Resumen de Drainage after total knee replacement

G. Sterling, J.A. Harris, G.D. McBain, M. Boland

• A simple lumped hydraulic model of knee drainage following arthroplasty is developed incorporating a pressure-volume equation of state for the knee capsule and a wound healing rate dynamically retarded by the blood flow-induced shear stress. The resulting second-order nonlinear ordinary differential system is examined numerically and qualitatively to map the parameter space. In the model, moderate suction or a slight back-pressure promotes gradual drainage and healing whereas excessive suction can lead to a bifurcation in which healing is retarded or even prevented. Guided, then, by the model, the literature, and experience, continuous drainage with a small constant back-pressure appeared beneficial so we prospectively evaluated a series of ten patients. The results are consistent with the model and promising.