OBJECTIVETo evaluate the earlier safety of closed suction drainage systems for knee arthroplasty.

METHODSAll randomised or quasi-randomised trials comparing the use of closed suction drainage systems with no drainage systems for all types of knee arthroplasty were searched. The trials' quality were assessed, and data was extracted. Where appropriate, results of comparable studies were pooled.

RESULTSTwelve studies involving 1122 participants with 1191 surgical wounds were identified. The methodology of the studies identified and included in the analysis varied considerably. Pooling of results indicated no statistically significant difference in the incidence of wound haematoma, dehiscence or deep vein thrombosis between those allocated to drains and the un-drained wounds. Blood transfusion was required more frequently in those who received drains. No difference between the groups was seen with respect to wound infection and the range of movement of the joint after surgery.

CONCLUSIONSThere is insufficient evidence from randomised trials to support the routine use of closed suction drainage in knee arthroplasty. It results in an increase in the number of patients requiring blood transfusion. However, because of the poor trial methodology of many of the studies and the inadequate reporting of outcomes, further randomized trials on this topic are justified.