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Indwelling urinary catheterization was unnecessary in non-drainage total knee arthroplasty: a randomized controlled trial

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

To investigate whether catheterization remains necessary in non-drainage total knee arthroplasty (TKA) using combined spinal epidural anesthesia (CSEA) with a short-acting opioid by comparing (1) incidences of postoperative urinary retention (POUR), and (2) postoperative clinical outcomes between retained urinary catheter (UC) and non-retained urinary catheter (non-UC) groups.

Methods

A total of 230 patients underwent non-drainage TKA using CSEA with fentanyl were randomized into UC and non-UC groups (115 patients each, 115 knees each). Incidences of POUR, clinical outcomes (intraoperative intravenous fluid, operative time, whole blood loss, urinary tract infection (UTI), and length of stay) were evaluated after the operation, while range of motion (ROM) and Knee society score (KSS) were evaluated 3- and 6-month postoperatively.

Results

Incidences of POUR and other perioperative and postoperative clinical outcomes between the two groups were not significantly different. ROM and KSS at 3- and 6-month postoperatively revealed no significant differences between the groups.

Conclusion

Given no significant difference in POUR incidence, clinical outcomes and knee scores and functions, catheterization in non-drainage TKA under CSEA with a short-acting opioid might not be necessary.

Clinical Trials

Clinical Trials gov (NCT03341819) (11/09/2017).

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Acknowledgements

The authors thank Ms Thikampa Wichai for help in collecting and organizing the data analyzed in this report.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Department of Orthopaedics, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, 681 Samsen Rd, Dusit, Bangkok, 10300, Thailand

    Satit Thiengwittayaporn, Pinyong Uthaitas, Natthapong Hongku & Revit Tunyasuwanakul

  2. Department of Anesthesiology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, 681 Samsen Rd, Dusit, Bangkok, 10300, Thailand

    Ploynapas Limphunudom & Fontip Leelachiewchankul

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  1. Satit Thiengwittayaporn
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  2. Pinyong Uthaitas
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Correspondence to Satit Thiengwittayaporn.

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Ethical approval

The study has been performed in compliance with the Helsinki Declaration, has been approved by the ethical committee of Navamindradhiraj University (COA126/2560) and registered on ClinicalTrials.gov (NCT03341819).

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Thiengwittayaporn, S., Uthaitas, P., Hongku, N. et al. Indwelling urinary catheterization was unnecessary in non-drainage total knee arthroplasty: a randomized controlled trial. Arch Orthop Trauma Surg 141, 469–476 (2021). https://doi.org/10.1007/s00402-020-03677-z

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