Post-operative clinical outcomes in patients with or without the use of tourniquet in total knee replacement surgery

Author(s): Dr. Mayur Rai, Dr. Amlan Mohapatra, Dr. Radhesh and Dr. Bhaskar Bhandary

Abstract: Introduction: The use of tourniquet in a total knee replacement (TKR) has been advocated by some researchers across the globe, though the evidence is still lacking. In this study we aimed to assess the effect of using a torniquet in patients undergoing total knee replacement on the post-operative blood drainage and range of movement of the operated knee.
Methodology: We included patients who were admitted for undergoing total knee replacement (TKR) surgeries in the Department of Orthopedics at the A.J. Institute of Medical Sciences during the period of November 2014 to May 2016. We included 20 patients who underwent TKR using a tourniquet and 20 age and gender matched control patients who underwent TKR without the use of tourniquet. The cases underwent surgery with tourniquet throughout the surgery at a pressure of 350 mmHg and the control group without tourniquet (inflated only for 20 minutes during cementing). Post-operative drain collection and recovery of range of movements at knee joint on 7th post-operative day were compared using unpaired t-test. p value less than 0.05 was considered statistical significant.
Results: At baseline, with respect to the demographic data and pain, both the groups were comparable. A mean of 1009 ± 168 mL drainage was collected in the torniquet group and 628 ± 116.5 mL drainage was collected in patients who were operated without the torniquet (p < 0.001). Range of motion was more at the end of 1 week post-operatively in patients without the use of torniquet (p < 0.01) as compared to patients with torniquet.
Conclusions: We compared the effect of tourniquet in patient undergoing total knee replacement. Multi-centric randomized trials are needed to further sustantiate our findings.

DOI: https://doi.org/10.22271/ortho.2017.v3.i4c.30