Can We Forgo the Use of Tourniquets in Total Knee Arthroplasty?

Abstract

Objective To analyze whether there is more bleeding in patients undergoing total knee arthroplasty (TKA) without using a tourniquet. The secondary objectives were to analyze the operative time, the length of hospital stay, the need for transfusion, and the complication rate.

Methods The present is a retrospective study through the analysis of medical records. The patients were divided into two groups: TKA with and without the use of a tourniquet. Reductions in the levels of hemoglobin and packed cell volume 24 h and 48 h after surgery, the operative time, the length of hospital stay, the need for transfusion, and the rate of complications up to 6 months postoperatively were compared between the groups.

Results During the period analyzed, 104 patients underwent TKA, and 94 were included in the study. There were no differences between the groups regarding the mean values of hemoglobin and packed cell volume before surgery (p = 0.675 and p = 0.265), 24 h (p = 0.099 and p = 0.563), and 48 h (p = 0.569 and p = 0.810) after the procedure. Neither were there differences between the groups in terms of the operative time and the length of hospital stay (p = 0.484 and p > 0.05). Moreover, there were no differences regarding the need for transfusion and the complication rate.

Conclusion It is possible to forgo the use a tourniquet in TKA without a significant change in hemoglobin and packed cell volume levels 24 h and 48 h after surgery when compared with the group using a tourniquet. There were no significant differences in the total operative time, length of stay, need for transfusion, and complication rate.

Keywords

arthroplasty - knee - hemorrhage - tourniquet

Authors' Contributions

Each author contributed individually and significantly to the development of the present paper. JPFG wrote and reviewed the paper, analyzed the results, developed the statistical analysis, participated in the intellectual conception of the study, and coordinated the entire project; CWJ, BZ, and PMC collected data, wrote, and reviewed the paper; PRB analyzed the results and developed the statistical analysis; MVD reviewed the paper and participated in the intellectual conception of the study.

Work developed at the Hospital Evangélico de Londrina, Hospital de Ortopedia Uniort.e, and the School of Medicine of Pontifícia Universidade Católica do Paraná – Câmpus Londrina, PR, Brazil.

Publication History

Received: 04 March 2023

Accepted: 21 July 2023

Article published online:
10 April 2024

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