Volume 10, Issue 1 (2-2023)
JROS 2023, 10(1): 15-20 |
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bagherifard A, jabalameli M, Yahyazadeh H, Bahamin S, Nozaeim M H. Impact of Tourniquet on Blood Loss and Postoperative Recovery in Total Knee Arthroplasty: A Randomized Clinical Trial. JROS 2023; 10 (1) :15-20
URL: http://jros.iums.ac.ir/article-1-2233-en.html
URL: http://jros.iums.ac.ir/article-1-2233-en.html
Abolfazl Bagherifard1 
, Mahmoud Jabalameli1 , Hooman Yahyazadeh1 , Seyda Bahamin 1, Mohammad Hasan Nozaeim1
, Mahmoud Jabalameli1 , Hooman Yahyazadeh1 , Seyda Bahamin 1, Mohammad Hasan Nozaeim1
1- Department of Orthopedics, Bone and Joint Reconstruction Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Abstract: (76 Views)
Background: Total knee arthroplasty (TKA) is an effective surgical procedure for alleviating pain and improving function in patients with severe knee osteoarthritis. However, significant intraoperative blood loss is a common concern, often necessitating blood transfusions and increasing the risk of complications. A tourniquet during TKA is a widely accepted technique to reduce blood loss and improve implant fixation, but it may lead to postoperative pain and restricted range of motion (ROM).
Objectives: This randomized clinical trial aimed to compare intraoperative blood loss, postoperative ROM, and pain in patients undergoing TKA with and without a tourniquet.
Methods: A total of 34 patients were randomized into two groups: 18 patients in the tourniquet group (TG) and 16 in the non-tourniquet group (NTG). Intraoperative blood loss, postoperative hemoglobin levels, ROM, thigh pain, and straight leg raise (SLR) were measured at multiple intervals postoperatively.
Results: The results showed that the TG group had significantly lower intraoperative blood loss (236.11 mL vs 531.25 mL, P<0.001) and higher postoperative hemoglobin levels than the NTG group. However, the TG group experienced significantly lower ROM on the first and second postoperative days (P<0.001) and reported greater thigh pain. By six months postoperatively, the two groups had no significant difference in ROM.
Conclusion: Using a tourniquet in TKA significantly reduces intraoperative blood loss but is associated with increased immediate postoperative pain and reduced early ROM. However, these adverse effects do not persist long-term. Individualized patient care and strategies to optimize tourniquet use are recommended to balance these outcomes.
Objectives: This randomized clinical trial aimed to compare intraoperative blood loss, postoperative ROM, and pain in patients undergoing TKA with and without a tourniquet.
Methods: A total of 34 patients were randomized into two groups: 18 patients in the tourniquet group (TG) and 16 in the non-tourniquet group (NTG). Intraoperative blood loss, postoperative hemoglobin levels, ROM, thigh pain, and straight leg raise (SLR) were measured at multiple intervals postoperatively.
Results: The results showed that the TG group had significantly lower intraoperative blood loss (236.11 mL vs 531.25 mL, P<0.001) and higher postoperative hemoglobin levels than the NTG group. However, the TG group experienced significantly lower ROM on the first and second postoperative days (P<0.001) and reported greater thigh pain. By six months postoperatively, the two groups had no significant difference in ROM.
Conclusion: Using a tourniquet in TKA significantly reduces intraoperative blood loss but is associated with increased immediate postoperative pain and reduced early ROM. However, these adverse effects do not persist long-term. Individualized patient care and strategies to optimize tourniquet use are recommended to balance these outcomes.
Keywords: Total knee arthroplasty (TKA), Tourniquet, Blood loss, Range of motion (ROM), Postoperative pain
Type of Study: Research Article |
Subject:
Knee surgery
Received: 2022/12/13 | Accepted: 2023/01/28 | Published: 2023/02/1
Received: 2022/12/13 | Accepted: 2023/01/28 | Published: 2023/02/1
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