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BACKGROUND CONTEXT Prophylactic drain placement is common practice in the prevention of interstitial fluid collection, hematoma, and/or pseudomeningocele after spine surgery. However, there is no standard protocol for the management of drains, specifically regarding when they should be removed. PURPOSE To compare surgical outcomes based on drain duration and quantity of drain output before removal. STUDY DESIGN/SETTING Retrospective cohort study. PATIENT SAMPLE Patients >18 years of age who underwent lumbar spinal surgery with drain placement and available drain output data. OUTCOME MEASURES Thirty- and 90-day readmission, number of surgical take-backs during readmission, wound complication rate, and infection rate. Methods A retrospective review of patients at a single academic institution undergoing lumbar surgery from April 2017 to March 2020 was performed. Patient demographics, 8-hour drain output before removal, and duration of drain were retrospectively reviewed. Cohorts were dichotomized by the 3rd quartile for last 8-hour drain output (≥40cc or 2 days or ≤2 days). Results A total of 1,166 patients were included in the analysis. The mean duration of drains was 2.45 days, last 8-hour shift output was 29.5 mL, levels fused 1.93, and length of stay was 3.76 days. The readmission rate was 9.51% with 69.4% occurring in the first 30 days and 28.8% within 90 days after discharge. The prevalence of infection was 1.63% and wound complication was 0.6%. Of total patients, 342 had ≥40 cc output over last 8-hour shift prior to removal, and 825 patients had less than 40 cc. The mean output for each group was 65.3 mL and 14.7 mL, respectively. Patients in the ≥40 cc group were younger age (p 2 days group and 687 patients in the ≤2 days group. Drains remaining for >2 days were associated with older (p=0.03) and female (p=0.01) patients, with a greater number of levels fused (p Conclusions The duration of drain placement or output at removal after lumbar spine surgery does not appear to influence the rates of infection, wound complications, readmission, or revision surgery. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.

Introduction Le positionnement du bouton patellaire de facon optimale est necessaire pour le succes d’une prothese totale de genou. Generalement, le bouton patellaire est place d’une maniere empirique au centre de la surface de coupe. La medialisation du bouton a ete recommandee. Cependant, aucune ligne directrice de technique chirurgicale n’a ete rapportee. Cette etude anatomique a pour objectif de quantifier la position ideale du bouton prothetique par rapport au centre de la surface de coupe patellaire. Materiel et methodes Nous presentons une serie prospective monocentrique de 129 PTG (117 patients). Nous avons realise dans tous les cas une voie d’abord mediane, une arthrotomie mediale et une eversion externe de la patella. La crete verticale cartilagineuse est dessinee. Le milieu de cette ligne est identifie comme le centre optimal du bouton patellaire. De ce point, on meche un tunnel partant perpendiculairement a la corticale anterieure de la patella sans la traverser. La coupe patellaire est alors realisee en gardant une epaisseur osseuse de 15 mm. Sur la surface de coupe obtenue, nous retrouvons le trou du mechage (centre optimal) et dessinons le milieu de cette surface. Nous mesurons alors la difference de distance entre le centre optimal et le centre de la coupe patellaire sur un axe vertical (proximal/distal) et sur un axe horizontal (medial/lateral). L’analyse statistique a ete faite sur logiciel StatsDirect (Altrincham) avec utilisation du Student test et des lignes de regression pour les correlations. Resultats Les resultats obtenus ont demontre que : (a) les coupes patellaires ont illustre une difference morphologique significative entre les hommes et les femmes (p Discussion Le positionnement du bouton patellaire durant une prothese totale de genou differe d’un individu a l’autre. Cependant, en determinant selon chaque patient, le centre optimal de positionnement du bouton patellaire, le chirurgien devrait pouvoir reproduire l’anatomie fonctionnelle de la patella de base.