The effect of tourniquet release timing on perioperative blood loss in simultaneous bilateral cemented total knee arthroplasty: A prospective randomized study

摘要

Abstract. Today the use of pneumatic tourniquet is commonly accepted in total knee arthroplasty (TKA) to reduce perioperativenblood loss. There are a few prospective randomised and nonrandomised studies that compare the effect of tourniquet releasentiming in cementless or cemented unilateral TKA. However, many of these studies show an inadequate reporting and methodology.nThis randomized prospective study was designed to investigate the efficiency of tourniquet release timing in preventingnperioperative blood loss in a simultaneous bilateral TKA study design. To our knowledge, this is the first study of its kind, innwhich the effect of tourniquet release timing on perioperative blood loss was investigated in simultaneous bilateral cementednTKA to compare both techniques intraindividually. In 20 patients (40 knees) one knee was operated with tourniquet release andnhemostasis before wound closure, and the other knee with tourniquet release after wound closure and pressure dressing. Wenfound no significant difference in total blood loss between both techniques (p = 0.930), but a significant difference in operatingntime (p = 0.035). There were no postoperative complications at a follow-up of 6 month. Other studies report an increase thenblood loss in early tourniquet release and an increase the risk of early postoperative complications in deflation of tourniquet afternwound closure. In this study we found no significant difference in perioperative blood loss and no increase of postoperativencomplications. Therefore, we recommend a tourniquet release after wound closure to reduce the duration of TKA procedurenand to avoid possible risks of extended anaesthesia.