Hamad Ali M, Hammad Yazan S, Maswadeh Ahmad B, Sweidat Ali, Alisi Mohammed S, Ajlouni Jihad
Trauma and Orthopaedics, Basildon University Hospital, Basildon, GBR.
Sarcoma and Complex Arthroplasty, Royal National Orthopaedic Hospital, London, GBR.
Cureus. 2025 Aug 12;17(8):e89922. doi: 10.7759/cureus.89922. eCollection 2025 Aug.
Background The timing of tourniquet release in total knee arthroplasty (TKA) remains a topic of debate, with studies suggesting varying impacts on blood loss, operative time, and wound healing. Despite widespread global research, data from our region are limited, and objective assessment tools remain underutilised. Methods We conducted a prospective comparative study involving 113 patients undergoing primary TKA. Patients were assigned to one of two groups: Group A (tourniquet released before wound closure) and Group B (released after closure). All surgeries were standardised in terms of technique, prosthesis, and personnel. Outcomes included post-operative haemoglobin drop, intra-articular haematoma volume (measured via ultrasound), operative time, and wound healing at one-week follow-up. Results There was no significant difference between the two groups in haemoglobin drop (p = 0.877), intra-articular haematoma volume (p = 0.794), or operative time (p = 0.051). No wound complications were observed in either group. Conclusion The timing of tourniquet release, before or after wound closure, did not significantly affect post-operative blood loss, haematoma formation, operative time, or short-term wound healing. Surgeons may safely individualise release timing based on preference and intraoperative factors, provided tourniquet pressure and duration remain within safe thresholds.
全膝关节置换术（TKA）中止血带松开的时机仍是一个有争议的话题，研究表明其对失血、手术时间和伤口愈合有不同影响。尽管全球范围内有广泛研究，但我们地区的数据有限，客观评估工具仍未得到充分利用。方法：我们进行了一项前瞻性比较研究，纳入113例行初次TKA的患者。患者被分为两组：A组（伤口闭合前松开止血带）和B组（伤口闭合后松开）。所有手术在技术、假体和人员方面均标准化。观察指标包括术后血红蛋白下降、关节内血肿体积（通过超声测量）、手术时间以及术后一周的伤口愈合情况。结果：两组在血红蛋白下降（p = 0.877）、关节内血肿体积（p = 0.794）或手术时间（p = 0.051）方面无显著差异。两组均未观察到伤口并发症。结论：伤口闭合前或后松开止血带的时机对术后失血、血肿形成、手术时间或短期伤口愈合无显著影响。只要止血带压力和持续时间保持在安全阈值内，外科医生可根据个人偏好和术中因素安全地个体化决定松开时机。
