title: Tourniquet use during total knee arthroplasty does not modulate the neutrophil-to-lymphocyte ratio, pain, or activity.
abstract: The purpose of our study was to identify the influence of tourniquet use during total knee arthroplasty (TKA) on the neutrophil-to-lymphocyte ratio (NLR) shortly after surgery and patient-reported outcomes (pain and physical activity) from outpatient physical therapy. This retrospective study consisted of 104 subjects who underwent primary unilateral TKA (51 subjects with and 53 subjects without tourniquet assistance) between 2010 and 2012. The NLR was calculated from the absolute neutrophil and lymphocyte counts obtained immediately before and after (1 and 2 days) knee arthroplasty. The Knee Outcome Survey (KOS) of Activities of Daily Living and numeric pain scores collected at the first [33.0 (34.2) days after surgery] and last [85.5 (40.7) days after surgery] outpatient physical therapy visits were extracted from an electronic database. The NLR, pain, and KOS score were not significantly (all p > 0.05) different with tourniquet use. Based on these findings, we conclude that tourniquet use during TKA neither increases systemic inflammation shortly after surgery nor impairs patient-reported outcomes obtained during outpatient physical therapy.
  
  
  METHODS
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authors.affiliation: The Orthopedic Specialty Hospital, 5848 S. Fashion Blvd., Murray, UT, 84107, USA. tyler.barker@imail.org.
authors.forename: Tyler
authors.initials: T
authors.lastname: Barker
authors.affiliation: The Orthopedic Specialty Hospital, 5848 S. Fashion Blvd., Murray, UT, 84107, USA.
authors.forename: Victoria E
authors.initials: VE
authors.lastname: Rogers
authors.affiliation: The Orthopedic Specialty Hospital, 5848 S. Fashion Blvd., Murray, UT, 84107, USA.
authors.forename: Kimberly B
authors.initials: KB
authors.lastname: Brown
authors.affiliation: The Orthopedic Specialty Hospital, 5848 S. Fashion Blvd., Murray, UT, 84107, USA.
authors.forename: Vanessa T
authors.initials: VT
authors.lastname: Henriksen
authors.affiliation: The Orthopedic Specialty Hospital, 5848 S. Fashion Blvd., Murray, UT, 84107, USA.|The Orthopedic Specialty Clinic, Murray, UT, 84107, USA.
authors.forename: G Lynn
authors.initials: GL
authors.lastname: Rasmussen
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000553:Ambulatory Care; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods* / Q000534:rehabilitation; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000276:immunology / Q000601:surgery*; D008214:Lymphocytes / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology; D020370:Osteoarthritis, Knee / Q000276:immunology / Q000601:surgery*; D010149:Postoperative Pain; D026741:Physical Therapy Modalities; D012189:Retrospective Studies; D014111:Tourniquets / Q000009:adverse effects*
keywords: Activity; Neutrophil-to-lymphocyte ratio; Pain; Total knee arthroplasty