Effects of Tourniquet Use on Blood Loss and Soft-Tissue Damage in Total Knee Arthroplasty

Abstract

The use of a tourniquet during total knee arthroplasty was effective for reducing blood loss and avoiding excessive postoperative inflammation and muscle damage. The use of a tourniquet was related to slightly more postoperative pain but did not affect postoperative recovery.

Evaluation of pain in bilateral total knee replacement with and without tourniquet; a prospective randomized control trial

“…Tourniquet use during TKA surgery decreases total blood loss, creates a bloodless field and decreases operative time. 1 Complications reported as a consequence of tourniquet application are skin injury [skin abrasions, blisters, breaks & pressure necrosis], nerve injury, post tourniquet syndrome, Deep venous thrombosis, Postoperative pain, wound healing disorders and early infections. 2e12 Pain is one of the most important outcome measures that contribute to patient dissatisfaction after TKA.…”

Reply to Letter to the Editor

“…The citation for Tai et al [11] in our study was incorrect and should have been Olivecrona et al [10]. Olivecrona and colleagues found fewer wound complications and drainage when tourniquet pressure was limited to 225-mm Hg.…”

“…There were a total of 13 articles reviewed in the two [2,11] meta-analysis studies. Four [1,10,12,13] of the thirteen studies (31%) showed no difference in pain. Three [6,10,13] of the thirteen (23%) studies measured swelling, and two [10,13] of the studies showed no difference between patients with and without tourniquet use.…”

Letter to the Editor

“…A study by Tai and colleagues [9] has been mentioned as reference for a study showing that increased drainage has been correlated to tourniquet pressure more than 225-mm of Mercury. However, this study compared the tourniquet and non-tourniquet group with respect to blood loss, soft tissue damage, pain, swelling rehabilitation, and hospital stay.…”

“…It does not address the correlation between tourniquet pressure and drainage. In fact, Tai et al [9] did not use a drain in their study in order to avoid excessive blood loss.…”