Department of Orthopaedics and Traumatology, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey.
Department of Orthopaedics Surgery and Traumatology, University of Health Sciences, Faculty of Medicine, Istanbul Training and Research Hospital, Istanbul, Turkey.
J Knee Surg. 2021 Aug;34(10):1057-1063. doi: 10.1055/s-0040-1701454. Epub 2020 Feb 19.
The present randomized controlled study aims to evaluate whether tourniquet application during total knee arthroplasty (TKA) has an effect on (1) thigh muscle strength (quadriceps and hamstring muscle strength) and (2) clinical outcomes (postoperative knee range of motion [ROM], postoperative pain level, and Knee Society Score [KSS]). The effects of tourniquet application during TKA were investigated in 65 patients randomly allocated to one of two groups: TKA with a tourniquet and TKA without a tourniquet. Patients in both groups were comparable in terms of the demographic and clinical data ( > 0.05 for age, number of patients, sex, radiographic gonarthrosis grade, American Society of Anesthesiologists [ASA] classification, and body mass index [BMI]). All patients in both groups were operated by the same surgeon using one type of prosthesis. Isokinetic muscle strength (peak torque and total work) of knee extensors (quadriceps) and flexors (hamstrings) was measured in Newton meters (Nm) using a CYBEX 350 isokinetic dynamometer (HUMAC/CYBEX 2009, Stoughton, MA). The combined KSS (knee score + function score), visual analog scale (VAS), and knee ROM were measured preoperatively and at 1 and 3 months postoperatively to evaluate clinical outcomes. There were no significant differences between the two groups in preoperative and postoperative values of isokinetic muscle strength (peak torque and total work) and aforementioned clinical outcomes ( < 0.05). The present study has shown that quadriceps strength and clinical outcomes were not improved in the early postoperative period (3 months) when a tourniquet was not used during TKA.
本随机对照研究旨在评估全膝关节置换术（TKA）中应用止血带是否对（1）股四头肌和腘绳肌力量（股四头肌和腘绳肌力量）和（2）临床结果（术后膝关节活动范围 [ROM]、术后疼痛水平和膝关节学会评分 [KSS]）产生影响。本研究共纳入 65 例患者，随机分为两组：TKA 加止血带组和 TKA 不加止血带组。两组患者在年龄、患者人数、性别、放射学骨关节炎分级、美国麻醉师协会（ASA）分级和体质量指数（BMI）等方面均无差异（ > 0.05）。两组患者均由同一位外科医生采用同一种假体进行手术。使用 CYBEX 350 等速测力计（HUMAC/CYBEX 2009，马萨诸塞州斯托顿）以牛顿米（Nm）为单位测量膝关节伸肌（股四头肌）和屈肌（腘绳肌）的等速肌肉力量（峰值扭矩和总功）。术前、术后 1 个月和 3 个月分别测量综合膝关节学会评分（膝关节评分 + 功能评分）、视觉模拟评分（VAS）和膝关节 ROM，以评估临床结果。两组患者在术前和术后的等速肌肉力量（峰值扭矩和总功）以及上述临床结果（ < 0.05）方面均无显著差异。本研究表明，在 TKA 期间不使用止血带不会改善术后早期（3 个月）的股四头肌力量和临床结果。
