Department of Orthopaedics, "Foisor" Orthopaedics Hospital, 030167 Bucharest, Romania.
"Carol Davila" Faculty of Medicine, University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Medicina (Kaunas). 2023 Apr 30;59(5):870. doi: 10.3390/medicina59050870.
: Total knee arthroplasties (TKAs) are the most effective surgical treatment for end-stage knee osteoarthritis. The tourniquet is used to reduce intraoperative blood loss, improving surgical field visualization. There is much controversy regarding the effectiveness and safety of using a tourniquet during total knee arthroplasties. The purpose of this prospective study is to determine the effect of tourniquet usage during TKAs on early functional outcomes and pain in our center. : We conducted a randomized controlled trial of patients following a primary total knee replacement between October 2020 and August 2021. We recorded presurgical data, which included age, sex and knee range of motion. Intraoperatively, we measured the amount of blood aspiration and the surgical room time. After the surgery, we measured the amount of blood aspirated through the drains and the hemoglobin. We measured flexion, extension, Visual Analogue Scale (VAS) scores, and Western Ontario and McMaster Universities Arthritis Index (WOMAC score) scores for the functional evaluation. : We included 96 patients in the T group and 94 in the NT group, respectively, who remained until the last follow-up. Regarding blood loss, the NT group demonstrated significantly lower levels: 245 ± 97.8 mL intraoperative and 324.8 ± 151.65 mL postoperative, compared to the T group, where we recorded 276 ± 109.2 mL during the surgical procedures and 353.44 ± 101.55 mL after the surgery, ( < 0.05). We also recorded significantly shorter operative room time for the NT group, ( < 0.05). During the follow-up, we noticed postoperative improvements but without significant differences between the groups. : We found a significant decrease in bleeding after no tourniquet usage during total knee replacements and shorter operative times. On the other hand, the knee function demonstrated no significant differences between the groups. Further studies may be required in order to assess complications.
全膝关节置换术（TKA）是治疗终末期膝骨关节炎最有效的手术方法。止血带用于减少术中失血量，改善手术视野。在全膝关节置换术中使用止血带的有效性和安全性存在很大争议。本前瞻性研究旨在确定我们中心使用止血带对 TKA 早期功能结果和疼痛的影响。
我们对 2020 年 10 月至 2021 年 8 月期间接受初次全膝关节置换的患者进行了随机对照试验。我们记录了术前数据，包括年龄、性别和膝关节活动范围。术中测量了吸引血量和手术间时间。手术后，我们通过引流管测量了吸出的血量和血红蛋白量。我们测量了膝关节的屈曲、伸展、视觉模拟评分（VAS）和西部安大略省和麦克马斯特大学关节炎指数（WOMAC 评分）以评估功能。
我们分别将 96 例患者纳入 T 组和 94 例 NT 组，两组患者均随访至最后。关于失血量，NT 组明显较低：术中 245±97.8ml，术后 324.8±151.65ml，而 T 组术中记录 276±109.2ml，术后 353.44±101.55ml（<0.05）。我们还记录了 NT 组手术间时间明显缩短（<0.05）。在随访过程中，我们注意到术后有改善，但两组之间无显著差异。
我们发现全膝关节置换术中不使用止血带可显著减少出血，同时缩短手术时间。另一方面，两组膝关节功能无显著差异。可能需要进一步的研究来评估并发症。
