Efficacy of Tourniquet Use in Total Knee Arthroplasty: A Retrospective Cohort Review
Background: 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, we conducted a retrospective cohort study to...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-10-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344122001753 |
| _version_ | 1817984688667492352 |
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| author | Patrick Riggle, DO Paul A. Ulrich, DO Samual Lindemeier, DO Jason M. Cochran, DO John M. Popovich, Jr., PhD, DPT, ATC |
| author_facet | Patrick Riggle, DO Paul A. Ulrich, DO Samual Lindemeier, DO Jason M. Cochran, DO John M. Popovich, Jr., PhD, DPT, ATC |
| author_sort | Patrick Riggle, DO |
| collection | DOAJ |
| description | Background: 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, we conducted a retrospective cohort study to examine the effects of TKA with and without the use of a tourniquet. Methods: 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 independent t-tests, Mann-Whitney U tests, and/or chi-square tests. Significance was determined using an alpha level of P < .05. Results: 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). However, 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. Conclusions: This study supports existing evidence that tourniquet use during TKA does not significantly alter blood loss and presents evidence that using a tourniquet during TKA may add additional cost and increase surgical time without benefit. |
| first_indexed | 2024-04-13T23:47:58Z |
| format | Article |
| id | doaj.art-4a2bc55c05b4413689059458bd2b8e4c |
| institution | Directory Open Access Journal |
| issn | 2352-3441 |
| language | English |
| last_indexed | 2024-04-13T23:47:58Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj.art-4a2bc55c05b4413689059458bd2b8e4c2022-12-22T02:24:13ZengElsevierArthroplasty Today2352-34412022-10-0117155158Efficacy of Tourniquet Use in Total Knee Arthroplasty: A Retrospective Cohort ReviewPatrick Riggle, DO0Paul A. Ulrich, DO1Samual Lindemeier, DO2Jason M. Cochran, DO3John M. Popovich, Jr., PhD, DPT, ATC4Department of Orthopedic Surgery, HealthPartners Specialty Center, Saint Paul, MN, USA; Department of Orthopedic Surgery, McLaren Greater Lansing Hospital, Lansing, MI, USA; Department of Osteopathic Surgical Specialties, Michigan State University, East Lansing, MI, USA; Department of Orthopedic Surgery, Sparrow Hospital, Lansing, MI, USADepartment of Orthopedic Surgery, McLaren Greater Lansing Hospital, Lansing, MI, USA; Department of Osteopathic Surgical Specialties, Michigan State University, East Lansing, MI, USA; Department of Orthopedic Surgery, Sparrow Hospital, Lansing, MI, USA; Corresponding author. Department of Orthopedic Surgery, McLaren-Greater Lansing Hospital, 2900 Collins Road, Lansing, MI 48910, USA. Tel. : +1 517 975 7877.Department of Orthopedic Surgery, McLaren Greater Lansing Hospital, Lansing, MI, USA; Department of Osteopathic Surgical Specialties, Michigan State University, East Lansing, MI, USA; Department of Orthopedic Surgery, Sparrow Hospital, Lansing, MI, USA; Department of Orthopedic Surgery, Essentia Health-Fargo, Fargo, ND, USADepartment of Orthopedic Surgery, McLaren Greater Lansing Hospital, Lansing, MI, USA; Department of Osteopathic Surgical Specialties, Michigan State University, East Lansing, MI, USA; Department of Orthopedic Surgery, Sparrow Hospital, Lansing, MI, USACenter for Neuromusculoskeletal Clinical Research, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USABackground: 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, we conducted a retrospective cohort study to examine the effects of TKA with and without the use of a tourniquet. Methods: 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 independent t-tests, Mann-Whitney U tests, and/or chi-square tests. Significance was determined using an alpha level of P < .05. Results: 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). However, 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. Conclusions: This study supports existing evidence that tourniquet use during TKA does not significantly alter blood loss and presents evidence that using a tourniquet during TKA may add additional cost and increase surgical time without benefit.http://www.sciencedirect.com/science/article/pii/S2352344122001753TourniquetTotal knee arthroplastyBlood lossTKA |
| spellingShingle | Patrick Riggle, DO Paul A. Ulrich, DO Samual Lindemeier, DO Jason M. Cochran, DO John M. Popovich, Jr., PhD, DPT, ATC Efficacy of Tourniquet Use in Total Knee Arthroplasty: A Retrospective Cohort Review Arthroplasty Today Tourniquet Total knee arthroplasty Blood loss TKA |
| title | Efficacy of Tourniquet Use in Total Knee Arthroplasty: A Retrospective Cohort Review |
| title_full | Efficacy of Tourniquet Use in Total Knee Arthroplasty: A Retrospective Cohort Review |
| title_fullStr | Efficacy of Tourniquet Use in Total Knee Arthroplasty: A Retrospective Cohort Review |
| title_full_unstemmed | Efficacy of Tourniquet Use in Total Knee Arthroplasty: A Retrospective Cohort Review |
| title_short | Efficacy of Tourniquet Use in Total Knee Arthroplasty: A Retrospective Cohort Review |
| title_sort | efficacy of tourniquet use in total knee arthroplasty a retrospective cohort review |
| topic | Tourniquet Total knee arthroplasty Blood loss TKA |
| url | http://www.sciencedirect.com/science/article/pii/S2352344122001753 |
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