Optimized Tourniquet Use in Primary Total Knee Arthroplasty: A Comparative, Prospective, and Randomized Study.

Este estudio ha sido identificado como potencialmente de alto impacto. La métrica de alto impacto de OE, basada en la inteligencia artificial, estima la influencia que puede tener un artículo integrando señales procedentes tanto de la revista en la que se publica como del contenido científico del propio artículo. Desarrollado mediante el procesamiento del lenguaje natural más avanzado, el modelo de Alto Impacto de OE predice con mayor precisión el futuro rendimiento de las citas de un estudio que el factor de impacto de la revista por sí solo. Esto permite reconocer antes las investigaciones clínicamente significativas y ayuda a los lectores a centrarse en los artículos con más probabilidades de configurar la práctica futura.

Resumen del estudio

130 patients with knee osteoarthritis undergoing a total knee arthroplasty procedure were randomized to receive optimized tourniquet use (n=65) or no tourniquet (n=65) during the procedure. For the tourniquet group, inflation pressure was set at 100mmHg above systolic blood pressure, applied after exsanguination of the limb with a crepe bandage and prior to skin incision, and removed immediately after fixation of the prosthesis to the bone with cement. Outcomes of interest included blood loss, hemoglobin levels, pain in the knee and thigh, lower limb circumference as a measure of swelling, range of motion, Knee Society Score (KSS), the straight leg test, and complications. Follow-up was up to 6 months post-operation. The optimized tourniquet use and the no tourniquet group had similar blood loss, operative time, pain or swelling, functional scores, and complication rate, with the exception of range of motion which was significantly better in the tourniquet group at 3 weeks. Given the benefits of tourniquet use with respect to providing a clear surgical field, this optimized tourniquet protocol is a promising solution to minimize the tourniquet-related adverse events often reported. However, future studies with longer follow-ups and a wider range of patients are necessary to confirm the results.