Clinical application of individualized tourniquet pressure in primary total knee arthroplasty

doi:10.3969/j.issn.2095-4344.1235

Abstract

Abstract:

BACKGROUND: Total knee arthroplasty is a routine surgical procedure for joint surgery. Tourniquet has been widely used in total knee arthroplasty. However, there is no unified understanding of how to select the appropriate tourniquet pressure, and whether the selection of appropriate individual tourniquet pressure is helpful to the enhanced rehabilitation of patients undergoing total knee arthroplasty needs further investigation.

OBEJCTIVE: To investigate the clinical efficiency and complications of individualized tourniquet pressure in patients undergoing primary total knee arthroplasty.

METHODS: One hundred patients with primary unilateral total knee arthroplasty were enrolled and randomly divided into trial and control groups, 50 in each group. The limb occlusion pressure was determined as tourniquet pressure by Doppler ultrasound in the trial group, while 70 kPa pressure was chosen as tourniquet pressure in the control group. All patients signed the informed consents and the study was approved by the ethics committee of the hospital. The intraoperative blood loss, postoperative drainage volume, hidden blood loss, total blood loss and the incidence of deep venous thrombosis were recorded. The Visual Analogue Scale score, range of motion of knee joint and lower extremity swelling at 1, 3 and 5 days after surgery, and the Hospital for Special Surgery score at 1 month after surgery were compared.

RESULTS AND CONCLUSION: (1) The Visual Analogue Scale scores at rest and in activity at 1 and 3 days after surgery and in activity at 5 days after surgery in the trial group were significantly lower than those in the control group (P < 0.05). There was no significant difference in the Visual Analogue Scale scores at rest at 5 days after surgery between two groups (P > 0.05). (2) The lower extremity swelling at 1 and 3 days after surgery in the trial group was significantly lighter than that in the control group (P < 0.05), and there was no significant difference at 5 days after surgery between two groups (P > 0.05). (3) There was no significant difference in the range of motion of knee joint at 1, 3, and 5 days after surgery between two groups (P > 0.05). (4) There was no significant difference in the Hospital for Special Surgery score, intraoperative blood loss, postoperative drainage volume, hidden blood loss and total blood loss at 1 month after surgery between two groups (P > 0.05). (5) These results indicate that the individualized tourniquet pressure assisted by Doppler ultrasound contributes to relieving early pain and lower extremity swelling after primary total knee arthroplasty, and can accelerate the functional recovery.

Key words: total knee arthroplasty, tourniquet, individualized tourniquet pressure, limb occlusion pressure, Doppler ultrasound, deep venous thrombosis, blood loss, lower extremity swelling, the National Natural Science Foundation of China

CLC Number:

R459.9

Zhou Jianguo, Hu Weiquan, Bi Shengrong, Hu Bijuan, Liu Shiwei, Xiong Long, Qian Rui. Clinical application of individualized tourniquet pressure in primary total knee arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(20): 3136-3142.

Figures/Tables 8

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