Knee Surg Relat Res 2019 Mar; 31(1): 25-30
A Multivariate Analysis on the Effect of No Closed Suction Drain on the Length of Hospital Stay in Total Knee Arthroplasty
Kohei Nishitani, MD, Shinichi Kuriyama, MD, Shinichiro Nakamura, MD, Hiromu Ito, MD, and Shuicih Matsuda, MD
Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Correspondence to: Kohei Nishitani, MD Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-Cho, Sakyo, Kyoto 606-8507, Japan Tel: +81-75-751-3366, Fax: +81-75-751-8409 E-mail:
Received: February 5, 2018; Revised: October 4, 2018; Accepted: October 4, 2018; Published online: March 1, 2019.
© Korean Knee Society. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: Despite the long history of drain use in total knee arthroplasty (TKA), no drain has been gaining popularity. The purpose of this study was to investigate whether drainage is related to the length of hospital stay.
Materials and Methods: A total of 166 consecutive unilateral TKAs performed on 135 patients with osteoarthritis were retrospectively reviewed. Closed suction drainage was used in 111 cases (67%). Length of hospital stay after surgery was recorded, and a multivariate linear regression analysis was performed to evaluate various variables (patient factors, surgical factors, and post-surgical factors) and to investigate whether drainage was an independent variable.
Results: Hospital stay was shorter in no drain cases (21.7±4.8 days) than in drain cases (24.2±3.7 days, p<0.001). The multivariate analysis showed that older age (β=0.12, p=0.02), drain use (β=2.81, p=0.03), and occurrence of comorbidity (β=1.46, p=0.04) were the independent variables associated with the extended hospital stay. There was no difference in comorbidity between drain cases (39.6%) and no drain cases (27.2%, p=0.13).
Conclusions: The drain use, age, and occurrence of comorbidity were related to the length of hospital stay. TKA without drain is an effective procedure both medically and economically.
Keywords: Knee, Arthroplasty, Drain, Hospitalization, Recovery


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