Background: The use of tourniquet during complete knee arthroplasty (TKA) improves protection and reduces blood loss intraoperative. Turniquet use, however, may also have a negative impact after TKA on early recovery of muscle strength and lower extremity function. The purpose of this study was to demonstrate the effect of tourniquet use in TKA on surgery length, need for blood transfusion, and amount of postoperative blood drainage by suction drain, incidence of postoperative wound hematoma, postoperative thigh pain, and early mobilization.
Methods: Seventy Patients are involved in this study and were divided into two groups; Group A (35) patients were treated with TKA with pneumatic thigh tourniquet. Group B (35) patients were treated with TKA without tourniquet. All patients were suffering from severe knee osteoarthritis and they failed to respond to conservative treatment so they are candidates for primary TKA. The two groups are matched related to age and gender. Selection of patients into two groups done randomly with regard of odd number for group A and even number for group B.
Results: The results showed no significant difference regarding age, gender ,postoperative DVT and wound hematoma between group A (when tourniquet was used) and group B (when tourniquet was not used) although we have 2 patients developed DVT and 3 patients had wound hematoma in group A but these are statistically not significant. Regarding post-operative VAS for thigh pain was significantly less in group B and this will result in early mobilization. Also there was significant difference in duration of surgery between two groups with less time in group A due to bloodless field of tourniquet while there was significantly more postoperative drainage amount of blood through the surgical drains in group A and significantly more amount of blood transfusion perioperatively in group B which explain that tourniquet can reduce the total amount of blood loss in TKA.
Conclusion: There is significant effect of tourniquet in TKA on thigh pain postoperatively, which will effect postoperative mobilization and rehabilitation. Also the tourniquet can result in significant reduction in time of operation, total blood loss and amount of blood transfusion.
Trial registration: NCT, NCT04130009. Registered 17 October 2019 - Retrospectively registered, https://clinicaltrials.gov/NCT04130009