Efficacy of modified Robert Jones bandages on reducing invisible blood loss after total knee arthroplasty: A randomized controlled trial

Abstract

Background: Modified Robert Jones bandage (MRJB) is a bulky compressive dressing, which commonly used to reduce blood loss, pain and swelling after total knee arthroplasty (TKA). But the complications associated with MRJB have been also reported. Theoretically, in terms of postoperative blood loss, the tamponade effect of MRJB should reduce the invisible blood loss (IBL) including hemarthrosis and space for extravasation. However this potential benefit is still unclear. Objectives: This study aimed to compare the efficacy and safety of MRJB and non-compressive dressing (NCD) on reducing IBL after TKA. Materials and Methods: Eighty patients who underwent unilateral primary TKA were randomly assigned into two groups; MRJB and NCD groups. Pre- and post-operative hematocrit levels, amount of drained blood and transfused blood volume were measured and used to calculate into IBL. Pain score, degree of knee and thigh swelling, blood transfusion rate, range of motions, functional outcomes and complications were also recorded and compared between both groups. Results: There was no significant difference in the mean IBL between MRJB (221.2 ± 233.3 ml) and NCD groups (158.5 ± 186.7 ml) (p = 0.219). Postoperative pain score at rest and during ambulation, degree of knee and thigh swelling, blood transfusion rate, range of motions and functional outcomes were also similar between two groups. No serious complications were observed in both groups. Conclusions: This study cannot determine the benefit of MRJB over NCD. The use of MRJB may not be necessary after primary TKA.