TITLE

Tourniquet Use During Total Knee Arthroplasty Did Not Reduce Total Blood Loss

AUTHOR(S)
Tetro, A.M.; Rudan, J.F.
PUB. DATE
August 2001
SOURCE
Journal of Bone & Joint Surgery, American Volume;Aug2001, Vol. 83-A Issue 8, p1282
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Question: In patients having cemented total knee arthroplasty, how effective is the use of tourniquets in preventing blood loss? Design: Randomized (allocation concealed), unblinded, controlled trial with 7-day follow-up. Setting: A hospital in Kingston, Ontario, Canada. Patients: 63 patients (mean age, 71 years; 59% women) who had cemented primary total knee arthroplasty. 94% had a diagnosis of osteoarthrifts and 6% had a diagnosis of rheumatoid arthritis. Exclusion criteria were bilateral total knee arthroplasty performed simultaneously or less than 3 months apart, bleeding diathesis, revision total knee arthroplasty, musculoskeletal infection of the ipsilateral limb, and peripheral vascular disease. Follow-up was complete. Intervention: Patients were assigned to a tourniquet group (n = 33) or a non-tourniquet group (n = 30) during cemented total knee arthroplasty. In the tourniquet group, the leg was elevated and exsanguinated before the tourniquet was inflated to 125 to 150 mm Hg above the systolic blood pressure (maximum, 300 mm Hg). The tourniquet was deflated after the bone cement set, and electrocautery was used to achieve hemostasis. In the non-tourniquet group, electrocautery was used as necessary. All patients had suction wound drains. Main outcome measures: The primary outcome measure was blood loss, which included intraoperative blood loss, blood loss due to Hemovac drainage, total measured blood loss (the sum of intraoperative and Hemovac-drainage blood loss), and calculated blood loss (adjusted for patient sex, height, and weight). Secondary outcome measures were operative time, complications, and length of hospital stay. Main results: Although intraoperative blood loss was greater in the non-tourniquet group (P < 0.001), the total measured blood loss did not differ between groups (P > 0.25) (table). The calculated blood loss was greater in the tourniquet group than in the non-tourniquet group (P = 0.02) (table). The tourniquet group required...
ACCESSION #
5977567

 

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