Department of Orthopedic Surgery, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, 6 Bejing Road West, Huai'an, 223300, Jiangsu Province, China.
BMC Musculoskelet Disord. 2019 Jan 22;20(1):35. doi: 10.1186/s12891-019-2406-6.
During total knee arthroplasty(TKA), tourniquet is widely used by most surgeons whereas the optimal application is still controversial. With this prospective randomized controlled study, we intend to investigate the effect of lower limb lifting and squeeze exsanguination methods on clinical outcomes in a series of TKAs.
Prospectively enrolled a total of 236 TKA patients from March, 2012 to November, 2016. Of which 118 patients randomly constitute Group A with lower limb lifting exsanguination technique; and the other 118 patients comprise Group B with squeeze exsanguination method. A year's follow-up measurements were recorded in detail for analysis.
The pre-tourniquet time of Group A was significantly shorter than that in Group B (P < 0.001). Significant difference was found on skin tension blister, 3 happened in Group A and 11 happened in Group B (P = 0.031), which resulted in a difference in total complications (P = 0.039). The VAS score was significantly lower in Group A at one and seven days postoperatively, P < 0.001 and P = 0.011, respectively. No significant differences were found regarding all other clinical outcome measurements.
The lower limb lifting exsanguination is a safe and effective technique. Compared with squeeze exsanguination method, it could decrease the incidence of skin tension blister and alleviate early postoperative pain reaction, no additional risks occurred regarding other clinical outcomes. Thus, it might have the potentiality to be commonly utilized in TKA procedure.
ClinicalTrials.gov Identifier: ChiCTR1800020471. Registered on 31 December 2018 Retrospectively registered.
在全膝关节置换术（TKA）中，大多数外科医生广泛使用止血带，但其最佳应用仍存在争议。本前瞻性随机对照研究旨在探讨下肢抬高和挤压放血法在一系列 TKA 中的临床效果。
前瞻性纳入 2012 年 3 月至 2016 年 11 月的 236 例 TKA 患者。其中 118 例患者随机分为 A 组，采用下肢抬高放血技术；另 118 例患者为 B 组，采用挤压放血法。详细记录 1 年的随访测量结果进行分析。
A 组止血带前时间明显短于 B 组（P<0.001）。A 组发生皮肤张力水疱 3 例，B 组发生 11 例，差异有统计学意义（P=0.031），总并发症发生率存在差异（P=0.039）。A 组术后 1 天和 7 天的 VAS 评分明显低于 B 组，P<0.001 和 P=0.011。其他所有临床结果测量均无显著差异。
下肢抬高放血是一种安全有效的技术。与挤压放血法相比，可降低皮肤张力水疱的发生率，减轻术后早期疼痛反应，其他临床结果无明显差异。因此，它可能有潜力在 TKA 手术中普遍应用。
ChiCTR1800020471. 于 2018 年 12 月 31 日注册。前瞻性注册。
