A Comparative study of perioperative bleeding of total knee arthroplasty and the need for blood transfusion with and without use of tourniquet

Abstract

Total knee arthroplasty (TKA) is one of the most common orthopedic surgeries in the world. The use of tourniquet is recommended by some surgeons around the world. However, the evidence of its usefulness in replacing the knee is still uncertain. In the present study, we assessed the effect of using tourniquet in reducing bleeding during and after operation and the amount of transfusion requirement in TKA surgery. Methods and Materials: Patients referred to Imam Reza and Tabriz universal hospitals for TKA surgery in case of absence of hemorrhagic diseases and non-use of anticoagulants were included in this study. In this study, 8 (25.8%) males and 23 (74.2%) females were present with an average age of 63.6 ± 7.86 with a minimum age of 52 years and a maximum age of 81 years. Patients' Randomization applied considering balanced mean age and body mass index (BMI). In the first group after the patient's preparation and induction of anesthesia, the tourniquet was considered and surgery was performed and the tourniquet was released immediately after the cement was inserted. In the second group after the patient's preparation and induction of anesthesia, tourniquet was not used until cementation and after that again deflated. All surgical procedures were performed by the same and experienced surgical team using spinal epidural anesthesia. The standard surgical procedure was considered by surgeons. Results: 23 (74.2%) patients did not need blood transfusion, and 8 (25.8%) patients needed transfusion. The mean duration of surgery was 175.32 ± 45.62 minutes with a minimum duration of 105 minutes and a maximum of 270 minutes. The mean preoperative HB level was 12.66 ± 1.67, which was 11.09 ± 1.62 after surgery.