TY  - JOUR
T1  - Effects of Tourniquet Use on Blood Loss and Soft-Tissue Damage in Total Knee ArthroplastyA Randomized Controlled Trial
AU  - Tai, Ta-Wei
AU  - Chang, Chih-Wei
AU  - Lai, Kuo-An
AU  - Lin, Chii-Jeng
AU  - Yang, Chyun-Yu
Y1  - 2012/12/19
N1  - 10.2106/JBJS.K.00813
JO  - The Journal of Bone & Joint Surgery
SP  - 2209
EP  - 2215
VL  - 94
IS  - 24
N2  - Background: 
  Although tourniquets are widely used in total knee arthroplasty, their effectiveness in reducing blood loss and their influence on the postoperative course remain unclear. Tourniquet-related soft-tissue damage is a related concern. We performed a prospective, randomized, controlled trial to clarify the effect of tourniquets in total knee arthroplasty.Methods: 
  Seventy-two patients undergoing total knee arthroplasty were randomly allocated to a tourniquet or non-tourniquet group. Blood loss and changes in C-reactive protein, creatine phosphokinase, and other indicators of soft-tissue damage were monitored preoperatively and postoperatively on Days 1, 2, and 4. Thigh pain, knee pain, limb swelling, rehabilitation progress, and hospital stays were also recorded for comparison.Results: 
  Patients in the tourniquet group showed smaller decreases in hemoglobin (mean and standard deviation, 2.6 ± 0.9 versus 3.7 ± 1.3 g/dL) and hematocrit (7.6% ± 2.8% versus 10.4% ± 4.0%), less calculated blood loss (303 ± 119 versus 423 ± 197 mL), and smaller increases in C-reactive protein (peak value, 175 ± 55 versus 139 ± 75 mg/dL) and creatine phosphokinase (peak value, 214 ± 89 versus 162 ± 104 U/L) compared with those in the non-tourniquet group. There was slightly less postoperative pain in the non-tourniquet group. There were no significant differences between the groups in terms of swelling, rehabilitation progress, or hospital stays.Conclusions: 
  The use of a tourniquet during total knee arthroplasty was effective for reducing blood loss and avoiding excessive postoperative inflammation and muscle damage. The use of a tourniquet was related to slightly more postoperative pain but did not affect postoperative recovery.Level of Evidence: 
  Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
SN  - 0021-9355
M3  - doi: 10.2106/JBJS.K.00813
UR  - http://dx.doi.org/10.2106/JBJS.K.00813
ER  -