Tourniquet use during total knee arthroplasty does not offer significant benefit: A retrospective cohort study.
BACKGROUND
Tourniquets are routinely employed during total knee arthroplasty; however, their use remains controversial.


METHODS
This study investigates the efficacy and safety of this practice. A retrospective analysis of 186 patients was performed to assess benefits and/or risks associated with tourniquet use during knee arthroplasty. Total knee arthroplasty was performed using the Biomet Vanguard(®) PCL Prosthesis (Biomet, Warsaw, IN, USA). In total, 126 patients who had undergone total knee arthroplasty were included in our final analysis.


RESULTS
Patients with tourniquets had significantly less intraoperative blood loss than patients without (P < .001); patients without tourniquets required more blood transfusions (P = .551), and had significantly longer surgical times (P = .011). However, patients with tourniquets had more postoperative blood loss (P < .001), longer hospital stays (P = .013), and more frequent complications (P = .571). Blood transfusion requirement was significantly associated with complications (P < .001).


CONCLUSIONS
Tourniquet use provided no overall benefit.
Department of Orthopaedics, Kanuni Sultan Suleyman Training and Research Hospital, Atakent Mh., 1. Cd, 34303, Küçükçekmece, Istanbul, Turkey. Electronic address: serhatmutlu@hotmail.com.
Serhat
S
Mutlu
Department of Orthopaedics, Medipol University Medical School, Atatürk Bulvarı No:27, Unkapanı, 34083, Fatih, Istanbul, Turkey.
Olcay
O
Guler
Department of Orthopaedics, Taksim Training and Research Hospital, Karayollari Mahallesi, Osmanbey Caddesi, No:120, 34255, Gaziosmanpasa, Istanbul, Turkey.
Harun
H
Mutlu
Department of Orthopaedics, Kanuni Sultan Suleyman Training and Research Hospital, Atakent Mh., 1. Cd, 34303, Küçükçekmece, Istanbul, Turkey.
Ozgur
O
Karaman
Department of Orthopaedics, Kanuni Sultan Suleyman Training and Research Hospital, Atakent Mh., 1. Cd, 34303, Küçükçekmece, Istanbul, Turkey.
Tahir Mutlu
TM
Duymus
Department of Orthopaedics, Taksim Training and Research Hospital, Karayollari Mahallesi, Osmanbey Caddesi, No:120, 34255, Gaziosmanpasa, Istanbul, Turkey.
Atilla Sancar
AS
Parmaksizoglu
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D016063:Blood Loss, Surgical / Q000517:prevention & control* / Q000706:statistics & numerical data; D001803:Blood Transfusion / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D012189:Retrospective Studies; D012449:Safety; D014111:Tourniquets / Q000009:adverse effects
Blood loss; Knee; Knee replacement surgery; Total knee arthroplasty; Tourniquet