3D Computed Tomography-Guided Management of Retained Surgical Drain in Total Knee Arthroplasty - A Case Report and Technical Note

Sep 29, 2026

Uploaded by hdkawk

Total knee arthroplasty is common and can involve complications, including entrapment or retention of a surgical closed drain. Two cases are presented where retained drain segments occurred after surgery, one due to breakage during removal attempt and another from impingement between the patella and femoral component. Three-dimensional CT precisely localized the retained segments, enabling accurate site marking and minimally invasive retrieval through targeted suture removal rather than extensive exploration. The report concludes that 3D CT supports prompt, dimension-guided management.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages5

Reading Time13 min

AccessFree to download

Introduction

Case Report

Case No: 1

Case No: 2

Conclusion

Case Report Journal of Orthopaedic Case Reports 2025 December:15( 12) :Page 242-246 3D Computed Tomography-Guided Management of Retained Surgical Drain inTotal KneeArthroplasty: A Case Report and Technical Note Ashwani Mudgil1, Ravneet Kaur Gill2 Learning Point of the Article: Three-dimensional computed tomography can accurately diagnose and guide treatment planning for impinged surgical drains in knee arthroplasty patients. Abstract Introduction: Total knee arthroplasty is oneof the most common orthopedic surgeries performed worldwide. Asa major surgery, it has its own spectrum of complications, one ofwhich is a retained surgical drain requiring prompt management. While traditional imaging modalities have limitations in localizingretained drain segments, 3Dcomputed tomography (CT) offers enhanced visualization capabilities. Case Report: We report two cases with retained segments ofsurgical drains after total knee arthroplasty. In the first case, a 56-year-old female had a retained drain segment that broke after an attempt to remove it. In the second case, a 69-year-old male experienced drain breakage due to impingement between the patella and the femoral component. Both cases were successfully managed using 3D CT for precise localization, enabling minimally invasive retrieval through targeted suture removal rather than extensive wound exploration. Conclusion: Three-dimensional CT can playa valuable role in managing these complications. It can help accurately mark the site and measure dimensions fromthe proximal suture line, ultimately enabling a minimally invasive re-exploration. Keywords: Computed tomography, knee arthroplasty, orthopedic surgery, surgical closed drain. Introduction Total knee arthroplasty is one of the most commonlyperformed orthopedic surgeries worldwide, with excellent long-term outcomes and cost-effectiveness [ 1 ] . These surgeries have increased substantially over the last two decades. One surgical aspect of arthroplasty is the use of surgical drains to prevent hematoma formation and reduce unwanted sequelae. However, every intervention has potential adverse effects, one of which isan entrapped or retained surgical drain. Entrapment may occur due to several causes, including unintentional suture fixation during wound closure or entrapment between the implant and bony surfaces. Regardless of the cause, it is an unnecessary burden for both the patient and surgeon. Here, we report two cases of entrapment and retained segments of surgical closed drains in knee arthroplasty and their management using3Dcomputed tomography (CT). Case Report Case No: 1 A 56-year-old female with Grade IV osteoarthritis of the left knee underwent primary total knee arthroplasty under regional anesthesia (combined spinal epidural anesthesia) . The |
Access this article online

Website: [www.jocr.co.in](www.jocr.co.in)

DOI:
[https://doi.org/10.13107/jocr.2025.v15.i12.6522](https://doi.org/10.13107/jocr.2025.v15.i12.6522) | Author’s Photo Gallery | | | --- | --- | --- | | | | | | |
1Department of Orthopaedics, Civil Hospital, Ambala Cantt, Haryana, India,
2Department of Anaesthesia, Dr B R Ambedkar State Institute of Medical Sciences, SahibzadaAjit Singh Nagar, Punjab, India.
Address of Correspondence:
Dr. Ashwani Mudgil,
Department of Orthopaedics, Civil Hospital, Ambala Cantt, Haryana, India.
[E-mail:](E-mail: docashwanimudgil@gmail.com)[ docashwanimudgil@gmail.com](E-mail: docashwanimudgil@gmail.com) | | | Submitted: 11/09/2025; Review: 19/10/2025; Accepted: November 2025; Published: December 2025 | | | | DOI: [https://doi.org/10.13107/jocr.2025.v15.i12.6522](https://doi.org/10.13107/jocr.2025.v15.i12.6522)
© The Author(s). 2025 Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ([https://creativecommons.org/licenses/by-nc/4.0/](https://creativecommons.org/licenses/by-nc/4.0

FAQs

What complication is discussed in these total knee arthroplasty cases?

The report focuses on entrapment and retention of a surgical closed drain after total knee arthroplasty, including breakage and proximal segment retention.

Why were traditional imaging approaches insufficient in these cases?

Conventional imaging failed to clearly localize the retained drain segments, making it difficult to plan safe and targeted removal.

How does 3D computed tomography help in management?

3D CT precisely localizes the retained drain segment, enabling accurate marking of the site and measurement from the proximal suture line to support minimally invasive re-exploration.

Sep 29, 2026

Uploaded by hdkawk