title: Effects of different methods of using pneumatic tourniquet in patients undergoing total knee arthroplasty: a randomized control trial.
abstract: BACKGROUND
  The goal of this work was to investigate the effects of different methods of using pneumatic tourniquet on reducing blood loss in patients undergoing cemented total knee arthroplasty (TKA).
  
  
  METHODS
  One hundred and fifty patients undergoing unilateral cemented TKA were randomly divided into three groups (50 patients per group). The tourniquet was used during the entire operation (Group A), used from the beginning of operation to the completion of joint replacement (Group B), and from the beginning of osteotomy to the completion of arthroplasty (Group C). The following parameters were recorded: intraoperative blood loss (IBL), postoperative blood loss (PBL), hidden blood loss (HBL), and total blood loss (TBL); operation time and tourniquet time; incidence of postoperative complications; and hospital for special surgery (HSS) score.
  
  
  RESULTS
  IBL, HBL, and TBL in group C was significantly less than that in group B (all P < 0.05). Tourniquet time in group C was significantly less than that in groups A and B (all P < 0.05). The incidence of tourniquet-related complications in group C (6%) was relatively lower than that in group A (10%) during hospitalization (P > 0.05). Post-operative HSS scores at 2 weeks after the operation in group C was significantly higher than that in group A and group B (all P < 0.05).
  
  
  CONCLUSIONS
  Our results suggest that using a tourniquet from the beginning of osteotomy to the completion of arthroplasty could significantly reduce TBL in TKA, and decrease the incidence of complications; thereby facilitating early post-operative functional recovery.
authors.affiliation: Department of Orthopedics, Qilu Hospital of Shandong University, No. 107 Wenhuaxi Road, Lixia District, Jinan, 250012, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, Qilu Hospital of Shandong University, No. 107 Wenhuaxi Road, Lixia District, Jinan, 250012, China. drzhangyk@163.com.
authors.forename: D
authors.initials: D
authors.lastname: Li
authors.affiliation: Department of Orthopedics, Qilu Hospital of Shandong University, No. 107 Wenhuaxi Road, Lixia District, Jinan, 250012, China.
authors.forename: P
authors.initials: P
authors.lastname: Liu
authors.affiliation: Department of Orthopedics, Qilu Hospital of Shandong University, No. 107 Wenhuaxi Road, Lixia District, Jinan, 250012, China.
authors.forename: X
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, Qilu Hospital of Shandong University, No. 107 Wenhuaxi Road, Lixia District, Jinan, 250012, China. ming_li_china@126.com.
authors.forename: M
authors.initials: M
authors.lastname: Li
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014111:Tourniquets
keywords: Blood loss; TKA; Total knee arthroplasty; Tourniquet; Venous thrombosis