Strategy of using a tourniquet in simultaneous bilateral total knee arthroplasty

doi:10.3969/j.issn.2095-4344.2015.39.006

Abstract

Abstract:

BACKGROUND: The tourniquet is usually fully used or bilaterally used in partial time during bilateral total knee arthroplasty. However, very few people try to use it on one side and on the other side in partial time.
OBJECTIVE: To investigate the effective strategy of using a tourniquet in simultaneous bilateral total knee arthroplasty.
METHODS: 80 patients (160 knees) with severe osteoarthritis who underwent simultaneous bilateral total knee arthroplasty in the Department of Orthopedics, Chinese PLA Medical School from January to December 2013 were divided into two groups according to the different tourniquet strategies. In test group (n=40), left knees did not receive tourniquet, and right knees received tourniquet in partial time. In control group (n=40), all knees received tourniquet in the whole time. The perioperative and postoperative blood loss, 3-day postoperative thigh swelling rate and pain visual analog scale, 3-week and 1-year postoperative Knee Society Score were recorded in both groups.
RESULTS AND CONCLUSION: There were no statistically significant differences between two groups in perioperative total blood loss (P > 0.05). However, postoperative blood loss in test group was less than that in control group (P < 0.05). The visual analog scale scores were significantly lower in the test group than in the control group at 3 days after surgery (P < 0.05). Visual analog scale scores on the left side were lower than on the right side in the test group at 3 days post surgery (P < 0.05). Bilateral thigh swelling rate was significantly lower in the test group than in the control group at 3 days after surgery (P < 0.05). The thigh swelling rate was lower on the left side than on the right side in the test group at 3 days after surgery (P < 0.05). Knee Society Score was higher in the test group than in the control group in the early stage, and no significant difference in long-term Knee Society Score was detected (P > 0.05). These findings verify that taking the strategy that the first knee without tourniquet and the second knee with part time tourniquet technique in simultaneous bilateral total knee arthroplasty will alleviate pain and swelling after operation and promote early functional rehabilitation without increasing the perioperative total blood loss.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Arthroplasty, Replacement, Knee, Knee Joint, Tourniquets, Hemorrhage

CLC Number:

R318

Gong Ke, An Xiao, Zhang Qi, Dong Ji-yuan. Strategy of using a tourniquet in simultaneous bilateral total knee arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(39): 6262-6267.

Figures/Tables 7

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