Zhou K, et al. - Recovery following uncomplicated primary total knee arthroplasty (TKA) was analyzed on the basis of tourniquet use or lack of it. As suggested by findings, early rehabilitation, with no increase in side effects, could be achieved with a non-tourniquet TKA.

Methods

• A prospective randomised double-blinded study was performed, wherein, 150 patients undergoing primary TKA were assigned to either a tourniquet or non-tourniquet group.
• Primary outcome measure (i.e. total blood loss) and secondary outcome measures (i.e. wound complications, visual analogue scale pain score and knee range of motion) were assessed by an independent observer at the early phase, 3 and 6 months after surgery.

Results

• Reduced intraoperative blood loss (215.7 ± 113.7 ml vs. 138.6 ± 93.9 ml, P < 0.001) and shorter operating time (77.2 ± 14.5 min vs. 82.0 ± 12.7 min, P=0.038) were reported in the tourniquet group.
• However, researchers observed that the non-tourniquet group exhibited less postoperative blood loss (180.2 ± 117.0 ml vs. 253.7 ± 144.2 ml, P=0.001) and drainage volume (89.2 ± 66.3 ml vs. 164.5 ± 97.8 ml, P=0.004), less thigh pain (all P < 0.001) in the initial 3 weeks.
• In addition, non-tourniquet group demonstrated better knee range of motion (ROM) in the initial 3 days (day 1 81.6 ± 17.1 vs. 75.95 ± 14.55, P=0.036; day 3 99.8 ± 13.7 vs. 93.95 ± 11.15, P=0.005) and fewer wound tension vesicles (10.3 vs. 29.2%, P=0.005).
• The other findings in the non-tourniquet group included earlier straight-leg raising (4.6 ± 3.8 h vs. 6.4 ± 4.3 h, P=0.01) and shorter length of stay (6.3 ± 1.7 days vs. 7.1 ± 1.9 days, P=0.001).
• For both groups, similar total blood loss and blood transfusion rate were observed.
• In addition, no significant differences were revealed by all other parameters.