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General Orthopaedics

Effects of Tourniquet on Soft Tissue Damage and Rehabilitation in Total Knee Arthroplasty- a Randomised Controlled Trial

International Society for Technology in Arthroplasty (ISTA) 2012 Annual Congress



Abstract

Background

Although tourniquets are widely used in total knee arthroplasty (TKA), their influence on the postoperative course is still unclear. In addition, tourniquet-related soft tissue damage is a major concern in daily practice. We performed a prospective, randomized controlled trial to clarify the role of tourniquets in TKA.

Methods

Seventy-two patients undergoing TKA were randomly allocated to a tourniquet or non-tourniquet group. Changes in C-reactive protein, creatine phosphokinase, and other indicators of soft tissue damage were monitored preoperatively and postoperatively on days 1, 2, and 4. Rehabilitation progress was also recorded for comparison.

Results

Patients in the tourniquet group showed smaller increases in C-reactive protein (peak values: 175 ± 55 versus 139 ± 75 mg/dl) and creatine phosphokinase (peak values: 214 ± 89 versus 162 ± 104 U/l) compared those in the non-tourniquet group. There was slightly less postoperative pain in the non-tourniquet group, and no significant differences in swelling, or rehabilitation progress.

Conclusions

Using tourniquets in TKA was effective for reducing blood loss and avoiding excessive postoperative inflammation and muscle damage. Tourniquets caused slightly more postoperative pain but did not affect postoperative recovery.