Plugging the intramedullary canal of the femur in total knee arthroplasty - Reduction in postoperative blood loss

A prospective, randomized trial comparing postoperative drainage was carrie d out in 120 consecutive knees undergoing total knee arthroplasties divided into 2 groups. In one (55 knees), the entry point for the femoral intramed ullary rod was left open. In the other (65 knees), the entry point was clos ed by an autologous bone plug. The mean drainage after 24 hours and the tot al drainage were lower when the femoral canal was plugged (800 vs 960 mL an d 925 vs 1,165 mL). The bone plug always united, and no loose bodies were s een 6 months after operation. We conclude that the femoral intramedullary g uide hole should be plugged with autologous bone because this technique res ults in a small but significant reduction in early blood loss without count ervailing disadvantages.