title: The influence of a half-course tourniquet strategy on peri-operative blood loss and early functional recovery in primary total knee arthroplasty.
abstract: OBJECTIVE
  The aim of this study was to explore the influence of a half-course tourniquet strategy on the peri-operative blood loss and early functional recovery in primary total knee arthroplasty.
  
  
  METHODS
  A prospective clinical randomised controlled study was carried out in which 64 patients were equally divided into two groups: half-course group and whole-course group. A series of indicators were observed and recorded. These included operation time, peri-operative blood loss, visual analogue scale (VAS) score of the thigh or knee, limb swelling index, rehabilitation progress and occurrence of deep venous thrombosis cases.
  
  
  RESULTS
  There was no significant difference in operation time between the two groups. The intra-operative blood loss was slightly more in the half-course group, while the difference was not significant. The post-operative blood loss and calculated blood loss were less in the half-course group and the difference was significant. The thigh VAS score, limb swelling and time intervals required for patients to achieve straight leg raises and 90° of knee flexion in the half-course group were better than in the whole-course group. No case of symptomatic deep venous thrombosis happened in this study, while occult incidence of deep venous thrombosis happened in both groups, but no significant difference between the groups was confirmed.
  
  
  CONCLUSIONS
  The half-course tourniquet strategy could decrease the total peri-operative blood loss in primary total knee arthroplasty. It was beneficial in helping patients to achieve earlier functional recovery by improving the pain experience and limb swelling early in the post-operative period.
authors.affiliation: Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, People's Republic of China.
authors.forename: Sen
authors.initials: S
authors.lastname: Chen
authors.forename: JianPing
authors.initials: J
authors.lastname: Li
authors.forename: Hao
authors.initials: H
authors.lastname: Peng
authors.forename: Jianlin
authors.initials: J
authors.lastname: Zhou
authors.forename: Hongsong
authors.initials: H
authors.lastname: Fang
authors.forename: Huifeng
authors.initials: H
authors.lastname: Zheng
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D007719:Knee Joint / Q000502:physiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D019990:Perioperative Care / Q000379:methods*; D011184:Postoperative Period; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology*; D014111:Tourniquets; D020246:Venous Thrombosis / Q000453:epidemiology; D064232:Visual Analog Scale