Optimized use of tourniquet in total knee arthroplasty

doi:10.3969/j.issn.2095-4344.1233

Abstract

Abstract:

BACKGROUND: Pneumatic tourniquet can reduce bleeding in operation area and provide clear surgical visual field. However, because of its many collateral injuries, scholars at home and abroad have more controversies on the application of tourniquet.

OBJECTIVE: To investigate the clinical efficacy of optimized use of tourniquet in total knee arthroplasty.

METHODS: Clinical data of 96 patients with osteoarthritis who underwent primary unilateral total knee arthroplasty at the People’s Hospital of Hebi from December 2016 to June 2018 were retrospectively analyzed. The patients were divided into two groups according to the strategy of tourniquet. The control group (n=56) was treated with tourniquet before osteotomy and removed after bone cement fixation. The observation group (n=40) used tourniquet only in bone cement fixation. The operation time, tourniquet usage time, intraoperative blood loss, postoperative blood loss, and incidence of complications were recorded. The Visual Analogue Scale score, Hospital for Special Surgery score, range of motion of the knee joint, swelling of the affected limb, quadriceps muscle strength recovery and surgical satisfaction at postoperative 3 days were evaluated and compared.

RESULTS AND CONCLUSION: (1) There was no significant difference in the operation time and total blood loss between two groups (P > 0.05). The tourniquet usage time in the observation group was significantly shorter than that in the control group (P < 0.05). The intraoperative blood loss in the observation group was higher than that in the control group, and the postoperative blood loss and hidden blood loss in the observation group were lower than those in the control group (P < 0.05). (2) The postoperative Visual Analogue Scale score, range of motion of the knee joint, Hospital for Special Surgery score, the swelling rate of the affected limbs, straight leg raise to 45°, and postoperative satisfaction in the observation group were significantly higher than those in the control group (P < 0. 05). (3) The incidence of postoperative complications in both groups showed no significant difference (P > 0.05). (4) In summary, the optimized use of tourniquet can reduce postoperative pain, swelling and drainage, promote the recovery of muscle strength and joint function, improve the satisfaction of patients, and has no significant effect on the total blood loss of total knee arthroplasty, but it can increase the intraoperative blood loss.

Key words: optimized use of tourniquet, total knee arthroplasty, blood loss, pain, swelling, muscle strength, range of motion of the knee joint, satisfaction of patients

CLC Number:

R459.9

Zhao Juntao, Zheng Chengsheng, Wang Bo. Optimized use of tourniquet in total knee arthroplasty [J]. Chinese Journal of Tissue Engineering Research, 2019, 23(20): 3124-3129.

Figures/Tables 5

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