The effect of limited versus no tourniquet use on rapid recovery in total knee replacement--a randomized controlled trial

Abstract

Background: Tourniquets are widely used in TKA, but few articles state the difference in postoperative effects between restricting tourniquet use and not.Objective:We hoping that this experiment will look at the effect of limited tourniquet use on enhanced recovery in TKA. Methods: 150 patients who received TKA in the Affiliated Hospital of Chengdu University of TCM from June 2018 to December 2019 were randomly selected and randomly divided into 3 groups: ①limited use tourniquet group: after the completion of osteotomy, tourniquet was applied only when the prosthesis was installed, ②second half tourniquet group: Install prosthesis until suture is complete ③ no tourniquet group: no tourniquet was used throughout. The postoperative venous blood hemoglobin, C-reactive protein, visual analogue scale and HSS score were compared among the three groups. Results: Compared with the restricted use of tourniquet group, the visual analogue scale of knee joint pain and venous blood C-reactive protein level at 1 and 3 d after operation and hemoglobin level at 1 d after operation in the second half of tourniquet group increased and the HSS score at 3 and 7 d after operation decreased (P <0.05).No significant differences in visual analogue scale,HSS score,C-reactive,and hemoglobin between the restricted tourniquet and the no tourniquet. Conclusion: The results confirmed that the use of tourniquet in the second half of TKA would aggravate the early postoperative pain. In the effect of early rehabilitation, there is no significant between limited use of tourniquet or no use.