A Staged use of Tourniquet Does Not Influence the Fast-Track Recovery After Total Knee Arthroplasty .
A staged use of tourniquet does not influence the fast-track recovery after total knee arthroplasty: a prospective randomized study.
Arch Orthop Trauma Surg . 2024 Nov;144(11):4677-4684.One hundred (n=100) patients undergoing unilateral primary total knee arthroplasty (TKA) were randomized to receive either surgery with a staged tourniquet application (Group A, n=50) or without a tourniquet (Group B, n=50). The primary outcome of interest was the time to reach rehabilitation milestones. Secondary outcomes included range of motion (ROM), post-operative pain, hemarthrosis, total blood loss, surgical field visualization, and functional outcomes assessed by the Knee Society (KS) and Oxford Knee Score (OKS). Outcomes were assessed preoperatively and at days 1, 3, and 20 postoperatively. Overall, the results revealed no statistically significant difference between groups in achieving rehabilitation milestones, pain levels, or functional scores. However, the tourniquet group experienced lower estimated blood loss and clearer surgical field visualization. Despite no significant difference in transfusion rates, thigh pain was slightly higher in the non-tourniquet group. These findings suggest that staged tourniquet use does not negatively impact early post-operative recovery while improving intraoperative efficiency.
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