title: Faster recovery without the use of a tourniquet in total knee arthroplasty.
abstract: OBJECTIVE
  Tourniquet application is still a common practice in total knee arthroplasty (TKA) surgery despite being associated with several adverse effects. We evaluated the effects of tourniquet use on functional and clinical outcome and on knee range of motion (ROM).
  
  
  METHODS
  70 patients who underwent TKA were randomized into a tourniquet group (n = 35) and a non-tourniquet group (n = 35). All operations were performed by the same surgeon and follow-up was for 1 year. Primary outcomes were functional and clinical outcomes, as evaluated by KOOS and knee ROM. Secondary outcomes were intraoperative blood loss, surgical time and visibility, postoperative pain, analgesic consumption, and transfusion requirements.
  
  
  RESULTS
  Patients in the non-tourniquet group showed a better outcome in all KOOS subscores and better early knee ROM from surgery to week 8. No difference was detected at the 6- and 12-month follow-ups. Postoperative pain and analgesic consumption were less when a tourniquet was not used. Surgical time and visibility were similar between groups. Intraoperative blood loss was greater when not using a tourniquet, but no postoperative transfusions were required.
  
  
  CONCLUSIONS
  This study shows that TKA without the use of a tourniquet results in faster recovery in terms of better functional outcome and improved knee ROM. Furthermore, reduced pain and analgesic use were registered and no intraoperative difficulties were encountered.
authors: Department of Orthopedic Surgery.
authors: Ashir
authors: A
authors: Ejaz
authors: Anders C
authors: AC
authors: Laursen
authors: Andreas
authors: A
authors: Kappel
authors: Mogens B
authors: MB
authors: Laursen
authors: Thomas
authors: T
authors: Jakobsen
authors: Sten
authors: S
authors: Rasmussen
authors: Poul Torben
authors: PT
authors: Nielsen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000209:etiology*; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation / Q000379:methods / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology*; D011446:Prospective Studies; D016059:Range of Motion, Articular; D020127:Recovery of Function; D014111:Tourniquets / Q000009:adverse effects*; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000209:etiology