Comparison of the outcomes of Total Knee Arthroplasty (TKA): tourniquet and tourniquet-less arthroplasty.

Abstract

Total knee replacement surgery (TKA) ranks among the most commonly performed orthopedic procedures nowadays. Many surgeons perform TKA with the use of tourniquet. It is also possible to carry out a tourniquet-less TKA. As with every surgery, TKA comes with the possibility of postoperative complications. The aim of this paper is to review the available scientific literature in order to systematize current knowledge and compare the pros and cons of tourniquet-based and tourniquet-less methods of total knee arthroplasty. This objective will serve to enhance patient awareness regarding the methods of total knee arthroplasty and provide reliable information to surgeons performing this procedure. The use of a tourniquet in total knee arthroplasty reduces intraoperative blood loss and operation time but may increase postoperative blood loss. It is associated with a higher risk of infection. Patients without a tourniquet experience less postoperative pain, shorter hospital stays, and comparable muscle function recovery over time. Tourniquet use increases the risk of deep vein thrombosis, influenced by tightening time. The choice between these methods involves balancing advantages and drawbacks in blood loss, infection risk, pain, and muscle recovery. Each method presents its own set of advantages and potential drawbacks, and the choice between the two methods requires a careful consideration of these factors.