The Effect of Tourniquet Duration on Pain, Bleeding, and Functional Outcomes in Total Knee Arthroplasty

Abstract

Objective The aim of this study was to evaluate the effects of tourniquet use on perioperative blood loss, pain, and functional and clinical outcomes.Patients and methods This is a prospective study that included 80 knees who underwent total knee arthroplasty. The patients were separated into two groups: those with a tourniquet used throughout the entire surgical procedure and those where the tourniquet was only used during the cementation procedure. In the postoperative period, the pain levels of the patients were evaluated using a visual analog scale (VAS), and the functional results were evaluated with knee range of motion measurement, the Western Ontario and Mcmaster Universities Osteoarthritis (WOMAC) index, the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Kujala Patellofemoral Scoring System, and the Oxford Knee Scoring system. The patients were examined in the early postoperative period and again in the 12th week, including possible complications that may develop postoperatively.Results In the early postoperative period, a greater hemoglobin decrease and calculated blood loss values, better functional clinical results, and better knee range of motion were determined in the group with a tourniquet applied only during the cementation, and the swelling in the knee was less (p<0.05). However, the difference between the two groups had disappeared by the postoperative 12th week. There was no significant difference in respect of complications.Conclusion Limiting the duration of tourniquet use during total knee arthroplasty has the significant advantage of providing better functional results with less pain in the early postoperative period.