Effect of Hemovac Drain Removal on Early Outcomes After Total Knee Arthroplasty

Total knee arthroplasty (TKA) is a widely performed surgical procedure for the treatment of advanced knee osteoarthritis. Postoperative management often includes the use of closed suction drains, such as Hemovac systems, to reduce hematoma formation and wound complications. However, the necessity and optimal timing of drain removal remain subjects of debate.

This prospective observational cohort study is designed to compare early clinical outcomes associated with two different timings of Hemovac drain removal following primary TKA. Patients who undergo primary TKA at a single tertiary care center will be enrolled prospectively. According to routine postoperative practice, patients will be allocated into two groups: drain removal before the first postoperative rehabilitation session or drain removal after completion of the first rehabilitation session.

All patients will receive standardized surgical techniques, anesthesia protocols, postoperative care, and rehabilitation programs. Data will be collected prospectively. Primary outcomes include postoperative hemarthrosis, early postoperative complications, and length of hospital stay. Secondary outcomes include postoperative pain intensity and functional outcome measures.

This study aims to provide evidence to guide clinical decision-making regarding postoperative drain management in patients undergoing total knee arthroplasty.

Inclusion criteria

• Patients aged 18 years or older
• Diagnosis of knee osteoarthritis
• Undergoing primary total knee arthroplasty
• Provided written informed consent to participate in the study

Exclusion criteria

• Revision total knee arthroplasty
• History of inflammatory arthritis
• Known bleeding disorders or coagulopathy
• Active infection or periprosthetic joint infection
• Incomplete clinical data or loss to follow-up