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Tourniquets are still widely used in total knee arthroplasty, but are associated with several adverse effects. Most of previous studies did not randomize the participants so the baseline difference of the patients might have influenced the outcome. Therefore, investigators conducted a randomized controlled trial, in which all the patients received staged bilateral TKA with two different durations of tourniquet use. Investigators aimed to quantify the effect of tourniquet use on reducing blood loss and to evaluate the impact of tourniquet use on functional and clinical outcome.
Fifty participants who underwent staged bilateral TKA were recruited in this study. On one side, the tourniquet was inflated immediately before incision and deflated after the hardening of the cement. On the other side the tourniquet was inflated immediately before cement application and deflated after its hardening. Blood loss, operating time, transfusion rate, postoperative pain, limb swelling, deep vein thrombosis (DVT) incidence and clinical outcomes were monitored for comparison.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Short-duration tourniquet group | Experimental | The tourniquet was inflated immediately before cement application and deflated after its hardening |
|
| Long-duration tourniquet group | Active Comparator | The tourniquet was inflated immediately before incision and deflated after the hardening of the cement |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Short-duration tourniquet | Procedure | Short-duration tourniquet group:inflate the tourniquet immediately before cement application and deflated after its hardening |
|
| Measure | Description | Time Frame |
|---|---|---|
| Intraoperative blood loss | within operation |
| Measure | Description | Time Frame |
|---|---|---|
| Thigh pain measured by Visual Analogue Scale/Score (VAS) | 1 day, 2 day, 1 week, 2 week and 6 week after surgery | |
| Thigh swelling measured by circumference 10 cm proximal to the patella | 1 day, 2 day, 1week, 2 week and 6 week after surgery |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jianhao Lin, M.D. | Peking University People's Hospital | Study Director |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21161177 | Background | Tai TW, Lin CJ, Jou IM, Chang CW, Lai KA, Yang CY. Tourniquet use in total knee arthroplasty: a meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2011 Jul;19(7):1121-30. doi: 10.1007/s00167-010-1342-7. Epub 2010 Dec 15. | |
| 23018303 | Background | Hernandez AJ, Almeida AM, Favaro E, Sguizzato GT. The influence of tourniquet use and operative time on the incidence of deep vein thrombosis in total knee arthroplasty. Clinics (Sao Paulo). 2012 Sep;67(9):1053-7. doi: 10.6061/clinics/2012(09)12. |
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| ID | Term |
|---|---|
| D006470 | Hemorrhage |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| Long-duration tourniquet | Procedure | Long-duration tourniquet group: inflate the tourniquet immediately before incision and deflated after the hardening of the cement |
|
| Postoperative blood loss measured by drainage volume | 1 day and 2 day after surgery |