The effects of tourniquet use on blood loss and perioperative complications in total knee arthroplasty

BMC Musculoskeletal Disorders

Research

Shun Guo¹  Xinyu Zhao¹  Yang Tan¹  Hua Wang¹  Jun Qin¹  Kai Tie¹  Liaobin Chen¹ 

[1] Division of Joint surgery and Sports Medicine, Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China;

关键词: Tourniquet;    Total knee arthroplasty;    Blood loss;    D-dimer;    Complications;   

DOI  :  10.1186/s12891-023-06979-6

 received in 2023-06-04, accepted in 2023-10-19,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThere has been ongoing debate about the use of tourniquets in total knee arthroplasty, and their application is widely studied. A comprehensive understanding of the advantages and disadvantages of tourniquet use during the procedure is crucial for optimizing surgical outcomes. This study aimed to investigate the effectiveness of tourniquet application, with a particular focus on blood loss and perioperative complications, providing valuable insights for clinical practice.MethodsFifty patients who underwent total knee arthroplasty were randomized into tourniquet (n = 25) and nontourniquet (n = 25) groups. The same surgeon performed all surgical procedures. The follow-up time was 14 days after surgery. Primary outcomes were hemoglobin level changes, blood loss, operation time, and perioperative plasma D-dimer levels. Secondary outcomes were postoperative complications, including thrombotic and nonthrombotic events.ResultsNo significant differences were found in drainage, calculated blood loss, total blood loss, postoperative hemoglobin levels, or blood transfusion between the two groups (P > 0.05). No differences in D-dimer levels were observed on postoperative Days 1, 3, and 14 between the two groups, except on postoperative Day 7, when the D-dimer level in the tourniquet group was lower than that in the nontourniquet group (P = 0.03). The incidence of local complications (thigh bruising, blisters, pain, fat liquefaction, and superficial infections) in the tourniquet group was significantly higher than that in the nontourniquet group (P = 0.03), but no significant differences were found in thromboembolic and nonthromboembolic events or overall complications (P > 0.05).ConclusionWe conclude that tourniquet use does not reduce the length of surgery or blood loss but does increase local complications in total knee arthroplasty.

【 授权许可】

CC BY   
© The Author(s) 2023