Optimized Tourniquet Use in Primary Total Knee Arthroplasty: A Comparative, Prospective, and Randomized Study

The results of recent studies investigating tourniquet (TNQ) use for knee arthroplasty are controversial. Therefore, this study aimed to compare patients undergoing total knee arthroplasty who did not have a TNQ to those in whom an optimized TNQ protocol was applied. We prospectively evaluated 127 p...

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Bibliographic Details
Published in:The Journal of arthroplasty 2023-04, Vol.38 (4), p.685-690
Main Authors: Pavão, Douglas M., Pires eAlbuquerque, Rodrigo S., de Faria, José Leonardo R., Sampaio, Yuri D., de Sousa, Eduardo B., Fogagnolo, Fabricio
Format: Article
Language:English
Subjects:
Arthroplasty, Replacement, Knee - adverse effects
blood loss
Blood Loss, Surgical
Edema - etiology
Humans
level I therapeutic
level of evidence
Pain - complications
Postoperative Complications
Prospective Studies
Range of Motion, Articular - physiology
total knee arthroplasty
tourniquet
Tourniquets - adverse effects
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Summary:The results of recent studies investigating tourniquet (TNQ) use for knee arthroplasty are controversial. Therefore, this study aimed to compare patients undergoing total knee arthroplasty who did not have a TNQ to those in whom an optimized TNQ protocol was applied. We prospectively evaluated 127 patients who had knee osteoarthritis who had undergone total knee arthroplasty and randomized them into two groups: “without TNQ” and “optimized TNQ” (TNQ inflation before skin incision, deflation after cementing, with pressure one hundred millimeters of mercury above the systolic blood pressure, and without articular suction drain usage). The means of surgery and TNQ duration, blood loss, number of blood transfusions, degree of pain, edema, range of motion (ROM), functional score over time, and postoperative complications were compared between the groups. Statistical significance was set at P < .05. No significant differences were found in terms of surgical timing, blood loss, thigh and knee pain, edema, ROM, functional scores, and complications between the “without TNQ” and “optimized TNQ” groups. The use of an optimized TNQ in primary total knee arthroplasty presents similar clinical results to surgery without a TNQ and did not increase the incidence of postoperative complications. Its use allowed surgery to occur with the benefits of a clean and dry surgical field provided by TNQ without increasing procedure-related comorbidities.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2022.10.026