Effects of tourniquet pressure on rehabilitation outcomes in patients undergoing total knee arthroplasty

摘要

Background: Although studies determinate that the tourniquet and high tourniquet pressure applications lead to several complications and decelerate the rehabilitation, there was not any study investigating the effects of tourniquet pressure on rehabilitation outcomes and postoperative complications. Purpose: To investigate the effects of the minimal and conventional tourniquet inflation pressures application on rehabilitation outcomes in patients undergoing total knee arthroplasty (TKA). Methods: Thirty-eight patients with unilateral primary TKA were included in the study. All patients underwent standardized inpatient physiotherapy during their hospital stay and followed by home-based exercise program. We used the Visual Analog Scale to quantify knee pain, Iowa Level of Assistance Scale, and Iowa Ambulation Velocity Scale to determine physical function. The dates of ability to perform straight leg raise actively and to reach 70 of knee flexion were recorded. Hospital for Special Surgery knee score and range of motion of all patients were assessed preoperatively, at 6, 12, and 26 weeks, postoperatively. Results: There was a significant difference in terms of Iowa Level of Assistance Scale on the postoperative 2nd and 6th days in favor of minimal inflation pressure group, in addition to the significant difference in pain level at discharge and the date of 70 knee flexion reach in favor of the same group, but Hospital for Special Surgery score and movement were similar at 6, 12, and 26 weeks. There was no significant difference between the groups in the date of performing straight leg raise. Conclusions: We conclude that TKA operations with a tourniquet application at lower inflation pressures might minimize the complications of tourniquet use and the patients can gain more rapidly early functional mobility.