Tourniquet use during TKA does not significantly alter blood loss: study

Written By : Dr Supreeth D R |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-01-10T10:30:55+05:30 | Updated On 10 Jan 2023 12:45 PM IST

The use of a tourniquet has become widely accepted as standard practice during total knee arthroplasty (TKA). There are conflicting outcomes in using a tourniquet during TKA. This brings to question the role a tourniquet has in TKA. Therefore, Patrick Riggle et al conducted a retrospective cohort study to examine the effects of TKA with and without the use of a tourniquet.

The study has been published in 'Arthroplasty Today' journal.

A total of 120 patients (n = 60 underwent TKA with tourniquet and n = 60 underwent TKA without tourniquet) were included in this study. Patient medical records were retrospectively reviewed for preoperative and postoperative data. The Gross formula, a validated formula for calculating blood loss, was used to calculate each patient's total blood loss. Statistical analysis was performed using in dependent t-tests, Mann-Whitney U tests, and/or chi-square tests. Significance was determined using an alpha level of P < .05.

Key findings of the study were:

•There were no statistically significant differences (P < .05) between groups with regards to age, sex, body mass index, preoperative hemoglobin and hematocrit, and American Society of Anesthesiologists score

•There was no statistically significant difference (P = .49) in the amount of total blood loss between patients undergoing TKA with a tourniquet and those without (199.6 ± 92.2 mL vs 211.1 ± 88.1 mL, respectively).

•There were statistically significant differences in the operating room time (P = .005), surgery time (P = .008), and functional return of postoperative straight leg raise (P < .001) between groups.

•There were no intraoperative or immediate postoperative complications observed in either group, and no transfusions were required during the hospital stay of any patients.

The authors commented – "In conclusion, based on the result of our study, there was no statistically significant difference in the amount of total blood loss between patients undergoing TKA with a tourniquet and those without. Furthermore, there were statistically significant differences in the OR time, surgery time, and functional return of postoperative SLR ability between groups. This study supports existing evidence that tourniquet use does not alter blood loss in TKA and presents evidence that using a tourniquet during TKA may add additional cost and increase surgical time without benefit."

Key Words: Tourniquet, Total knee arthroplasty, Blood loss, TKA, Patrick Riggle, Arthroplasty Today

MBBS, Dip. Ortho, DNB ortho, MNAMS

Dr Supreeth D R (MBBS, Dip. Ortho, DNB ortho, MNAMS) is a practicing orthopedician with interest in medical research and publishing articles. He completed MBBS from mysore medical college, dip ortho from Trivandrum medical college and sec. DNB from Manipal Hospital, Bengaluru. He has expirence of 7years in the field of orthopedics. He has presented scientific papers & posters in various state, national and international conferences. His interest in writing articles lead the way to join medical dialogues. He can be contacted at editorial@medicaldialogues.in.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751