Tourniquet versus no tourniquet on knee-extension strength early after fast-track total knee arthroplasty; a randomized controlled trial.Harsten, Andreas; Bandholm, Thomas; Kehlet, Henrik; Toksvig-Larsen, Sören Link to publication Citation for published version (APA): Harsten, A., Bandholm, T., Kehlet, H., & Toksvig-Larsen, S. (2015). Tourniquet versus no tourniquet on kneeextension strength early after fast-track total knee arthroplasty; a randomized controlled trial. Knee, 22(2), 126-130. DOI: 10.1016/j.knee.2014 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal TKA= total knee arthroplasty, CNS= central nervous system, ASA = American Society of Anesthesiologists, PACU= post anaesthesia care unit, LOS = length of hospital stay
Declaration of interestNone declared
FundingThe study was supported with institutional grants.Trial registry number: NCT01808859. The study was approved by the Research Ethics Committee at Lund University (no 2012/11) and was carried out at Hässleholm Hospital, Sweden.TKA= total knee arthroplasty, CNS= central nervous system, ASA = American Society of Anesthesiologists, PACU= post anaesthesia care unit, LOS = length of hospital stay
AbstractBackground. Thigh tourniquet is commonly used in total knee arthroplasty (TKA) but may contribute to pain and muscle damage. Consequently, the reduction in knee-extension strength after TKA may be caused by quadriceps muscle ischaemia underneath the cuff.Aim. To examine if not using a thigh tourniquet during surgery was more effective than using a thigh tourniquet in preserving knee-extension strength 48hours after fast-track TKA.
Methods.A total of 64 patients undergoing TKA were randomized (1:1) to the use of tourniquet (T-group) or no tourniquet (NT-group). In the T-group the tourniquet cuff pressure was based on the patient's systolic pressure and a margin of 100 mm Hg. It was inflated immediately before surgery and deflated as soon as surgery ended. The primary outcome was the change in kneeextension strength from pre-surgery to 48 hours after surgery (primary end point). Secondary outcomes were pain, nausea, length of hospital stay (LOS) and periarticular swelling.Results. Knee-extension strength 48 hours after surgery was substantially reduced by about 90% in both groups, with no statistically significant difference between groups (mean difference 1.5 N/kg, 95% CI 1.3-1.6). Among the secondary outcomes, the T-group had less bleeding during surgery (56 vs 182 mL, P < 0.01) compared with the NT-g...
