Effect of tourniquet application on deep vein thrombosis after total knee arthroplasty.
BACKGROUND
There is a great deal of controversy about the effect of tourniquets on development of deep vein thrombosis (DVT) after total knee arthroplasty (TKA).


METHODS
We investigated the incidence of postoperative DVT after TKA with or without the use of a tourniquet. The patients were 48 consecutive patients undergoing primary ipsilateral cemented TKA for osteoarthritis. Group A (21 patients) underwent the operation without a tourniquet, and Group B (27 patients) underwent the operation with a tourniquet. Ultrasonography to assess DVT was performed before and after the operation.


RESULTS
Group B had less intraoperative and total blood loss than Group A. Postoperative DVT was detected in 81.3% of all cases, and symptomatic pulmonary embolism occurred in 1.7%. Most of DVT was found in the calf vein. There was no significant difference in the incidence of postoperative DVT between the two groups.


CONCLUSIONS
We conclude that the use of a tourniquet is beneficial, because it decreases perioperative blood loss and does not increase the risk of DVT. The incidence of DVT after TKA is considerably high with or without use of a tourniquet. Therefore, prevention and early detection of DVT are important for prevention of fatal pulmonary thromboembolism.
Fukuda
Aki
A
Department of Orthopaedic Surgery, Mie University Faculty of Medicine, 2-174 Edobashi, Tsu city, Mie 514-8507, Japan. aki0611@clin.medic.mie-u.ac.jp
Hasegawa
Masahiro
M
Kato
Ko
K
Shi
Dequan
D
Sudo
Akihiro
A
Uchida
Atsumasa
A
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery; D011183:Postoperative Complications; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000209:etiology; D014111:Tourniquets; D020246:Venous Thrombosis / Q000209:etiology*