The use of tourniquet in total knee arthroplasty does not impact the functional outcome: a randomised controlled study.

Autor:	Johnsen, Magnus, Havik, Steinar, Husby, Vigdis Schnell, Winther, Siri Bjørgen, Foss, Olav A., Husby, Otto Schnell, Lian, Øystein Bjerkestrand
Předmět:	QUADRICEPS muscle physiology RESEARCH funding ACADEMIC medical centers TOURNIQUETS POSTOPERATIVE pain STATISTICAL sampling HEMOGLOBINS BLIND experiment VENOUS thrombosis TREATMENT effectiveness RANDOMIZED controlled trials SURGICAL blood loss DESCRIPTIVE statistics KNEE joint MUSCLE strength SURGICAL complications LONGITUDINAL method TOTAL knee replacement OPIOID analgesics LENGTH of stay in hospitals ANTHROPOMETRY COMPARATIVE studies CONFIDENCE intervals HEMORRHAGE RANGE of motion of joints
Zdroj:	Journal of Orthopaedic Surgery & Research; 10/30/2024, Vol. 19 Issue 1, p1-10, 10p
Abstrakt:	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: 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: 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: 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: 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: Clinicaltrails.gov. Registry Number: NCT03666598. Registered 30 August 2018. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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