Non-use of intra-articular drain after anterior cruciate ligament reconstruction does not affect postoperative knee pain and muscle strength on early period

Kengo Shimozaki; Junsuke Nakase; Rikuto Yoshimizu; Tomoyuki Kanayama; Yusuke Yanatori; Takuya Sengoku; Hiroyuki Tsuchiya

doi:10.1016/j.asmart.2023.04.002

Non-use of intra-articular drain after anterior cruciate ligament reconstruction does not affect postoperative knee pain and muscle strength on early period

Asia Pac J Sports Med Arthrosc Rehabil Technol. 2023 May 3:32:7-11. doi: 10.1016/j.asmart.2023.04.002. eCollection 2023 Apr.

Authors

Kengo Shimozaki¹, Junsuke Nakase¹, Rikuto Yoshimizu¹, Tomoyuki Kanayama¹, Yusuke Yanatori¹, Takuya Sengoku¹, Hiroyuki Tsuchiya¹

Affiliation

¹ Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa-shi, Ishikawa-ken, 920-8641, Japan.

Abstract

Introduction: This study aimed to determine the effect of using an intra-articular drain after anterior cruciate ligament (ACL) reconstruction on early postoperative pain, range of motion (ROM), muscle strength, and complications.

Materials and methods: Between 2017 and 2020, of the 200 consecutive patients who underwent anatomical single-bundle ACL reconstruction, 128 patients underwent primary ACL reconstruction with hamstring tendons and were evaluated for postoperative pain and muscle strength at 3 months postoperatively. Sixty-eight patients who received intra-articular drain before April 2019 were classified as group D and 60 patients without an intra-articular drain after ACL reconstruction after May 2019 were classified as group N. Patient background, operative time, postoperative pain, number of additional analgesics used, presence of intra-articular hematoma, ROM at 2, 4, and 12 weeks postoperatively, extensor and flexor muscle strength at 12 weeks postoperatively, and perioperative complications were compared between the two groups.

Results: The postoperative pain at 4 h after surgery was significantly greater in group D than in group N although no significant difference was found in the pain felt in the immediate postoperative period and at 1 day and 2 days postoperatively and in the number of additional analgesics used. No significant difference in the postoperative ROM and muscle strength was noted between the two groups. Six patients with intra-articular hematomas in group D and four patients in group N needed puncture by 2 weeks postoperatively, and no significant difference was found between the two groups.

Conclusion: Postoperative pain was greater at 4 h postoperatively in group D. Furthermore, the intra-articular drain did not affect muscle strength, ROM, and complications on the early postoperative period. The usefulness of intra-articular drain after ACL reconstruction was considered low.

Level of evidence: Level IV.

Keywords: Anterior cruciate ligament reconstruction; Intra-articular drain; Muscle strength; Postoperative pain.