The effects of using a tourniquet in total knee arthroplasty: A study of 77 patients

Introduction: Total Knee Arthroplasty (TKA) is usually performed with a tourniquet. Previous studies investigated the relationship between tourniquet and blood loss. This study evaluated tourniquet usage regarding parameters such as blood loss, drainage, blood administration, knee flexion, and complications. Patients and Methods: A cohort of 77 patients who underwent total knee arthroplasty was reviewed. Results: No difference in 24-hours postoperative hemoglobin levels was observed. Blood collected in drains was slightly higher in the tourniquet group, yet there was more overall administration of blood for non-tourniquet group: a mean of 1.2 units of packed RBC versus a mean of 0.63 units for the tourniquet group. Complication rate was comparable, but a higher rate of local infection in tourniquet group was observed. No thromboembolic events were observed. Conclusion: With regards to direct blood loss parameters, there was no statistical difference between groups, provided that meticulous hemostasis is undertaken. Operating without a tourniquet poses a risk of increased demand for blood products. There is also some concern regarding local complication rate when tourniquets are used.