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全膝关节置换术(TKA)的结果比较:使用止血带和不使用止血带的关节置换术。

Comparison of the outcomes of Total Knee Arthroplasty (TKA): tourniquet and tourniquet-less arthroplasty.

机构信息

Śląski Uniwersytet Medyczny w Katowicach, Wydział lekarski, Katowice, Polska / Silesian Medical University in Katowice, Faculty of Medicine, Katowice, Poland.

Klinika Nieborowice sp. z o.o, Nieborowice, Polska / Nieborowice Centre, Nieborowice, Poland.

出版信息

Ortop Traumatol Rehabil. 2024 Jun 30;26(3):93-98. doi: 10.5604/01.3001.0054.7270.

Abstract

Total knee replacement surgery (TKA) ranks among the most commonly performed orthopedic procedures nowadays. Many surgeons perform TKA with the use of tourniquet. It is also possible to carry out a tourniquet-less TKA. As with every surgery, TKA comes with the possibility of postoperative complications. The aim of this paper is to review the available scientific literature in order to systematize current knowledge and compare the pros and cons of tourniquet-based and tourniquet-less methods of total knee arthroplasty. This objective will serve to enhance patient awareness regarding the methods of total knee arthroplasty and provide reliable information to surgeons performing this procedure. The use of a tourniquet in total knee arthroplasty reduces intraoperative blood loss and operation time but may increase postoperative blood loss. It is associated with a higher risk of infection. Patients without a tourniquet experience less postoperative pain, shorter hospital stays, and comparable muscle function recovery over time. Tourniquet use increases the risk of deep vein thrombosis, influenced by tightening time. The choice between these methods involves balancing advantages and drawbacks in blood loss, infection risk, pain, and muscle recovery. Each method presents its own set of advantages and potential drawbacks, and the choice between the two methods requires a careful consideration of these factors.

摘要

全膝关节置换术(TKA)是当今最常见的骨科手术之一。许多外科医生在进行 TKA 时使用止血带。也可以进行无止血带的 TKA。与所有手术一样,TKA 有可能发生术后并发症。本文的目的是回顾现有的科学文献,以便系统地总结当前的知识,并比较基于止血带和无止血带的全膝关节置换术方法的优缺点。这一目标将有助于提高患者对全膝关节置换术方法的认识,并为进行该手术的外科医生提供可靠的信息。在全膝关节置换术中使用止血带可以减少术中失血量和手术时间,但可能会增加术后失血量。它与更高的感染风险相关。不使用止血带的患者术后疼痛较轻,住院时间较短,随着时间的推移,肌肉功能恢复情况相当。止血带的使用会增加深静脉血栓形成的风险,这与收紧时间有关。在这些方法之间进行选择涉及到在失血量、感染风险、疼痛和肌肉恢复方面的优势和劣势之间进行权衡。每种方法都有其自身的一系列优点和潜在缺点,两种方法的选择需要仔细考虑这些因素。

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