenaj miktarı anlamlı olarak daha yüksek bulundu (p<0,001). Bununla birlikte, gruplar arasında hemoglobin değişimi ve kan transfüzyonu gereksinimi açısından anlamlı fark saptanmadı (p>0,05). Hastanede yatış süresi, mobilizasyon sonrası dren çıkarılan grupta anlamlı olarak daha kısa bulundu (p<0,001). Akut enfeksiyon oranları ve 6. hafta fonksiyonel sonuçları (KSS, KSS-F ve VAS) açısından gruplar arasında istatistiksel olarak anlamlı fark izlenmedi (p>0,05). Sonuç: Total diz artroplastisi sonrası hemovak dreninin ilk mobilizasyondan sonra çıkarılması, erken klinik güvenlik veya fonksiyonel iyileşme üzerinde olumsuz etki oluşturmaksızın hastanede yatış süresini kısaltmaktadır. Dren çıkarım zamanlamasının mobilizasyon sonrasına alınması, postoperatif bakım sürecini optimize ederek erken taburculuğa katkı sağlayabilir. Anahtar Kelimeler: Total diz artroplastisi, Hemovak dren, Dren çıkarım zamanı, Erken mobilizasyon, Hastanede yatış süresi

Anahtar Kelimeler

• Total diz artroplastisi
• Hemovak dren
• Dren çıkarım zamanı
• Erken mobilizasyon
• Hastanede yatış süresi

Destekleyen Kurum

yok

Etik Beyan

Çalışma için yerel kurum etik kurulundan etik onay alınmıştır (2-25-1015, 30.04.2025) ve çalışma Helsinki Bildirgesi ilkelerine uygun olarak yürütülmüştür.

Teşekkür

yok

Kaynakça

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