The effect of tourniquet use on fixation quality in cemented total knee arthroplasty a prospective randomized clinical controlled RSA trial.
BACKGROUND
A concern that arises with any change in technique is whether it affects the long-term implant stability. The objective of this study was to evaluate the early migration, measured by radiostereometric analysis (RSA), and the functional outcome of the Triathlon™ cemented knee prosthesis, operated on with or without a tourniquet. During the last decades RSA has emerged as a way to assess prosthetic fixation and long time prognosis. The method has been used extensively in both hip and knee arthroplasty.


METHODS
This was a single centre prospective study including 60 patients randomized into two groups operated on either with or without tourniquet. RSA investigation was done within 2-3 days postoperatively after full weight bearing, and then at 3 months, 1 year and 2 years postoperatively.


RESULTS
There were no differences between the groups regarding the translation along or rotation around the three coordinal axes, or in maximum total point motion (MTPM). At 2 years the mean MTPM (SD) was 0.71 mm (0.64) for the tourniquet-group and 0.53 mm (0.21) for the non-tourniquet-group.


CONCLUSIONS
The tibial tray of the Triathlon™ cemented knee prosthesis showed similar early stability whether operated on with or without tourniquet.


METHODS
Level I.
Article focus: A safety study for total knee replacement operated on with or without perioperative tourniquet regarding the prosthetic fixation. Strengths and limitations: Strength of this study is that it is a randomized prospective trial using an objective measuring tool. The sample size of 25-30 patients is reportedly sufficient for the screening of implants using RSA (1-3).


BACKGROUND
Clinical trials NCT01604382, Ethics Committee approval D-nr: 144/20085.
Department of Orthopaedics, Hässleholm-Kristianstad-Ystad, Sweden; Department of Clinical Sciences, Lund University, Lund, Sweden. Electronic address: mats.molt@skane.se.
Mats
M
Molt
Department of Anaesthesiology, Hässleholm Hospital, Hässleholm, Sweden; Department of Clinical Sciences, Lund University, Lund, Sweden.
Andreas
A
Harsten
Department of Orthopaedics, Hässleholm-Kristianstad-Ystad, Sweden; Department of Clinical Sciences, Lund University, Lund, Sweden.
Sören
S
Toksvig-Larsen
D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001843:Bone Cements; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D007720:Knee Prosthesis; D008297:Male; D020370:Osteoarthritis, Knee / Q000601:surgery; D011446:Prospective Studies; D059869:Radiostereometric Analysis; D016059:Range of Motion, Articular / Q000502:physiology; D012399:Rotation; D014111:Tourniquets
D001843:Bone Cements
Prospective; RSA; Randomized; Total knee arthroplasty; Tourniquet