The use of tourniquet in total knee arthroplasty does not impact the functional outcome: a randomised controlled study.
Blood loss
Functional outcome
Pain
Strength
Total knee arthroplasty
Tourniquet
Journal
Journal of orthopaedic surgery and research
ISSN: 1749-799X
Titre abrégé: J Orthop Surg Res
Pays: England
ID NLM: 101265112
Informations de publication
Date de publication:
30 Oct 2024
30 Oct 2024
Historique:
received:
03
09
2024
accepted:
23
10
2024
medline:
31
10
2024
pubmed:
31
10
2024
entrez:
31
10
2024
Statut:
epublish
Résumé
This study evaluates the clinical evidence for performing total knee arthroplasty (TKA) without a tourniquet, a shift from the near-universal use in 2009 to current trends towards tourniquet-less TKA in Norway and Sweden. This change is set against a backdrop of conflicting evidence regarding the positive and negative effects of tourniquet use. The aims were to determine if the tourniquet has an impact on [1] Forgotten Joint Score-12 (FJS-12) at 8 weeks after surgery; [2] postoperative strength and function; [3] postoperative pain and opioid analgesic use; and [4] operative time, bleeding, and length of stay (LOS). Eighty-one patients were randomised to TKA with or without a tourniquet. The outcome measures, FJS-12, muscle strength, functional test, pain, estimated blood loss, haemoglobin (Hb) loss, knee circumference, opioid consumption, and LOS were assessed preoperatively and at 1 day, 8 weeks, and 1 year after surgery. No significant difference in FJS-12 scores was found between the two groups at postoperative 8 weeks. However, the tourniquet group showed statistically significant better knee extension strength at 8 weeks (p = 0.045). There were no differences in other outcomes, except for a greater decrease in haemoglobin levels (p = 0.02) and higher estimated perioperative blood loss (p < 0.001) in the no tourniquet group than the torniquet group. Our study indicates that tourniquet use during TKA causes no significant differences in FJS-12 at 8 weeks, significantly reduces bleeding and postoperative Hb loss, and improves quadriceps strength at 8 weeks. Clinicaltrails.gov. Registry Number: NCT03666598. Registered 30 August 2018.
Sections du résumé
BACKGROUND
BACKGROUND
This study evaluates the clinical evidence for performing total knee arthroplasty (TKA) without a tourniquet, a shift from the near-universal use in 2009 to current trends towards tourniquet-less TKA in Norway and Sweden. This change is set against a backdrop of conflicting evidence regarding the positive and negative effects of tourniquet use.
QUESTIONS/PURPOSES
OBJECTIVE
The aims were to determine if the tourniquet has an impact on [1] Forgotten Joint Score-12 (FJS-12) at 8 weeks after surgery; [2] postoperative strength and function; [3] postoperative pain and opioid analgesic use; and [4] operative time, bleeding, and length of stay (LOS).
METHODS
METHODS
Eighty-one patients were randomised to TKA with or without a tourniquet. The outcome measures, FJS-12, muscle strength, functional test, pain, estimated blood loss, haemoglobin (Hb) loss, knee circumference, opioid consumption, and LOS were assessed preoperatively and at 1 day, 8 weeks, and 1 year after surgery.
RESULTS
RESULTS
No significant difference in FJS-12 scores was found between the two groups at postoperative 8 weeks. However, the tourniquet group showed statistically significant better knee extension strength at 8 weeks (p = 0.045). There were no differences in other outcomes, except for a greater decrease in haemoglobin levels (p = 0.02) and higher estimated perioperative blood loss (p < 0.001) in the no tourniquet group than the torniquet group.
CONCLUSIONS
CONCLUSIONS
Our study indicates that tourniquet use during TKA causes no significant differences in FJS-12 at 8 weeks, significantly reduces bleeding and postoperative Hb loss, and improves quadriceps strength at 8 weeks.
TRIAL REGISTRATION
BACKGROUND
Clinicaltrails.gov. Registry Number: NCT03666598. Registered 30 August 2018.
Identifiants
pubmed: 39478609
doi: 10.1186/s13018-024-05203-y
pii: 10.1186/s13018-024-05203-y
doi:
Banques de données
ClinicalTrials.gov
['NCT03666598']
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
704Informations de copyright
© 2024. The Author(s).
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