Zhong Qigang, Yang Hu, Qi Renfei, Zhang Tao, Zhan Junfeng, Yao Yunfeng
Department of Orthopedics, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, China.
Institute of Orthopaedics, Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, China.
BMC Musculoskelet Disord. 2025 Feb 27;26(1):205. doi: 10.1186/s12891-025-08462-w.
Applying non-tourniquet technology in total knee arthroplasty (TKA) is becoming increasingly popular. However, there is no consensus on its effect on the service life of knee prostheses. This study examined the effect of tourniquet use on cement penetration and radiolucent line (RLL) to assess whether the use of tournique in TKA affects prosthesis survival.
We retrospectively analyzed 166 patients admitted to our hospital between January 1, 2014, and June 1, 2015, who met the inclusion criteria. The patients were divided into the tourniquet (80 cases) and non-tourniquet groups (86 cases) according to whether a tourniquet was used during the operation. We compared the preoperative data and related complications between both groups. Hip-knee-ankle (HKA), medial proximal tibial angle (MPTA) and the penetration depth of bone cement on the osteotomy surface was measured according to postoperative imaging data. Furthermore, the probability of occurrence of radio-clear lines around the prosthesis was observed.
A total of 166 patients were enrolled with a mean age of 68.52 ± 4.74 years and a mean follow-up time of 105.67 ± 5.98 years. No significant demographic differences were observed between the two groups (P > 0.05). Revision surgery was performed for one patient in each group due to aseptic loosening of the prosthesis. The preoperative and postoperative knee association function scores (HSS), knee range of motion, HKA, and MPTA between the two groups did not differ significantly (P > 0.05). In the lateral observation of zone femur 3A and the average observation area of the femur, the penetration depth of the osteotomy surface were significantly different between the two groups (P < 0.05). The incidence of radiolucent lines differed slightly between both groups in different observation areas,but the revision rate did not differ significantly between the two groups (P > 0.05).
In the long term, TKA without tournique use can achieve clinical effects comparable to the use of tourniquet in many aspects, such as prosthesis stability, prosthesis survival rate, reoperations rate, knee range of motion, and knee functionality.
在全膝关节置换术（TKA）中应用非止血带技术越来越普遍。然而，对于其对膝关节假体使用寿命的影响尚无共识。本研究探讨了使用止血带对骨水泥渗透和透光线（RLL）的影响，以评估在TKA中使用止血带是否会影响假体的存活。
我们回顾性分析了2014年1月1日至2015年6月1日期间我院收治的166例符合纳入标准的患者。根据手术中是否使用止血带，将患者分为止血带组（80例）和非止血带组（86例）。我们比较了两组患者的术前数据和相关并发症。根据术后影像学数据测量髋-膝-踝（HKA）、胫骨近端内侧角（MPTA）以及截骨面上骨水泥的渗透深度。此外，观察假体周围出现透光线的概率。
共纳入166例患者，平均年龄68.52±4.74岁，平均随访时间105.67±5.98年。两组间在人口统计学上无显著差异（P>0.05）。每组各有1例患者因假体无菌性松动而进行翻修手术。两组患者术前和术后膝关节协会功能评分（HSS）、膝关节活动范围、HKA和MPTA差异均无统计学意义（P>0.05）。在股骨3A区的外侧观察以及股骨的平均观察区域，两组截骨面的渗透深度差异有统计学意义（P<0.05）。两组在不同观察区域的透光线发生率略有差异，但两组的翻修率差异无统计学意义（P>0.05）。
从长期来看，不使用止血带的TKA在假体稳定性、假体存活率、再次手术率|膝关节活动范围和膝关节功能等许多方面可取得与使用止血带相当的临床效果。
