Tourniquet application only during cement fixation in total knee arthroplasty: a double-blind, randomized controlled trial

ANZ Journal of Surgery
Rajat MittalSusan Dietsch

Abstract

The functional benefits of tourniquet application for short periods compared with standard duration applications during total knee arthroplasty surgery have not been well explored. We aimed to compare functional outcomes between tourniquet application of short duration (during cement fixation only) and tourniquet application of longer duration (from skin incision to just after cement fixation). We planned to randomize 230 patients to short and long duration groups. The primary outcome was Oxford Knee Score at 10 weeks post-surgery. In-hospital blood transfusion rate was also a primary safety measure. Serial measures of knee function were taken together with knee range, quadriceps lag and timed stair tests. The trial was discontinued after randomization of 65 patients. Interim analysis indicated a higher risk of transfusion (odds ratio 7.38, P= 0.015) in the short duration group. No significant difference was observed in Oxford Knee Score at 10 weeks. There were no between-group differences in rate of recovery up to 52 weeks for any outcome. Restricting tourniquet application to the period of cementing is associated with a significantly higher risk of transfusion. This approach is impractical if it is not offset by gains in func...Continue Reading

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Citations

Mar 14, 2014·Clinical Orthopaedics and Related Research·Ankur B BamneSang Hwa Eom
Jul 12, 2013·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Xu LiYing-Ze Zhang
Jun 24, 2015·Clinical Orthopaedics and Related Research·Douglas A DennisJennifer E Stevens-Lapsley
Jun 8, 2012·ANZ Journal of Surgery·Peter F M Choong
Mar 8, 2014·Journal of Orthopaedic Surgery and Research·Wei ZhangLiaobin Chen
Sep 19, 2014·World Journal of Orthopedics·Vasileios S NikolaouGeorge C Babis
Jul 11, 2019·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Yuan LiuBin Shen
Aug 3, 2019·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Ahmed JawharUdo Obertacke
Jan 9, 2021·Archives of Orthopaedic and Trauma Surgery·Filippo MiglioriniAlice Baroncini
May 11, 2021·The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland·Filippo MiglioriniMarcel Betsch

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