gms | German Medical Science

Objectives: Although intraoperative tourniquets are routinely employed during total knee arthroplasty, the use of these devices remains controversial. Thus, further investigation of the efficacy and safety of this practice is fundamental.

Methods: A retrospective analysis of 186 patients (mean age, 64.2 years) was performed to assess the benefits and/or risks associated with tourniquet use during knee replacement surgery.

Results and Conclusion: Patients undergoing arthroplasty with tourniquets had significantly less intraoperative blood loss than did patients without (106 vs. 312 ml, respectively; P < 0.001). Thus, there was a non-significant trend toward a requirement for more blood transfusions without than with tourniquets (72.2% vs. 62.6%, respectively; P = 0.551), and the surgical time was significantly longer without than with tourniquets (70 vs. 64 min, respectively; P = 0.011). However, patients with tourniquets had more postoperative blood loss and longer hospital stays than did patients without tourniquets (560 vs. 380 ml, respectively; P < 0.001 and 4.8 vs. 4.1 days, respectively; P = 0.013). Moreover, complications were more frequent in patients with than without tourniquets, although the difference was not statistically significant (16.1% vs. 8.2%, respectively; P = 0.571). Finally, the increased requirements for blood transfusions were significantly associated with complications (P < 0.001).

Our data support the notion that no significant overall benefit is achieved through tourniquet use during arthroplasty. These findings will contribute to the establishment of effective recommendations for knee replacement surgery.